7/20/25, 11:12 AM AHIP - 5
AHIP -5 CERTIFICATION ACTUAL EXAM STUDY GUIDE 2025\
LATEST UPDATE WITH COMPLETE QUESTIONS AND CORRECT
DETAILED ANSWERS \THE DOCUMENT INCLUDES
COMPREHENSIVE STUDY NOTES AND PRACTICE QUESTIONS
FOR AHIP CERTIFICATION .IT COVERS KEY TOPICS SUCH AS
:MEDICARE BASICS (PART A , B , C , D ) FWA , MARKETING AND
COMPLIANCE GUIDELINES ,ENROLLMENT PERIODS AND PLAN
TYPES AND 2025 POLICY UPDATES.ALL CONTENT IS UP-TO-
DATE AND DESIGNED TO HELP YOU PASS THE EXAM AND THE
FIRST ATTEMPT
Ms. Gonzales decided to There is a MA Open Enrollment Period (OEP) that takes
remain in Original Medicare place between January 1 and March 31, but Ms.
(Parts A and B) and Part D
during the Annual Enrollment Gonzales cannot use it because eligibility to use the OEP
Period (AEP). At the beginning is
of January, her neighbor told
available only to MA enrollees.
her about the Medicare
Advantage (MA) plan he
selected. He also told her
there was an open enrollment
period that she might be able
to use to enroll in a MA plan.
Ms.
Gonzales comes to you for
advice shortly after speaking 3 multiple choice options
to her neighbor. What
should you tell her?
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,7/20/25, 11:12 AM AHIP - 5
Ms. Claggett is sixty-six (66) Ms. Claggett has had two IEPs and missed them both.
years old. She has been The first occurred three months before and three
covered under Original months after the month when she was first entitled to
Medicare for the last six Part A OR enrolled in Part B. Because she was
years due to her disability eligible for Medicare before age 65, Ms. Claggett had
and has never been enrolled a second IEP based on turning age 65, which has
in a Medicare Advantage or a also expired.
Part D plan before. She
wants to enroll in a Part D
plan. She knows that there is
such a thing as the "Part D
Initial Enrollment Period" (IEP)
3 multiple choice options
and has concluded that,
since she has never
enrolled in such a plan
before, she should be
eligible to enroll under
this period.
What should you tell her
about how the Part D
Initial Enrollment Period
applies to her situation?
Mr. Garcia was told he If the SEP is for MA coverage, he will generally have one
qualifies for a opportunity to change his MA coverage.
Special Enrollment Period
(SEP), but he lost the paper 3 multiple choice options
that explains what he could
do
during the SEP. What can you
tell him?
Mrs. Walters is entitled to Yes. Mrs. Walters must be entitled to Part A or enrolled
Part A and has medical in Part B to be eligible for coverage under the
coverage without drug Medicare prescription drug program.
coverage through an
employer retiree plan.
She is not enrolled in Part 3 multiple choice options
B. Since the employer plan
does not cover
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,7/20/25, 11:12 AM AHIP - 5
prescription drugs, she
wants to enroll in a
Medicare
prescription drug plan. Will
she be able to?
Mrs. Goodman enrolled in During the MA Open Enrollment Period, from January 1 -
an MA-PD plan during the March 31, she may disenroll from the MA-PD plan into
Annual Election Period. In Original Medicare and also may add a stand-alone
mid- January of the prescription drug plan.
following year, she wants to
3 multiple choice options
switch back to Original
Medicare and enroll in a
stand-alone prescription
drug plan.
What should you tell her?
Mrs. Berkowitz wants to enroll If the Medicare Advantage plan is a Private Fee-for-
in a Service (PFFS) plan that does not offer drug coverage
Medicare Advantage plan that
or a Medical Savings Account plan, Mrs. Berkowitz
does not
can do this.
include drug coverage and
also enroll in a stand-
alone Medicare 3 multiple choice options
prescription drug
plan. Under what
circumstances can she do
this?
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, 7/20/25, 11:12 AM AHIP - 5
Ms. Lee is enrolled in an She is eligible for a Special Election Period that begins
MA-PD plan but will be either the month before her permanent move, if the
moving out of the plan's plan is notified in advance, or the month she provides
service notice of the move, and this period typically lasts an
area next month. She is additional two months.
worried that she will not be
able to enroll in another
3 multiple choice options
plan available in her new
residence until the Annual
Election Period. What
should you tell her?
You are doing a sales "If you're not in very good health, you will probably do
presentation for Mrs. better with a different product."
Pearson. You know that
Medicare
marketing guidelines prohibit 3 multiple choice options
certain types of statements.
Apply those guidelines to
the following statements and
identify which would be
prohibited.
Mr. Anderson is a very Tell Mr. Anderson that you cannot accept any enrollment
organized individual and has forms until the annual election period begins.
filled out and brought to
you an
3 multiple choice options
enrollment form on October
10 for a new plan available
January 1 next year. He is
currently enrolled in
Original Medicare. What
should you do?
You are visiting with Mr. Tully Mr. Tully's daughter can do so only, if she is authorized under
and his state law as a court-
daughter at her request. He appointed legal guardian, has a durable power of
has advanced Alzheimer's attorney for health care decisions, or is authorized
and is incapable of under state surrogate consent laws to make health
understanding the decisions.
