AHIP FINAL EXAM – 2026 MEDICARE CERTIFICATION COMPLETE (125) CURRENT TESTING QUESTIONS AND CORRECT ANSWERS WITH DETAILED RATIONALES.

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AHIP FINAL EXAM – 2026 MEDICARE
CERTIFICATION COMPLETE (125) CURRENT
TESTING QUESTIONS AND CORRECT
ANSWERS WITH DETAILED RATIONALES.
AHIP
Prepare for success with this AHIP Final Exam – Medicare Certification
practice exam designed to reinforce essential Medicare Advantage,
medicare basics & eligibility, Part D prescription drug plans, compliance
regulations, and ethical selling practices. The exam-style questions help
strengthen your understanding, identify knowledge gaps, and build
confidence before the certification assessment. A valuable study
resource for focused review and effective exam preparation. Suitable for
insurance agents pursuing AHIP Medicare certification.



MULTIPLE CHOICE.
SECTION 1: MEDICARE BASICS & ELIGIBILITY
1. Mr. Carlini has heard that Medicare prescription drug plans
are only offered through private companies under a program
known as Medicare Advantage (MA), not by the government. He
likes Original Medicare and does not want to sign up for an MA
product, but he also wants prescription drug coverage. What
should you tell him?
A. He must enroll in a Medicare Advantage plan to get prescription
drug coverage.
B. He can stay with Original Medicare and also enroll in a Medicare

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prescription drug plan through a private company that has
contracted with the government to provide only such drug coverage.
C. He cannot get prescription drug coverage unless he enrolls in a
Medicare Advantage plan.
D. He should wait until he turns 65 to enroll in a prescription drug
plan.
Correct answer: B. He can stay with Original Medicare and also
enroll in a Medicare prescription drug plan through a private
company that has contracted with the government to provide
only such drug coverage.
Rationale: Beneficiaries can remain in Original Medicare (Parts A
and B) and enroll in a standalone Medicare Prescription Drug Plan
(PDP) offered by a private company. PDPs are available to all
Medicare beneficiaries, regardless of whether they are in Original
Medicare or a Medicare Advantage plan.
2. Ms. Daley is considering a Medicare Advantage plan that has a
5-star rating in customer service and care coordination, and
received an overall plan performance of 4-stars. Which of the
following would be the correct statement to say to her?
A. The Medicare Advantage plan received a 5-star rating in customer
service and care coordination with an overall performance rating of
4-stars.
B. The Medicare Advantage plan received a 5-star overall rating.
C. The Medicare Advantage plan received a 4-star rating in customer
service.
D. The Medicare Advantage plan is not rated.
Correct answer: A. The Medicare Advantage plan received a 5-
star rating in customer service and care coordination with an

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overall performance rating of 4-stars.
Rationale: When discussing plan star ratings, agents must
accurately represent the specific ratings. If the plan received a 5-
star rating in customer service and care coordination but an overall
performance rating of 4-stars, both must be stated correctly.
3. Mrs. Pena is 66 years old, has coverage under an employer
plan and will retire next year. She heard she must enroll in Part B
at the beginning of the year to ensure no gap in coverage. What
can you tell her?
A. She must enroll in Part B during the General Enrollment Period
(January 1 – March 31) to avoid a gap in coverage.
B. She may enroll at any time while she is covered under her
employer plan, but she will have a special eight-month enrollment
period that differs from the standard general enrollment period,
during which she may enroll in Medicare Part B.
C. She must enroll in Part B immediately to avoid a late enrollment
penalty.
D. She cannot enroll in Part B until she retires.
Correct answer: B. She may enroll at any time while she is
covered under her employer plan, but she will have a special
eight-month enrollment period that differs from the standard
general enrollment period, during which she may enroll in
Medicare Part B.
Rationale: Individuals covered under an employer group health plan
based on current employment (their own or a spouse's) have a
Special Enrollment Period (SEP) to enroll in Part B. This SEP lasts for
eight months after the employment or coverage ends, allowing them
to enroll without penalty.

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4. Mr. Capadona would like to purchase a Medicare Advantage
(MA) plan and a Medigap plan to pick up costs not covered by
that plan. What should you tell him?
A. You can sell him a Medigap plan to help with costs not covered
under Medicare Advantage.
B. It is illegal for you to sell Mr. Capadona a Medigap plan if he is
enrolled in an MA plan, and besides, Medigap only works with
Original Medicare.
C. Medigap plans are designed to work alongside Medicare
Advantage plans.
D. He must disenroll from his MA plan before buying a Medigap plan.
Correct answer: B. It is illegal for you to sell Mr. Capadona a
Medigap plan if he is enrolled in an MA plan, and besides,
Medigap only works with Original Medicare.
Rationale: Federal law prohibits the sale of a Medigap policy to an
individual enrolled in a Medicare Advantage plan. Medigap plans are
designed to supplement Original Medicare (Parts A and B) and
cannot pay deductibles, copayments, or coinsurance associated
with Medicare Advantage plans. This prevents duplicate coverage
and ensures proper coordination of benefits.
5. Mr. Moy will soon turn age 65. He wants to understand what
coverage Medicare Supplemental Insurance provides. What
could you tell Mr. Moy?
A. It covers everything Original Medicare does not.
B. It provides prescription drug coverage.
C. Medicare Supplemental Insurance would help cover his Part A
deductible and Part B coinsurance or copayments in Original Fee-
for-Service (FFS) Medicare as well as possibly some services that