AHIP FINAL EXAM, PRACTICE EXAM
AND STUDY GUIDE LATEST 2025/2026
ACTUAL EXAM QUESTIONS AND
CORRECT ANSWERS RAT
Mr. Edwards, a marketing representative of the ACME Insurance
Company, scheduled a marketing event and expects about 40
people to attend. He has hired a magician at a cost of $200 to
entertain attendees. Can he do this in a way that complies with
guidance from the Medicare agency? - ANSWER-a. He can do this
because the estimated number of attendees is based on the
venue size and response rate and the value of the gift does not
exceed $15.
Mrs. Ramos is considering a Medicare Advantage PPO and has
questions about which providers she can go to for her health care.
,What should you tell her? - ANSWER-b. Mrs. Ramos can obtain
care from any provider who participates in Original Medicare, but
generally will have a higher cost-sharing amount if she sees a
provider who/that is not a part of the PPO network.
Julia Harris is turning 66 in July, at which time she will retire. She
has contacted your office and requested a meeting so that she
can learn about Medicare and the products you represent. How
should you respond? - ANSWER-c. Tell Julia that you will meet
with her to explain Medicare and should she be interested you
can accept and submit an enrollment request, since this is an
initial enrollment qualifying her for a special enrollment period.
Mr. Rivera has Qualified Medicare Beneficiary (QMB) eligibility and
is thus covered by both Medicare and Medicaid. He decides to
enroll in a Medicare Advantage (MA) PPO plan. Later he sees an
out-of-network doctor to receive a Medicare covered service. How
much The doctor may only collect from Mr. Rivera the cost
sharing allowable under the state's Medicaid program.may the
doctor collect from Mr. Rivera? - ANSWER-The doctor may only
collect from Mr. Rivera the cost sharing allowable under the
state's Medicaid program.
During a sales presentation in Ms. Sullivan's home, she tells you
that she has heard about a type of Medicare health plan known as
Private Fee-for-Service (PFFS). She wants to know if this would be
,available to her. What should you tell her about PFFS plans? -
ANSWER-
Choose one answer. - ANSWER-
- ANSWER-a. A PFFS plan is a type of Medicare Supplement plan
and she may enroll in one if it is available in her area.
- ANSWER-b. A PFFS plan is exactly the same as Original
Medicare, only offered by a private entity and she may enroll in
one if it is available in her area.
- ANSWER-c. PFFS plans are designed to cover only prescription
drugs and if that is the type of coverage she wants, she may enroll
in one if it is available in her area.
- ANSWER-d. A PFFS plan is one of the various types of Medicare
Advantage plans offered by private entities and she may enroll in
one if it is available in her area.
Question8 - ANSWER-
Marks: 1 - ANSWER-
, During an appointment scheduled to discuss a Medicare
Advantage Prescription Drug plan (MA-PD), Mr. Peters asked his
agent to describe a stand-alone prescription drug plan (Part D
plan) that his neighbor told him about. What should his agent do?
- ANSWER-
Choose one answer. - ANSWER-
- ANSWER-a. Since Mr. Peters requested a description of the Part
D plan, his agent must leave the Part D plan brochure, but not an
enrollment form, and would have to schedule another
appointment after at least 48 hours have passed to discuss the
Part D plan with Mr. Peters.
- ANSWER-b. Since Mr. Peters requested a description of the Part
D plan, his agent must have Mr. Peters sign a new scope of
appointment form that includes Part D, and then the agent may
discuss the Part D plan so Mr. Peters can compare plans and make
an informed enrollment choice during the appointment.
- ANSWER-c. Since Mr. Peters requested a description of the Part
D plan, his agent must inform Mr. Peters that he can only sign up
for the MA-PD plan and cannot receive a brochure or any other
AND STUDY GUIDE LATEST 2025/2026
ACTUAL EXAM QUESTIONS AND
CORRECT ANSWERS RAT
Mr. Edwards, a marketing representative of the ACME Insurance
Company, scheduled a marketing event and expects about 40
people to attend. He has hired a magician at a cost of $200 to
entertain attendees. Can he do this in a way that complies with
guidance from the Medicare agency? - ANSWER-a. He can do this
because the estimated number of attendees is based on the
venue size and response rate and the value of the gift does not
exceed $15.
Mrs. Ramos is considering a Medicare Advantage PPO and has
questions about which providers she can go to for her health care.
,What should you tell her? - ANSWER-b. Mrs. Ramos can obtain
care from any provider who participates in Original Medicare, but
generally will have a higher cost-sharing amount if she sees a
provider who/that is not a part of the PPO network.
Julia Harris is turning 66 in July, at which time she will retire. She
has contacted your office and requested a meeting so that she
can learn about Medicare and the products you represent. How
should you respond? - ANSWER-c. Tell Julia that you will meet
with her to explain Medicare and should she be interested you
can accept and submit an enrollment request, since this is an
initial enrollment qualifying her for a special enrollment period.
Mr. Rivera has Qualified Medicare Beneficiary (QMB) eligibility and
is thus covered by both Medicare and Medicaid. He decides to
enroll in a Medicare Advantage (MA) PPO plan. Later he sees an
out-of-network doctor to receive a Medicare covered service. How
much The doctor may only collect from Mr. Rivera the cost
sharing allowable under the state's Medicaid program.may the
doctor collect from Mr. Rivera? - ANSWER-The doctor may only
collect from Mr. Rivera the cost sharing allowable under the
state's Medicaid program.
During a sales presentation in Ms. Sullivan's home, she tells you
that she has heard about a type of Medicare health plan known as
Private Fee-for-Service (PFFS). She wants to know if this would be
,available to her. What should you tell her about PFFS plans? -
ANSWER-
Choose one answer. - ANSWER-
- ANSWER-a. A PFFS plan is a type of Medicare Supplement plan
and she may enroll in one if it is available in her area.
- ANSWER-b. A PFFS plan is exactly the same as Original
Medicare, only offered by a private entity and she may enroll in
one if it is available in her area.
- ANSWER-c. PFFS plans are designed to cover only prescription
drugs and if that is the type of coverage she wants, she may enroll
in one if it is available in her area.
- ANSWER-d. A PFFS plan is one of the various types of Medicare
Advantage plans offered by private entities and she may enroll in
one if it is available in her area.
Question8 - ANSWER-
Marks: 1 - ANSWER-
, During an appointment scheduled to discuss a Medicare
Advantage Prescription Drug plan (MA-PD), Mr. Peters asked his
agent to describe a stand-alone prescription drug plan (Part D
plan) that his neighbor told him about. What should his agent do?
- ANSWER-
Choose one answer. - ANSWER-
- ANSWER-a. Since Mr. Peters requested a description of the Part
D plan, his agent must leave the Part D plan brochure, but not an
enrollment form, and would have to schedule another
appointment after at least 48 hours have passed to discuss the
Part D plan with Mr. Peters.
- ANSWER-b. Since Mr. Peters requested a description of the Part
D plan, his agent must have Mr. Peters sign a new scope of
appointment form that includes Part D, and then the agent may
discuss the Part D plan so Mr. Peters can compare plans and make
an informed enrollment choice during the appointment.
- ANSWER-c. Since Mr. Peters requested a description of the Part
D plan, his agent must inform Mr. Peters that he can only sign up
for the MA-PD plan and cannot receive a brochure or any other
