FINAL EXAM
Actual Questions and Answers
What’s Inside?
Actual AHIP 2026 Final Exam questions with verified and
explained answers
Fully aligned with the latest CMS & AHIP training modules
Detailed coverage of all exam sections,
Each question includes rationales and key references to reinforce
understanding
Content designed to mirror the official AHIP
testing environment
,**1. 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.
**Expert Rationale:**
Medigap plans are supplemental policies that fill gaps in Original
Medicare (Parts A and B) coverage. Federal law prohibits issuance
of a Medigap policy to anyone currently enrolled in a Medicare
Advantage plan; Medigap cannot pay costs associated with MA.
This ensures coordination of benefits and prevents duplicate
coverage.
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,**2. Agent John Miller is meeting with Jerry Smith, a new
prospect. Jerry is currently enrolled in Medicare Parts A
and B. Jerry has also purchased a Medicare Supplement
(Medigap) plan which he has had for several years.
However, the plan does not provide drug benefits. How
would you advise Agent John Miller to proceed?**
A) Advise Jerry to switch to a Medicare Advantage plan for drug
coverage.
B) Tell prospect Jerry Smith that he should consider adding a
standalone Part D prescription drug coverage policy to his present
coverage.
C) Inform Jerry that Medigap automatically covers prescription
drugs.
D) Recommend canceling the Medigap plan.
**Correct Answer:**
B) Tell prospect Jerry Smith that he should consider adding a
standalone Part D prescription drug coverage policy to his present
coverage.
**Expert Rationale:**
Medigap plans sold after 2006 do not include prescription drug
coverage. Beneficiaries needing drug coverage must enroll in a
standalone Medicare Part D plan. This allows individuals to retain
their Medigap coverage while accessing necessary medications
through an appropriate channel.
, ---
**3. Mr. Wu is eligible for Medicare. He has limited
financial resources but failed to qualify for the Part D low-
income subsidy. Where might he turn for help with his
prescription drug costs?**
A) Apply for Medicaid to cover prescription costs.
B) Seek assistance from pharmaceutical company discount
programs.
C) Mr. Wu may still qualify for help in paying Part D costs through
his State Pharmaceutical Assistance Program (SPAP).
D) Try to enroll in a Medigap plan with drug coverage.
**Correct Answer:**
C) Mr. Wu may still qualify for help in paying Part D costs through
his State Pharmaceutical Assistance Program (SPAP).
**Expert Rationale:**
States may offer SPAPs to assist residents who do not qualify for
the federal Low Income Subsidy but still need help with Part D
drug costs. Eligibility and benefits vary by state, but these
programs can provide meaningful financial support when other
federal options aren’t available.
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