AHIP Module 5 2026\2027 questions and
answers 2026\2027 A+ Grade
Willard works as a representative focused on the senior marketplace. What would be considered
prohibited activity by Willard?
- correct answer Implying that only seniors can enroll in a Medicare Advantage plan when meeting with
Mr. Hernandez, who is 58 but qualifies for Medicare because he is disabled.
Mr. Wendt suffers from diabetes which has gotten progressively worse during the last year. He is
currently enrolled in Original Medicare (Parts A and B) and a Part D prescription drug plan and did not
enroll in a Medicare Advantage (MA) plan during the last annual open enrollment period (AEP) which
has just closed. Mr. Wendt has heard certain MA plans might provide him with more specialized
coverage for his diabetes and wants to know if he must wait until the next annual open enrollment
period (AEP) before enrolling in such a plan. What should you tell him?
- correct answer If there is a special needs plan (SNP) in Mr. Wendt's area that specializes in caring for
individuals with diabetes, he may enroll in the SNP at any time under a special election period (SEP)
Ms. Thomas has worked for many years and is turning 68 in June. She is eligible for Medicare Part A and
did not enroll for Part B when first eligible because she has insurance through her employer - Coffee
Brew, Inc. She also did not enroll in Part D because she had creditable coverage. She would like to retire
in June and enroll in a Medicare Advantage plan. She has been informed that her group coverage will
end on her retirement effective date. How would you advise Ms. Thomas?
- correct answer Ms. Thomas can enroll in Part B without a late penalty at any time she is still covered by
her employer group and 8 months after her last month of employer group coverage without a penalty.
However, because she wants to enroll in a MA plan after retirement, she should make sure her Part B
coverage is effective in time to use the Medicare Advantage/Part D special election period for
individuals changing from employer group coverage to enroll in a MA plan or MA-PD. The SEP begins
while she has employer group coverage and will last until 2 months after the month after the month her
employer coverage ends. If she wants Part D coverage she should enroll in an MA-PD or a PDP
(depending on how she decides to receive her Part A and B benefits) during this time.
Mrs. Johnson calls to tell you she has not received her new plan ID card yet, but she needs to see a
doctor. What can she expect to receive from the plan after the plan has received her enrollment form?
- correct answer Evidence of plan membership, information on how to obtain services, and the effective
date of coverage.
, Mrs. Jenkins is enrolled in both Part A and Part B of Medicare. She has recently also become eligible for
Medicaid and would like to enroll in a MA-PD plan. Since this is her first experience with Medicare
Advantage, she is concerned that she will be locked into a plan and unable to make any coverage
changes for at least a year if not longer. What should you tell her?
- correct answer Since Mrs. Jenkins has Medicare Part A and Part B and receives Medicaid, she has a
special election period (SEP) that will allow her to enroll or disenroll from an MA or MA-PD plan during
the first 9 months of each calendar year.
Ms. O'Donnell learned about a new MA-PD plan that her neighbor suggested and that you represent.
She plans to switch from her old MA HMO plan to the new MA-PD plan during the Annual Election
Period. However, she wants to make sure she does not end up paying premiums for two plans. What
can you tell her?
- correct answer She only needs to enroll in the new MA-PD plan and she will automatically be
disenrolled from her old MA plan.
Mrs. Reynolds is in her Medicare initial coverage election period (ICEP) and the date of her entitlement
to Part A and B has already occurred. Mrs. Reynolds has just signed up for a Medicare Advantage plan
on the second of the month. She is leaving for vacation in two weeks and wants to know if her new
coverage will start before she leaves. What should you tell her?
- correct answer Typically, her coverage would begin on the first day of the next month, so she should
not expect her coverage to begin before she leaves.
Miles is a licensed agent who represents Colgate Health and its Medicare Advantage (MA) plans. Miles
has several clients who have recently come to him for help. They are in their initial coverage periods)
(ICEP) and are interested in enrolling in one of Colgate Health's MA plans. Adam will soon turn 68 and
has decided to retire. Betty is about to turn 65 and has also decided to retire. Adam and Betty both
currently have coverage through Colgate Health. Charles had health coverage through Colgate but
dropped the coverage when he retired early to travel to Europe. Charles has just turned age 65 and is
now back in the United States. Diedre, who will turn 65 next month, currently has coverage through
Ditmas Health - a company that Miles also represents. Who qualifies for the opt-in simplified enrollment
mechanism?
- correct answer Adam and Betty because each of them will not have a break between their non-
Medicare and Medicare coverage through Colgate Health Plan.
Ms. Claggett is sixty-six (66) years old. She has been covered under Original Medicare for the last six
years due to her disability and has never been enrolled in a Medicare Advantage or a 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) and has concluded that, since she has never enrolled in such a plan before, she should be
answers 2026\2027 A+ Grade
Willard works as a representative focused on the senior marketplace. What would be considered
prohibited activity by Willard?
