2025 Latest Ahip Test – 190 Prep Questions and
Correct Detailed Answers// AHIP Exam Prep 2025-
2026 Practice Questions and Answers (100% Correct)
Which of the following statement is/are correct about a Medicare Savings Account
(MSA) Plans?
I. MSAs may have either a partial network, full network, or no network of
providers.
II. MSA plans cover Part A and Part B benefits but not Part D prescription drug
benefits.
III. An individual who is enrolled in an MSA plan is responsible for a minimal
deductible of $500 indexed for inflation.
IV. Non-network providers must accept the same amount that Original Medicare
would pay them as payment in full.
I, II, and IV only
3 multiple choice options
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?
He could enroll either in one of the MA plans that include prescription drug
coverage or Original Medicare with a Medigap plan and standalone Part D
prescription drug coverage, but he cannot enroll in the MA-only PPO plan and a
stand-alone prescription drug plan.
3 multiple choice options
Mr. Cole has been a Medicaid beneficiary for some time, and recently qualified for
Medicare as well. He is concerned about changes in his cost-sharing. What should
you tell him?
pg. 1
,He should know that Medicaid will pay cost sharing only for services provided by
Medicaid participating providers.
3 multiple choice options
Juan Perez, who is turning age 65 next month, intends to work for several more
years at Smallcap, Incorporated. Smallcap has a workforce of 15 employees and
offers employer-sponsored healthcare coverage. Juan is a naturalized citizen and
has contributed to the Medicare system for over 20 years. Juan asks you if he will
be entitled to Medicare and if he enrolls how that will impact his employer-
sponsored healthcare coverage. How would you respond?
Juan is likely to be eligible for Medicare once he turns age 65 and if he enrolls
Medicare would become the primary payor of his healthcare claims and Smallcap
does not have to continue to offer him coverage comparable to those under age 65
under its employer-sponsored group health plan.
Daniel is a middle-income Medicare beneficiary. He has chronic bronchitis,
putting him at severe risk for pneumonia. Otherwise, he has no problems
functioning. Which type of SNP is likely to be most appropriate for him?
C-SNP
3 multiple choice options
Juan Hernandez is turning 65 next month, Juan legally entered the United States
over twenty years ago but is not a citizen. Since his entry into the country, Juan has
worked at Smallcap Incorporated and contributed to the Medicare system. Juan
suffers from diabetes. He will soon retire and asks you if he can enroll in a
Medicare Advantage plan that you represent. How would you respond?
Juan is eligible to enroll in a Medicare Advantage as long as he is entitled to Part A
and enrolled in Part B. Juan should go to the Social Security website to enroll in
Medicare Part A and B if he has not done so already. Once he is enrolled, he can
choose a Medicare Advantage plan.
3 multiple choice options
Mr. Kelly wants to know whether he is eligible to sign up for a Private fee-for-
service (PFFS) plan. What questions would you need to ask to determine his
eligibility?
pg. 2
,You would need to ask Mr. Kelly if he is entitled to Part A, enrolled in Part B, and
if he lives in the PFFS plan's service area.
3 multiple choice options
Mrs. Wang wants to know generally how the benefits under Original Medicare
might compare to the benefits package of a Medicare Advantage Plan before she
starts looking at specific plans. What could you tell her?
Medicare Advantage Plans may offer extra benefits that Original Medicare does
not offer such as vision, hearing, and dental services. It must include a maximum
out-of-pocket limit on Part A and Part B services.
3 multiple choice options
A Medicare beneficiary has walked into your office and requested that you sit
down with her and discuss her options under the Medicare Advantage program.
Before engaging in such a discussion, what should you do?
You must have her sign a scope of appointment form, indicating which products
she wishes to discuss. You may then proceed with the discussion.
3 multiple choice options
You will be holding a sales event in the near future, at which you would like to
offer door prizes to attendees. Under guidelines from the Medicare agency, what
types of gifts or prizes would not be allowed in this situation?
Gift cards or gift certificates of $15 or less that can be readily converted to cash.
3 multiple choice options
During a sales presentation, your client asks you whether the Medicare agency
recommends that she sign up for your plan or stay in Original Medicare. What
should you tell her?
Tell her that the Medicare agency does not endorse or recommend any plan.
3 multiple choice options
ABC is a Medicare Advantage (MA) plan sponsor. It would like to use its
enrollees' information to market non-health related products such as life insurance
and annuities. To do so it must obtain authorization from the enrollees. Which
statement best describes the authorization process?
pg. 3
, Authorization may be obtained by directing a beneficiary to a website to provide
consent as long as the website includes a mechanism for an electronic signature
that is valid under applicable law.
3 multiple choice options
Agent Martinez wishes to solicit Medicare Advantage prospects through e-mail
and asks you for advice as to whether this is possible. What should you tell her?
Marketing representatives may initiate electronic contact through e-mail but an
opt-out process must be provided.
3 multiple choice options
Miguel Sanchez is a relatively new agent who has come to you for advice as to
what he can do during the Medicare Advantage Open Enrollment Period (MA-
OEP). What advice should you give Miguel?
During the MA-OEP, Miguel can have one-on-one meetings with beneficiaries
who have requested such meetings.
3 multiple choice options
Mrs. Lu is turning 65 in November and called to ask for your help deciding on a
Medicare Advantage plan. She agreed to sign a scope of appointment form and
meet with you on October 15. During the appointment, what are you permitted to
do?
You may provide her with the required enrollment materials and take her
completed enrollment application.
3 multiple choice options
You are working several plans and community organizations to sponsor an
educational event. When putting together advertisements for this event, what
should you do?
You must ensure that the advertisements indicate it is an educational event,
otherwise it will be considered a marketing event.
