QUESTIONS AND CORRECT DETAILED ANSWERS
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Overview
The AHIP Module 2 Actual Exam 2025–2026 provides comprehensive
coverage of the rules, processes, and ethical guidelines surrounding
Medicare health plans and agent responsibilities. Each question includes
in-depth explanations to help learners understand complex regulatory
concepts and prepare effectively for the official AHIP certification.
Updated with the newest compliance guidelines and plan structures, this
resource is ideal for agents, brokers, and compliance professionals
seeking to maintain or obtain certification.
Key Features
✅ 80 Real Exam-Style Questions with Detailed Explanations
✅ Fully Updated for the 2025–2026 AHIP Certification Standards
✅ Covers Medicare Advantage, Part D, and Compliance Rules
✅ Verified and Reviewed for Accuracy and Relevance
✅ Ideal for Independent Study or Certification Review
Purpose
• To strengthen understanding of Medicare Advantage and Prescription Drug Plans
• To prepare candidates for AHIP certification or renewal
• To ensure compliance with federal CMS regulations and ethical standards
Recommended For
• Insurance Agents and Brokers completing AHIP Certification
• Compliance Officers and Healthcare Administrators
• Trainers and Educators in Medicare and Health Insurance Programs
,Your Complete AHIP Exam Resource
With 80 verified questions and comprehensive explanations, the AHIP Module 2 Actual
Exam 2025–2026 provides the most reliable, updated, and effective preparation tool to help you
pass your certification exam and stay compliant with CMS guidelines.
Mrs. Chi is age 75 and enjoys a comfortable but not extremely high-income level. She wishes to
enroll in a MA MSA plan that she heard about from her neighbor. She also wants to have
prescription drug coverage since her doctor recently prescribed several expensive medications.
Currently, she is enrolled in
Original Medicare and a standalone Part D plan. How would you advise Mrs. Chi? - ANSWER-
Mrs. Chi may enroll in a MA MSA plan and remain in her current standalone Part D prescription
drug plan.
Mr. Romero is 64, retiring soon, and considering enrollment in his employer-sponsored retiree
group health plan that includes drug coverage with nominal copays. He heard about a neighbor's
MA-PD plan that you represent and because he takes numerous prescription drugs, he is
considering signing up for it. What should you tell him? - ANSWER-He should compare the
benefits in his employer-sponsored retiree group health plan with the benefits in his neighbor's
MA-PD plan to determine which one will provide sufficient coverage for his prescription needs.
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? - ANSWER-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 standalone prescription drug plan.
Mrs. Radford asks whether there are any special eligibility requirements for Medicare
Advantage. What should you tell her? - ANSWER-Mrs. Radford must be entitled to Part A and
enrolled in Part B to enroll in Medicare Advantage.
Mrs. Velasquez cares for her frail elderly mother, Maria, who lives in North Carolina. She is
worried that without additional support, her mother will need to go into a nursing home. Mrs.
Velasquez asks you if there is any Medicare plan that might allow her mother to remain in the
community rather than going into a nursing home. How should you advise Mrs. Velasquez? -
ANSWER-There are Programs of
, AllInclusive Care for the Elderly (PACE) for frail elderly beneficiaries certified as needing a
nursing home level of care but are able to live safely in the community at the time of enrolment.
Mrs. Burton is a retiree with substantial income. She is enrolled in an MA-PD plan and was
disappointed with the service she received from her primary care physician because she was told
she would have to wait five weeks to get an appointment when she was feeling ill. She called you
to ask what she could do so she would not have to put up with such poor access to care. What
could you tell her? - ANSWER-
She could file a grievance with her plan to complain about the lack of timeliness in getting an
appointment.
Mrs. Walters is enrolled in her state's Medicaid program in addition to Medicare. What should
she be aware of when considering enrollment in a Medicare Advantage (MA) plan? - ANSWER-
She cannot enroll in an MA Medical Savings Account (MSA) plan.
Mr. Wells is trying to understand the difference between Original Medicare and Medicare
Advantage. What would be the correct description? - ANSWER-Medicare Advantage is a way of
covering all the Original Medicare benefits through private health insurance companies.
Hank's Fish Store, Inc. is a small company with just 15 employees located in Florida. Hank, the
store owner, has provided excellent health benefits to the store's workforce. William, one of the
store's longtime employees, will soon be reaching age 65 and eligible for Medicare. William is in
good health.
He intends to remain an active full-time employee, working several years after becoming eligible
for
Medicare. What type(s) of retiree health benefit will Hank's Fish Store be able to offer William?
- ANSWER-Hank's can continue to offer William the same employee health benefit plan, or, if
William enrolls in Medicare Part B, it can enroll him in a Medicare Advantage plan that is
offered to the public.
Mrs. Lyons is in good health, uses a single prescription, and lives independently in her own
home. She is attracted by the idea of maintaining control over a Medical Savings Account (MSA)
but is not sure if the plan associated with the account will fit her needs. What specific piece of
information about a Medicare MSA plan would it be important for her to know, prior to enrolling
in such a plan? - ANSWER-All MSAs cover Part A and Part B benefits, but not Part D
prescription drug benefits, which could be obtained by also enrolling in a separate prescription
drug plan.
Which of the following statement(s) is/are correct about a Medicare Savings Account (MSA)
Plans?