AHIP EXAM LATEST
(2025/2026) COMPLETE
QUESTIONS AND CORRECT
ANSWERS COMPLETE
GRADED A+
[Document subtitle]
[DATE]
[COMPANY NAME]
[Company address]
,1. Mrs. Burton is a retiree with substantial income. She is
enrolled in an MA-PD plan and was disappointed with
the service she received from her primary care
physician because she was told she would have to wait
five weeks to get an appointment when she was
feeling ill. She called you to ask what she could do so
she would not have to put up with such poor access to
care. What could you tell her?
o She could file a grievance with her plan to complain
about the lack of timeliness in getting an
appointment.
2. Mrs. Walters is enrolled in her state's Medicaid
program in addition to Medicare. What should she be
aware of when considering enrollment in a Medicare
Advantage (MA) plan?
o She cannot enroll in an MA Medical Savings Account
(MSA) plan.
3. Ms. Gibson recently lost her employer group health
and drug coverage and now she wants to enroll in a
PPO that does not include drug coverage. What should
you tell her about obtaining drug coverage?
o She can enroll in the PPO, but she will not be able to
purchase a stand-alone Medicare Part D prescription
drug plan.
4. Mr. Lombardi is interested in a Medicare Advantage
(MA) PPO plan that you represent. It is one of three
plans operated by the same organization in Mr.
Lombardi's area. The MA PPO plan does not include
drug coverage, but the other two plans do. Mr.
Lombardi likes the PPO plan that does not include
drug coverage and intends to obtain his drug coverage
, through a stand-alone Medicare prescription drug
plan. What should you tell him about this situation?
o He could enroll either in one of the MA plans that
include prescription drug coverage or Original
Medicare with a Medigap plan and standalone Part D
prescription drug coverage, but he cannot enroll in
the MA-only PPO plan and a stand-alone prescription
drug plan.
5. Mrs. Wang wants to know generally how the benefits
under Original Medicare might compare to the
benefits package of a Medicare Advantage Plan before
she starts looking at specific plans. What could you tell
her?
o Medicare Advantage Plans may offer extra benefits
that Original Medicare does not offer such as vision,
hearing, and dental services. It must include a
maximum out-of-pocket limit on Part A and Part B
services.
6. Mr. Wells is trying to understand the difference
between Original Medicare and Medicare Advantage.
What would be the correct description?
o Medicare Advantage is a way of covering all the
Original Medicare benefits through private health
insurance companies.
7. Mr. Kelly wants to know whether he is eligible to sign
up for a private fee-for-service (PFFS) plan. What
questions would you need to ask to determine his
eligibility?
o You would need to ask Mr. Kelly if he is entitled to
Part A, enrolled in Part B, and if he lives in the PFFS
plan's service area.
, 8. Mr. Lopez has heard that he can sign up for a product
called "Medicare Advantage" but is not sure about
what type of plan designs are available through this
program. What should you tell him about the types of
health plans that are available through the Medicare
Advantage program?
o There are Medicare health plans such as HMOs, PPOs,
PFFS, and MSAs.
9. Which of the following statement(s) is/are correct
about a Medicare Savings Account (MSA) Plans?
o I, II, and IV only.
10. Mrs. Kelly, age 65, is entitled to Part A but has not
yet enrolled in Part B. She is considering enrollment in
a Medicare Advantage plan (Part C). What should you
advise her to do before she can enroll in a Medicare
Advantage plan?
o To join a Medicare Advantage plan, she also must
enroll in Part B.
11. Mrs. Chi is age 75 and enjoys a comfortable but
not extremely high-income level. She wishes to enroll
in a MA MSA plan that she heard about from her
neighbor. She also wants to have prescription drug
coverage since her doctor recently prescribed several
expensive medications. Currently, she is enrolled in
Original Medicare and a standalone Part D plan. How
would you advise Mrs. Chi?
o Mrs. Chi may enroll in a MA MSA plan and remain in
her current standalone Part D prescription drug plan.
