AHIP 2025 Final Exam Questions and Answers (2025–2026) –
Verified Certification Prep Material for Medicare Agents
This document includes the verified questions and accurate answers for the AHIP 2025
Final Exam, tailored for the 2025–2026 certification year. It covers key topics such as
Medicare Advantage, Medicare Part D, eligibility requirements, enrollment periods, and
compliance with CMS marketing and fraud-prevention regulations. Perfect for insurance
agents and brokers preparing for AHIP recertification or initial certification.
1. Mrs. Turner is comparing her employer's retiree insurance to Original
Medicare and would like to know which of the following services Original
Medicare will cover if the appropriate criteria are met. What could you tell
her?: Original Medicare covers ambulance services.
2. Mrs. Duarte is enrolled in Original Medicare Parts A and B. She has recently
reviewed her Medicare Summary Notice (MSN) and disagrees with a
determination that partially denied one of her claims for services. What
advice would you give her?: Mrs. Duarte should file an appeal of this initial
determination within 120 days of the date she received the MSN in the mail.
3. Mrs. Geisler's neighbor told her she should look at her Part D options
during the annual Medicare enrollment period because the features of Part
D might have changed. Mrs. Geisler can't remember what Part D is so she
called you to ask what her neighbor was talking about. What could you tell
, her?: Part D covers prescription drugs and she should look at her premiums,
formulary, and cost-sharing among other factors to see if they have changed.
4. Mrs. Park is an elderly retiree. Mrs. Park has a low fixed income. What could
you tell Mrs. Park that might be of assistance?: She should contact her state
Medicaid agency to see if she qualifies for one of several programs that can help
with Medicare costs for which she is responsible.
5. Mrs. Quinn recently turned 66 and decided after many years of work to retire
and begin receiving Social Security benefits. Shortly thereafter Mrs. Quinn
received a letter informing her that she had been automatically enrolled in
Medicare Part B. She wants to understand what this means. What should
you tell Mrs. Quinn?: Part B primarily covers physician services. She will be
paying a monthly premium and, except for many preventive and screening tests,
generally will have 20% co-payments for these services, in addition to an annual
deductible.
6. Anita Magri will turn age 65 in August 2023. Anita intends to enroll in
Original Medicare Part A and Part B. She would also like to enroll in a Medicare
Supplement (Medigap) plan. Anita's older neighbor Mel has told her about the
Medigap Plan F in which he is enrolled. It not only provides foreign travel
emergency benefits but also covers his Medicare Part B deductible. Anita
comes to you for advice. What should you tell her?: You are sorry to disappoint
Anita, but a Medigap F plan is no longer available to those who turn age 65 after
January 1, 2020. Anita might instead consider other Medigap plans that offer foreign
travel benefits but do not cover the Part B deductible.
7. Mr. Singh would like drug coverage but does not want to be enrolled in
a Medicare Advantage plan. What should you tell him?: Mr. Singh can enroll
in a stand-alone prescription drug plan and continue to be covered for Part A and
Part B services through Original Fee-for-Service Medicare.
8. Mrs. Chen will be 65 soon, has been a citizen for twelve years, has been
employed full time, and paid taxes during that entire period. She is
Verified Certification Prep Material for Medicare Agents
This document includes the verified questions and accurate answers for the AHIP 2025
Final Exam, tailored for the 2025–2026 certification year. It covers key topics such as
Medicare Advantage, Medicare Part D, eligibility requirements, enrollment periods, and
compliance with CMS marketing and fraud-prevention regulations. Perfect for insurance
agents and brokers preparing for AHIP recertification or initial certification.
1. Mrs. Turner is comparing her employer's retiree insurance to Original
Medicare and would like to know which of the following services Original
Medicare will cover if the appropriate criteria are met. What could you tell
her?: Original Medicare covers ambulance services.
2. Mrs. Duarte is enrolled in Original Medicare Parts A and B. She has recently
reviewed her Medicare Summary Notice (MSN) and disagrees with a
determination that partially denied one of her claims for services. What
advice would you give her?: Mrs. Duarte should file an appeal of this initial
determination within 120 days of the date she received the MSN in the mail.
3. Mrs. Geisler's neighbor told her she should look at her Part D options
during the annual Medicare enrollment period because the features of Part
D might have changed. Mrs. Geisler can't remember what Part D is so she
called you to ask what her neighbor was talking about. What could you tell
, her?: Part D covers prescription drugs and she should look at her premiums,
formulary, and cost-sharing among other factors to see if they have changed.
4. Mrs. Park is an elderly retiree. Mrs. Park has a low fixed income. What could
you tell Mrs. Park that might be of assistance?: She should contact her state
Medicaid agency to see if she qualifies for one of several programs that can help
with Medicare costs for which she is responsible.
5. Mrs. Quinn recently turned 66 and decided after many years of work to retire
and begin receiving Social Security benefits. Shortly thereafter Mrs. Quinn
received a letter informing her that she had been automatically enrolled in
Medicare Part B. She wants to understand what this means. What should
you tell Mrs. Quinn?: Part B primarily covers physician services. She will be
paying a monthly premium and, except for many preventive and screening tests,
generally will have 20% co-payments for these services, in addition to an annual
deductible.
6. Anita Magri will turn age 65 in August 2023. Anita intends to enroll in
Original Medicare Part A and Part B. She would also like to enroll in a Medicare
Supplement (Medigap) plan. Anita's older neighbor Mel has told her about the
Medigap Plan F in which he is enrolled. It not only provides foreign travel
emergency benefits but also covers his Medicare Part B deductible. Anita
comes to you for advice. What should you tell her?: You are sorry to disappoint
Anita, but a Medigap F plan is no longer available to those who turn age 65 after
January 1, 2020. Anita might instead consider other Medigap plans that offer foreign
travel benefits but do not cover the Part B deductible.
7. Mr. Singh would like drug coverage but does not want to be enrolled in
a Medicare Advantage plan. What should you tell him?: Mr. Singh can enroll
in a stand-alone prescription drug plan and continue to be covered for Part A and
Part B services through Original Fee-for-Service Medicare.
8. Mrs. Chen will be 65 soon, has been a citizen for twelve years, has been
employed full time, and paid taxes during that entire period. She is
