AHIP Final Exam Test Questions and answers
2025\2026 A+ Grade
Mrs. West wears glasses and dentures and has enjoyed considerable pain relief from arthritis through
acupuncture. She is concerned about whether or not Medicare will cover these items and services. What
should you tell her?
- correct answer Medicare does not cover acupuncture, or, in general, glasses or dentures.
Mr. Bickford did not quite qualify for the extra help low-income subsidy under the Medicare Part D
Prescription Drug program and he is wondering if there is any other option he has for obtaining help
with his considerable drug costs. What should you tell him?
- correct answer He could check with the manufacturers of his medications to see if they offer an
assistance program to help people with limited means obtain the medications they need. Alternatively,
he could check to see whether his state has a pharmacy assistance program to help him with his
expenses.
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?
- correct answer He could enroll in one of the MA plans that include prescription drug coverage or a
Medigap plan and a stand-alone prescription drug plan, but he cannot enroll in the MA-only PPO plan
and a stand-alone prescription drug plan.
Mr. Torres has a small savings account. He would like to pay for his monthly Part D premiums with an
automatic monthly withdrawal from his savings account until it is exhausted, and then have his
premiums withheld from his Social Security check. What should you tell him?
- correct answer In general, he must select a single Part D premium payment mechanism that will be
used throughout the year.
Agent Jennings makes a presentation on Medicare advertised as an educational event. Agent Jennings
distributes materials that are solely educational in nature. However, she gives a brief presentation that
mentions plan-specific premiums. Is this a prohibited activity at an event that has been advertised as
educational?
, - correct answer Yes. When an event has been advertised as "educational," discussing plan-specific
premiums is impermissible.
Mrs. Mulcahy is concerned that she may not qualify for enrollment in a Medicare prescription drug plan
because, although she is entitled to Part A, she is not enrolled under Medicare Part B. What should you
tell her?
- correct answer Everyone who is entitled to Part A or enrolled under Part B is eligible to enroll in a
Medicare prescription drug plan. As long as Mrs. Mulcahy is entitled to Part A, she does not need to
enroll under Part B before enrolling in a prescription drug plan.
Mr. Jacob understands that there is a standard Medicare Part D prescription drug benefit, but when he
looks at information on various plans available in his area, he sees a wide range in what they charge for
deductibles, premiums and cost sharing. How can you explain this to him?
- correct answer Medicare Part D drug plans may have different benefit structures, but on average, they
must all be at least as good as the standard model established by the government.
Ms. Moore plans to retire when she turns 65 in a few months. She is in excellent health and will have
considerable income when she retires. She is concerned that her income will make it impossible for her
to qualify for Medicare. What could you tell her to address her concern?
- correct answer Medicare is a program for people age 65 or older and those under age 65 with certain
disabilities, end stage renal disease or Lou Gehrig's disease, so she will be eligible for Medicare.
Agent Armstrong is employed by XYZ Agency, which is under contract with ABC Health Plan, a Medicare
Advantage (MA) plan that offers plans in multiple states. XYZ Agency maintains a website marketing the
MA plans with which it has contracts. Agent Armstrong follows up with individuals who request more
information about ABC MA plans via the website and tries to persuade them to enroll in ABC plans.
What statement best describes the marketing and compliance rules that apply to Agent Armstrong?
- correct answer Agent Armstrong needs to be licensed and appointed in every state in which
beneficiaries to whom he markets ABC MA plans are located.
Mr. Schmidt would like to plan for retirement and has asked you what is covered under Original Fee-for-
Service (FFS) Medicare? What could you tell him?
- correct answer Part A, which covers hospital, skilled nursing facility, hospice and home health services
and Part B, which covers professional services such as those provided by a doctor are covered under
Original Medicare.
You are seeking to represent an individual Medicare Advantage plan and an individual Part D plan in
your state. You have completed the required training for each plan, but you did not achieve a passing
2025\2026 A+ Grade
Mrs. West wears glasses and dentures and has enjoyed considerable pain relief from arthritis through
acupuncture. She is concerned about whether or not Medicare will cover these items and services. What
should you tell her?
- correct answer Medicare does not cover acupuncture, or, in general, glasses or dentures.
Mr. Bickford did not quite qualify for the extra help low-income subsidy under the Medicare Part D
Prescription Drug program and he is wondering if there is any other option he has for obtaining help
with his considerable drug costs. What should you tell him?
- correct answer He could check with the manufacturers of his medications to see if they offer an
assistance program to help people with limited means obtain the medications they need. Alternatively,
he could check to see whether his state has a pharmacy assistance program to help him with his
expenses.
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?
- correct answer He could enroll in one of the MA plans that include prescription drug coverage or a
Medigap plan and a stand-alone prescription drug plan, but he cannot enroll in the MA-only PPO plan
and a stand-alone prescription drug plan.
Mr. Torres has a small savings account. He would like to pay for his monthly Part D premiums with an
automatic monthly withdrawal from his savings account until it is exhausted, and then have his
premiums withheld from his Social Security check. What should you tell him?
- correct answer In general, he must select a single Part D premium payment mechanism that will be
used throughout the year.
Agent Jennings makes a presentation on Medicare advertised as an educational event. Agent Jennings
distributes materials that are solely educational in nature. However, she gives a brief presentation that
mentions plan-specific premiums. Is this a prohibited activity at an event that has been advertised as
educational?
, - correct answer Yes. When an event has been advertised as "educational," discussing plan-specific
premiums is impermissible.
Mrs. Mulcahy is concerned that she may not qualify for enrollment in a Medicare prescription drug plan
because, although she is entitled to Part A, she is not enrolled under Medicare Part B. What should you
tell her?
- correct answer Everyone who is entitled to Part A or enrolled under Part B is eligible to enroll in a
Medicare prescription drug plan. As long as Mrs. Mulcahy is entitled to Part A, she does not need to
enroll under Part B before enrolling in a prescription drug plan.
Mr. Jacob understands that there is a standard Medicare Part D prescription drug benefit, but when he
looks at information on various plans available in his area, he sees a wide range in what they charge for
deductibles, premiums and cost sharing. How can you explain this to him?
- correct answer Medicare Part D drug plans may have different benefit structures, but on average, they
must all be at least as good as the standard model established by the government.
Ms. Moore plans to retire when she turns 65 in a few months. She is in excellent health and will have
considerable income when she retires. She is concerned that her income will make it impossible for her
to qualify for Medicare. What could you tell her to address her concern?
- correct answer Medicare is a program for people age 65 or older and those under age 65 with certain
disabilities, end stage renal disease or Lou Gehrig's disease, so she will be eligible for Medicare.
Agent Armstrong is employed by XYZ Agency, which is under contract with ABC Health Plan, a Medicare
Advantage (MA) plan that offers plans in multiple states. XYZ Agency maintains a website marketing the
MA plans with which it has contracts. Agent Armstrong follows up with individuals who request more
information about ABC MA plans via the website and tries to persuade them to enroll in ABC plans.
What statement best describes the marketing and compliance rules that apply to Agent Armstrong?
- correct answer Agent Armstrong needs to be licensed and appointed in every state in which
beneficiaries to whom he markets ABC MA plans are located.
Mr. Schmidt would like to plan for retirement and has asked you what is covered under Original Fee-for-
Service (FFS) Medicare? What could you tell him?
- correct answer Part A, which covers hospital, skilled nursing facility, hospice and home health services
and Part B, which covers professional services such as those provided by a doctor are covered under
Original Medicare.
You are seeking to represent an individual Medicare Advantage plan and an individual Part D plan in
your state. You have completed the required training for each plan, but you did not achieve a passing