12. Mrs. Chou likes a Private Fee-for-Service (PFFS)
plan available in her area that does not include drug
coverage. She wants to enroll in the plan and enroll in
(2025/2026) COMPLETE
QUESTIONS AND CORRECT
ANSWERS COMPLETE
GRADED A+
[Document subtitle]
[DATE]
[COMPANY NAME]
[Company address]
,1. Mrs. Burton is a retiree with substantial income. She is
enrolled in an MA-PD plan and was disappointed with
the service she received from her primary care
physician because she was told she would have to wait
five weeks to get an appointment when she was
feeling ill. She called you to ask what she could do so
she would not have to put up with such poor access to
care. What could you tell her?
o She could file a grievance with her plan to complain
about the lack of timeliness in getting an
appointment.
2. Mrs. Walters is enrolled in her state's Medicaid
program in addition to Medicare. What should she be
aware of when considering enrollment in a Medicare
Advantage (MA) plan?
o She cannot enroll in an MA Medical Savings Account
(MSA) plan.
3. Ms. Gibson recently lost her employer group health
and drug coverage and now she wants to enroll in a
PPO that does not include drug coverage. What should
you tell her about obtaining drug coverage?
o She can enroll in the PPO, but she will not be able to
purchase a stand-alone Medicare Part D prescription
drug plan.
4. Mr. Lombardi is interested in a Medicare Advantage
(MA) PPO plan that you represent. It is one of three
plans operated by the same organization in Mr.
Lombardi's area. The MA PPO plan does not include
drug coverage, but the other two plans do. Mr.
Lombardi likes the PPO plan that does not include
drug coverage and intends to obtain his drug coverage
, through a stand-alone Medicare prescription drug
plan. What should you tell him about this situation?
o He could enroll either in one of the MA plans that
include prescription drug coverage or Original
Medicare with a Medigap plan and standalone Part D
prescription drug coverage, but he cannot enroll in
the MA-only PPO plan and a stand-alone prescription
drug plan.
5. Mrs. Wang wants to know generally how the benefits
under Original Medicare might compare to the
benefits package of a Medicare Advantage Plan before
she starts looking at specific plans. What could you tell
her?
o Medicare Advantage Plans may offer extra benefits
that Original Medicare does not offer such as vision,
hearing, and dental services. It must include a
maximum out-of-pocket limit on Part A and Part B
services.
6. Mr. Wells is trying to understand the difference
between Original Medicare and Medicare Advantage.
What would be the correct description?
o Medicare Advantage is a way of covering all the
Original Medicare benefits through private health
insurance companies.
7. Mr. Kelly wants to know whether he is eligible to sign
up for a private fee-for-service (PFFS) plan. What
questions would you need to ask to determine his
eligibility?
o You would need to ask Mr. Kelly if he is entitled to
Part A, enrolled in Part B, and if he lives in the PFFS
plan's service area.
, 8. Mr. Lopez has heard that he can sign up for a product
called "Medicare Advantage" but is not sure about
what type of plan designs are available through this
program. What should you tell him about the types of
health plans that are available through the Medicare
Advantage program?
o There are Medicare health plans such as HMOs, PPOs,
PFFS, and MSAs.
9. Which of the following statement(s) is/are correct
about a Medicare Savings Account (MSA) Plans?
o I, II, and IV only.
10. Mrs. Kelly, age 65, is entitled to Part A but has not
yet enrolled in Part B. She is considering enrollment in
a Medicare Advantage plan (Part C). What should you
advise her to do before she can enroll in a Medicare
Advantage plan?
o To join a Medicare Advantage plan, she also must
enroll in Part B.
11. Mrs. Chi is age 75 and enjoys a comfortable but
not extremely high-income level. She wishes to enroll
in a MA MSA plan that she heard about from her
neighbor. She also wants to have prescription drug
coverage since her doctor recently prescribed several
expensive medications. Currently, she is enrolled in
Original Medicare and a standalone Part D plan. How
would you advise Mrs. Chi?
o Mrs. Chi may enroll in a MA MSA plan and remain in
her current standalone Part D prescription drug plan.
12. Mrs. Chou likes a Private Fee-for-Service (PFFS)
plan available in her area that does not include drug
coverage. She wants to enroll in the plan and enroll in
