AHIP 2026 Final Exam Answer Key for
2025/2026 Certification Period – Verified
Answers for Medicare Certification
1. Mrs. Turner is turning 65 next month and is eligible for Medicare. She is
currently covered under her employer's group health plan. What should she
know about enrolling in Medicare?
• A) She must enroll in Medicare Part A and Part B immediately upon turning 65
• B) She may delay enrolling in Medicare Part B without penalty if she has
credible employer coverage
• C) She must drop her employer coverage before enrolling in Medicare
• D) She can only enroll in Medicare during the Annual Enrollment Period
,,,answer,,,,: B. Individuals who are still working and have credible employer
coverage may delay enrolling in Medicare Part B without incurring a late enrollment
penalty. They must enroll during a Special Enrollment Period (SEP) when they lose
employer coverage.
2. Mr. Davis is enrolled in a Medicare Advantage (MA) plan. He is considering
switching back to Original Medicare and purchasing a Medigap policy. When is
he guaranteed the right to purchase a Medigap policy?
• A) Only during the Annual Enrollment Period
• B) During his 6-month Medigap Open Enrollment Period
• C) At any time, regardless of health status
, • D) Only if he has a qualifying life event
,,,answer,,,,: B. The Medigap Open Enrollment Period is a 6-month period that
begins when an individual is 65 or older and enrolled in Medicare Part B. During this
period, they have the guaranteed right to purchase any Medigap policy sold in their
state.
3. Which of the following is TRUE regarding the Medicare Part D Coverage Gap
(Donut Hole)?
• A) The coverage gap has been completely eliminated
• B) Beneficiaries pay 25% of the cost for brand-name and generic drugs in the
coverage gap
• C) Beneficiaries pay 100% of drug costs in the coverage gap
• D) The coverage gap only applies to Medicare Advantage plans
,,,answer,,,,: B. Under the Inflation Reduction Act, beneficiaries in the coverage gap
pay 25% of the cost for both brand-name and generic drugs. The gap has not been
completely eliminated (A), and it applies to all Part D plans (D).
4. Mr. Chen is enrolled in a Medicare Advantage plan and wants to switch to a
different MA plan. During which period can he make this change?
• A) Initial Enrollment Period only
• B) Annual Enrollment Period (October 15 – December 7)
• C) Medicare Advantage Open Enrollment Period (January 1 – March 31)
• D) Both B and C
2025/2026 Certification Period – Verified
Answers for Medicare Certification
1. Mrs. Turner is turning 65 next month and is eligible for Medicare. She is
currently covered under her employer's group health plan. What should she
know about enrolling in Medicare?
• A) She must enroll in Medicare Part A and Part B immediately upon turning 65
• B) She may delay enrolling in Medicare Part B without penalty if she has
credible employer coverage
• C) She must drop her employer coverage before enrolling in Medicare
• D) She can only enroll in Medicare during the Annual Enrollment Period
,,,answer,,,,: B. Individuals who are still working and have credible employer
coverage may delay enrolling in Medicare Part B without incurring a late enrollment
penalty. They must enroll during a Special Enrollment Period (SEP) when they lose
employer coverage.
2. Mr. Davis is enrolled in a Medicare Advantage (MA) plan. He is considering
switching back to Original Medicare and purchasing a Medigap policy. When is
he guaranteed the right to purchase a Medigap policy?
• A) Only during the Annual Enrollment Period
• B) During his 6-month Medigap Open Enrollment Period
• C) At any time, regardless of health status
, • D) Only if he has a qualifying life event
,,,answer,,,,: B. The Medigap Open Enrollment Period is a 6-month period that
begins when an individual is 65 or older and enrolled in Medicare Part B. During this
period, they have the guaranteed right to purchase any Medigap policy sold in their
state.
3. Which of the following is TRUE regarding the Medicare Part D Coverage Gap
(Donut Hole)?
• A) The coverage gap has been completely eliminated
• B) Beneficiaries pay 25% of the cost for brand-name and generic drugs in the
coverage gap
• C) Beneficiaries pay 100% of drug costs in the coverage gap
• D) The coverage gap only applies to Medicare Advantage plans
,,,answer,,,,: B. Under the Inflation Reduction Act, beneficiaries in the coverage gap
pay 25% of the cost for both brand-name and generic drugs. The gap has not been
completely eliminated (A), and it applies to all Part D plans (D).
4. Mr. Chen is enrolled in a Medicare Advantage plan and wants to switch to a
different MA plan. During which period can he make this change?
• A) Initial Enrollment Period only
• B) Annual Enrollment Period (October 15 – December 7)
• C) Medicare Advantage Open Enrollment Period (January 1 – March 31)
• D) Both B and C