3 multiple choice options
pg. 4
Correct Detailed Answers// AHIP Exam Prep 2025-
2026 Practice Questions and Answers (100% Correct)
Which of the following statement is/are correct about a Medicare Savings Account
(MSA) Plans?
I. MSAs may have either a partial network, full network, or no network of
providers.
II. MSA plans cover Part A and Part B benefits but not Part D prescription drug
benefits.
III. An individual who is enrolled in an MSA plan is responsible for a minimal
deductible of $500 indexed for inflation.
IV. Non-network providers must accept the same amount that Original Medicare
would pay them as payment in full.
I, II, and IV only
3 multiple choice options
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?
He could enroll either in one of the MA plans that include prescription drug
coverage or Original Medicare with a Medigap plan and standalone Part D
prescription drug coverage, but he cannot enroll in the MA-only PPO plan and a
stand-alone prescription drug plan.
3 multiple choice options
Mr. Cole has been a Medicaid beneficiary for some time, and recently qualified for
Medicare as well. He is concerned about changes in his cost-sharing. What should
you tell him?
pg. 1
,He should know that Medicaid will pay cost sharing only for services provided by
Medicaid participating providers.
3 multiple choice options
Juan Perez, who is turning age 65 next month, intends to work for several more
years at Smallcap, Incorporated. Smallcap has a workforce of 15 employees and
offers employer-sponsored healthcare coverage. Juan is a naturalized citizen and
has contributed to the Medicare system for over 20 years. Juan asks you if he will
be entitled to Medicare and if he enrolls how that will impact his employer-
sponsored healthcare coverage. How would you respond?
Juan is likely to be eligible for Medicare once he turns age 65 and if he enrolls
Medicare would become the primary payor of his healthcare claims and Smallcap
does not have to continue to offer him coverage comparable to those under age 65
under its employer-sponsored group health plan.
Daniel is a middle-income Medicare beneficiary. He has chronic bronchitis,
putting him at severe risk for pneumonia. Otherwise, he has no problems
functioning. Which type of SNP is likely to be most appropriate for him?
C-SNP
3 multiple choice options
Juan Hernandez is turning 65 next month, Juan legally entered the United States
over twenty years ago but is not a citizen. Since his entry into the country, Juan has
worked at Smallcap Incorporated and contributed to the Medicare system. Juan
suffers from diabetes. He will soon retire and asks you if he can enroll in a
Medicare Advantage plan that you represent. How would you respond?
Juan is eligible to enroll in a Medicare Advantage as long as he is entitled to Part A
and enrolled in Part B. Juan should go to the Social Security website to enroll in
Medicare Part A and B if he has not done so already. Once he is enrolled, he can
choose a Medicare Advantage plan.
3 multiple choice options
Mr. Kelly wants to know whether he is eligible to sign up for a Private fee-for-
service (PFFS) plan. What questions would you need to ask to determine his
eligibility?
pg. 2
,You would need to ask Mr. Kelly if he is entitled to Part A, enrolled in Part B, and
if he lives in the PFFS plan's service area.
3 multiple choice options
Mrs. Wang wants to know generally how the benefits under Original Medicare
might compare to the benefits package of a Medicare Advantage Plan before she
starts looking at specific plans. What could you tell her?
Medicare Advantage Plans may offer extra benefits that Original Medicare does
not offer such as vision, hearing, and dental services. It must include a maximum
out-of-pocket limit on Part A and Part B services.
3 multiple choice options
A Medicare beneficiary has walked into your office and requested that you sit
down with her and discuss her options under the Medicare Advantage program.
Before engaging in such a discussion, what should you do?
You must have her sign a scope of appointment form, indicating which products
she wishes to discuss. You may then proceed with the discussion.
3 multiple choice options
You will be holding a sales event in the near future, at which you would like to
offer door prizes to attendees. Under guidelines from the Medicare agency, what
types of gifts or prizes would not be allowed in this situation?
Gift cards or gift certificates of $15 or less that can be readily converted to cash.
3 multiple choice options
During a sales presentation, your client asks you whether the Medicare agency
recommends that she sign up for your plan or stay in Original Medicare. What
should you tell her?
Tell her that the Medicare agency does not endorse or recommend any plan.
3 multiple choice options
ABC is a Medicare Advantage (MA) plan sponsor. It would like to use its
enrollees' information to market non-health related products such as life insurance
and annuities. To do so it must obtain authorization from the enrollees. Which
statement best describes the authorization process?
pg. 3
, Authorization may be obtained by directing a beneficiary to a website to provide
consent as long as the website includes a mechanism for an electronic signature
that is valid under applicable law.
3 multiple choice options
Agent Martinez wishes to solicit Medicare Advantage prospects through e-mail
and asks you for advice as to whether this is possible. What should you tell her?
Marketing representatives may initiate electronic contact through e-mail but an
opt-out process must be provided.
3 multiple choice options
Miguel Sanchez is a relatively new agent who has come to you for advice as to
what he can do during the Medicare Advantage Open Enrollment Period (MA-
OEP). What advice should you give Miguel?
During the MA-OEP, Miguel can have one-on-one meetings with beneficiaries
who have requested such meetings.
3 multiple choice options
Mrs. Lu is turning 65 in November and called to ask for your help deciding on a
Medicare Advantage plan. She agreed to sign a scope of appointment form and
meet with you on October 15. During the appointment, what are you permitted to
do?
You may provide her with the required enrollment materials and take her
completed enrollment application.
3 multiple choice options
You are working several plans and community organizations to sponsor an
educational event. When putting together advertisements for this event, what
should you do?
You must ensure that the advertisements indicate it is an educational event,
otherwise it will be considered a marketing event.
3 multiple choice options
pg. 4