4/32
AHIP -5 CERTIFICATION ACTUAL EXAM STUDY GUIDE 2025\
LATEST UPDATE WITH COMPLETE QUESTIONS AND CORRECT
DETAILED ANSWERS \THE DOCUMENT INCLUDES
COMPREHENSIVE STUDY NOTES AND PRACTICE QUESTIONS
FOR AHIP CERTIFICATION .IT COVERS KEY TOPICS SUCH AS
:MEDICARE BASICS (PART A , B , C , D ) FWA , MARKETING AND
COMPLIANCE GUIDELINES ,ENROLLMENT PERIODS AND PLAN
TYPES AND 2025 POLICY UPDATES.ALL CONTENT IS UP-TO-
DATE AND DESIGNED TO HELP YOU PASS THE EXAM AND THE
FIRST ATTEMPT
Ms. Gonzales decided to There is a MA Open Enrollment Period (OEP) that takes
remain in Original Medicare place between January 1 and March 31, but Ms.
(Parts A and B) and Part D
during the Annual Enrollment Gonzales cannot use it because eligibility to use the OEP
Period (AEP). At the beginning is
of January, her neighbor told
available only to MA enrollees.
her about the Medicare
Advantage (MA) plan he
selected. He also told her
there was an open enrollment
period that she might be able
to use to enroll in a MA plan.
Ms.
Gonzales comes to you for
advice shortly after speaking 3 multiple choice options
to her neighbor. What
should you tell her?
1/32
,7/20/25, 11:12 AM AHIP - 5
Ms. Claggett is sixty-six (66) Ms. Claggett has had two IEPs and missed them both.
years old. She has been The first occurred three months before and three
covered under Original months after the month when she was first entitled to
Medicare for the last six Part A OR enrolled in Part B. Because she was
years due to her disability eligible for Medicare before age 65, Ms. Claggett had
and has never been enrolled a second IEP based on turning age 65, which has
in a Medicare Advantage or a also expired.
Part D plan before. She
wants to enroll in a Part D
plan. She knows that there is
such a thing as the "Part D
Initial Enrollment Period" (IEP)
3 multiple choice options
and has concluded that,
since she has never
enrolled in such a plan
before, she should be
eligible to enroll under
this period.
What should you tell her
about how the Part D
Initial Enrollment Period
applies to her situation?
Mr. Garcia was told he If the SEP is for MA coverage, he will generally have one
qualifies for a opportunity to change his MA coverage.
Special Enrollment Period
(SEP), but he lost the paper 3 multiple choice options
that explains what he could
do
during the SEP. What can you
tell him?
Mrs. Walters is entitled to Yes. Mrs. Walters must be entitled to Part A or enrolled
Part A and has medical in Part B to be eligible for coverage under the
coverage without drug Medicare prescription drug program.
coverage through an
employer retiree plan.
She is not enrolled in Part 3 multiple choice options
B. Since the employer plan
does not cover
2/32
,7/20/25, 11:12 AM AHIP - 5
prescription drugs, she
wants to enroll in a
Medicare
prescription drug plan. Will
she be able to?
Mrs. Goodman enrolled in During the MA Open Enrollment Period, from January 1 -
an MA-PD plan during the March 31, she may disenroll from the MA-PD plan into
Annual Election Period. In Original Medicare and also may add a stand-alone
mid- January of the prescription drug plan.
following year, she wants to
3 multiple choice options
switch back to Original
Medicare and enroll in a
stand-alone prescription
drug plan.
What should you tell her?
Mrs. Berkowitz wants to enroll If the Medicare Advantage plan is a Private Fee-for-
in a Service (PFFS) plan that does not offer drug coverage
Medicare Advantage plan that
or a Medical Savings Account plan, Mrs. Berkowitz
does not
can do this.
include drug coverage and
also enroll in a stand-
alone Medicare 3 multiple choice options
prescription drug
plan. Under what
circumstances can she do
this?
3/32
, 7/20/25, 11:12 AM AHIP - 5
Ms. Lee is enrolled in an She is eligible for a Special Election Period that begins
MA-PD plan but will be either the month before her permanent move, if the
moving out of the plan's plan is notified in advance, or the month she provides
service notice of the move, and this period typically lasts an
area next month. She is additional two months.
worried that she will not be
able to enroll in another
3 multiple choice options
plan available in her new
residence until the Annual
Election Period. What
should you tell her?
You are doing a sales "If you're not in very good health, you will probably do
presentation for Mrs. better with a different product."
Pearson. You know that
Medicare
marketing guidelines prohibit 3 multiple choice options
certain types of statements.
Apply those guidelines to
the following statements and
identify which would be
prohibited.
Mr. Anderson is a very Tell Mr. Anderson that you cannot accept any enrollment
organized individual and has forms until the annual election period begins.
filled out and brought to
you an
3 multiple choice options
enrollment form on October
10 for a new plan available
January 1 next year. He is
currently enrolled in
Original Medicare. What
should you do?
You are visiting with Mr. Tully Mr. Tully's daughter can do so only, if she is authorized under
and his state law as a court-
daughter at her request. He appointed legal guardian, has a durable power of
has advanced Alzheimer's attorney for health care decisions, or is authorized
and is incapable of under state surrogate consent laws to make health
understanding the decisions.
4/32