- correct answer Implying that only seniors can enroll in a Medicare Advantage plan when meeting with
Mr. Hernandez, who is 58 but qualifies for Medicare because he is disabled.
Mr. Wendt suffers from diabetes which has gotten progressively worse during the last year. He is
currently enrolled in Original Medicare (Parts A and B) and a Part D prescription drug plan and did not
enroll in a Medicare Advantage (MA) plan during the last annual open enrollment period (AEP) which
has just closed. Mr. Wendt has heard certain MA plans might provide him with more specialized
coverage for his diabetes and wants to know if he must wait until the next annual open enrollment
period (AEP) before enrolling in such a plan. What should you tell him?
- correct answer If there is a special needs plan (SNP) in Mr. Wendt's area that specializes in caring for
individuals with diabetes, he may enroll in the SNP at any time under a special election period (SEP)
Ms. Thomas has worked for many years and is turning 68 in June. She is eligible for Medicare Part A and
did not enroll for Part B when first eligible because she has insurance through her employer - Coffee
Brew, Inc. She also did not enroll in Part D because she had creditable coverage. She would like to retire
in June and enroll in a Medicare Advantage plan. She has been informed that her group coverage will
end on her retirement effective date. How would you advise Ms. Thomas?
- correct answer Ms. Thomas can enroll in Part B without a late penalty at any time she is still covered by
her employer group and 8 months after her last month of employer group coverage without a penalty.
However, because she wants to enroll in a MA plan after retirement, she should make sure her Part B
coverage is effective in time to use the Medicare Advantage/Part D special election period for
individuals changing from employer group coverage to enroll in a MA plan or MA-PD. The SEP begins
while she has employer group coverage and will last until 2 months after the month after the month her
employer coverage ends. If she wants Part D coverage she should enroll in an MA-PD or a PDP
(depending on how she decides to receive her Part A and B benefits) during this time.
Mrs. Johnson calls to tell you she has not received her new plan ID card yet, but she needs to see a
doctor. What can she expect to receive from the plan after the plan has received her enrollment form?
- correct answer Evidence of plan membership, information on how to obtain services, and the effective
date of coverage.
, Mrs. Jenkins is enrolled in both Part A and Part B of Medicare. She has recently also become eligible for
Medicaid and would like to enroll in a MA-PD plan. Since this is her first experience with Medicare
Advantage, she is concerned that she will be locked into a plan and unable to make any coverage
changes for at least a year if not longer. What should you tell her?
- correct answer Since Mrs. Jenkins has Medicare Part A and Part B and receives Medicaid, she has a
special election period (SEP) that will allow her to enroll or disenroll from an MA or MA-PD plan during
the first 9 months of each calendar year.
Ms. O'Donnell learned about a new MA-PD plan that her neighbor suggested and that you represent.
She plans to switch from her old MA HMO plan to the new MA-PD plan during the Annual Election
Period. However, she wants to make sure she does not end up paying premiums for two plans. What
can you tell her?
- correct answer She only needs to enroll in the new MA-PD plan and she will automatically be
disenrolled from her old MA plan.
Mrs. Reynolds is in her Medicare initial coverage election period (ICEP) and the date of her entitlement
to Part A and B has already occurred. Mrs. Reynolds has just signed up for a Medicare Advantage plan
on the second of the month. She is leaving for vacation in two weeks and wants to know if her new
coverage will start before she leaves. What should you tell her?
- correct answer Typically, her coverage would begin on the first day of the next month, so she should
not expect her coverage to begin before she leaves.
Miles is a licensed agent who represents Colgate Health and its Medicare Advantage (MA) plans. Miles
has several clients who have recently come to him for help. They are in their initial coverage periods)
(ICEP) and are interested in enrolling in one of Colgate Health's MA plans. Adam will soon turn 68 and
has decided to retire. Betty is about to turn 65 and has also decided to retire. Adam and Betty both
currently have coverage through Colgate Health. Charles had health coverage through Colgate but
dropped the coverage when he retired early to travel to Europe. Charles has just turned age 65 and is
now back in the United States. Diedre, who will turn 65 next month, currently has coverage through
Ditmas Health - a company that Miles also represents. Who qualifies for the opt-in simplified enrollment
mechanism?
- correct answer Adam and Betty because each of them will not have a break between their non-
Medicare and Medicare coverage through Colgate Health Plan.
Ms. Claggett is sixty-six (66) years old. She has been covered under Original Medicare for the last six
years due to her disability and has never been enrolled in a Medicare Advantage or a 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) and has concluded that, since she has never enrolled in such a plan before, she should be
