AHIP - 2026 - MODULE 1, MOD 2, MOD 3,
MOD 4, MODULE 5 & FINAL | 105
COMPREHENSIVE QUESTIONS &
ANSWERS | GRADE A | 100% CORRECT -
THE ULTIMATE ALL-IN-ONE GUIDE FOR YR.
(2026/2027)
This 2026 AHIP Medicare Training (Modules 1-5) is a, 105-question covering
Medicare Basics (A, B, C, D), eligibility, product types (HMO, PPO, SNP),
marketing compliance, and enrollment procedures. It includes Fraud, Waste, and
Abuse (FWA) training and focuses on 2026 guidelines.
Module Breakdown (2026 Training)
• Module 1: Medicare Basics: Covers eligibility, entitlement, and the
structure of Medicare Parts A, B, C, and D.
• Module 2: Health Plans: Details Medicare Advantage (HMO, PPO) and
Special Needs Plans (SNPs).
• Module 3: Prescription Drug Plans: Covers Medicare Part D,
formulary requirements, and coverage gap details.
• Module 4: Marketing Regulations: Focuses on CMS marketing
guidelines, compliance rules, and allowed/prohibited activities.
• Module 5: Enrollment Requirements: Covers enrollment types,
election periods, and post-enrollment activities.
NB Key Exam Information
• Format: 105 multiple-choice questions total, usually followed by an FWA
training module.
• Open Book: It is open book (as long as you are not seeking CE credits).
• Passing Score: Typically, 90% or higher is required, though this can vary
by carrier.
, • Requirement: Must be completed and transferred to carriers
(e.g., BCBSNC,
Quiz_________________?
Mr. Cappadonna 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?
-
Answer
It is illegal for you to sell Mr. Cappadonna a Medigap plan if he is enrolled in an
MA plan, and besides, Medigap only works with Original Medicare.
Quiz_________________?
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? -
Answer
Tell prospect Jerry Smith that he should consider adding a standalone Part D
prescription drug coverage policy to his present coverage.
Quiz_________________?
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? -
Answer
,Mr. Wu may still qualify for help in paying Part D costs through his State
Pharmaceutical Assistance Program (SPAP).
Quiz_________________?
Mr. Vasquez is in good health and is preparing a budget in anticipation of his
retirement when he turns 66. He wants to understand the health care costs he
might be exposed to under Medicare if he were to require hospitalization because
of an illness. In general terms, what could you tell him about his costs for inpatient
hospital services under Original Medicare? -
Answer
Under Original Medicare, there is a single deductible amount due for the first 60
days of any inpatient hospital stay, after which it converts into a per-day
coinsurance amount through day 90. After day 90, he would pay a daily amount
up to 60 days over his lifetime, after which he would be responsible for all costs.
Quiz_________________?
Mr. Moy will soon turn age 65. He is slightly younger than his wife. Mr. Moy's wife
has a Medicare Advantage plan, but he wants to understand what coverage
Medicare Supplemental Insurance provides since his health care needs are
different from his wife's needs. What could you tell Mr. Moy? -
Answer
Medicare Supplemental Insurance would help cover his Part A deductible and Part
B coinsurance or copayments in Original Fee-for-Service (FFS) Medicare as well as
possibly some services that Medicare does not cover.
Quiz_________________?
, 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? -
Answer
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. 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 but Smallcap must continue to offer him
coverage under its employer-sponsored group health plan and would become a
secondary payor.
Quiz_________________?
Ms. Kumar plans to retire when she turns 65 in a few months. She is in excellent
health and will have considerable income when she retires. She is concerned that
her income will make it impossible for her to qualify for Medicare. What could
you tell her to address her concern? -
Answer
Medicare is a program for people age 65 or older and those under age 65 with
certain disabilities, end-stage renal disease, and Lou Gehrig's disease so she will be
eligible for Medicare.
Quiz_________________?
Mrs. Ellis recently turned 66 and decided after many years of work to retire and
begin receiving Social Security benefits. Shortly thereafter Mrs. Ellis received a
MOD 4, MODULE 5 & FINAL | 105
COMPREHENSIVE QUESTIONS &
ANSWERS | GRADE A | 100% CORRECT -
THE ULTIMATE ALL-IN-ONE GUIDE FOR YR.
(2026/2027)
This 2026 AHIP Medicare Training (Modules 1-5) is a, 105-question covering
Medicare Basics (A, B, C, D), eligibility, product types (HMO, PPO, SNP),
marketing compliance, and enrollment procedures. It includes Fraud, Waste, and
Abuse (FWA) training and focuses on 2026 guidelines.
Module Breakdown (2026 Training)
• Module 1: Medicare Basics: Covers eligibility, entitlement, and the
structure of Medicare Parts A, B, C, and D.
• Module 2: Health Plans: Details Medicare Advantage (HMO, PPO) and
Special Needs Plans (SNPs).
• Module 3: Prescription Drug Plans: Covers Medicare Part D,
formulary requirements, and coverage gap details.
• Module 4: Marketing Regulations: Focuses on CMS marketing
guidelines, compliance rules, and allowed/prohibited activities.
• Module 5: Enrollment Requirements: Covers enrollment types,
election periods, and post-enrollment activities.
NB Key Exam Information
• Format: 105 multiple-choice questions total, usually followed by an FWA
training module.
• Open Book: It is open book (as long as you are not seeking CE credits).
• Passing Score: Typically, 90% or higher is required, though this can vary
by carrier.
, • Requirement: Must be completed and transferred to carriers
(e.g., BCBSNC,
Quiz_________________?
Mr. Cappadonna 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?
-
Answer
It is illegal for you to sell Mr. Cappadonna a Medigap plan if he is enrolled in an
MA plan, and besides, Medigap only works with Original Medicare.
Quiz_________________?
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? -
Answer
Tell prospect Jerry Smith that he should consider adding a standalone Part D
prescription drug coverage policy to his present coverage.
Quiz_________________?
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? -
Answer
,Mr. Wu may still qualify for help in paying Part D costs through his State
Pharmaceutical Assistance Program (SPAP).
Quiz_________________?
Mr. Vasquez is in good health and is preparing a budget in anticipation of his
retirement when he turns 66. He wants to understand the health care costs he
might be exposed to under Medicare if he were to require hospitalization because
of an illness. In general terms, what could you tell him about his costs for inpatient
hospital services under Original Medicare? -
Answer
Under Original Medicare, there is a single deductible amount due for the first 60
days of any inpatient hospital stay, after which it converts into a per-day
coinsurance amount through day 90. After day 90, he would pay a daily amount
up to 60 days over his lifetime, after which he would be responsible for all costs.
Quiz_________________?
Mr. Moy will soon turn age 65. He is slightly younger than his wife. Mr. Moy's wife
has a Medicare Advantage plan, but he wants to understand what coverage
Medicare Supplemental Insurance provides since his health care needs are
different from his wife's needs. What could you tell Mr. Moy? -
Answer
Medicare Supplemental Insurance would help cover his Part A deductible and Part
B coinsurance or copayments in Original Fee-for-Service (FFS) Medicare as well as
possibly some services that Medicare does not cover.
Quiz_________________?
, 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? -
Answer
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. 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 but Smallcap must continue to offer him
coverage under its employer-sponsored group health plan and would become a
secondary payor.
Quiz_________________?
Ms. Kumar plans to retire when she turns 65 in a few months. She is in excellent
health and will have considerable income when she retires. She is concerned that
her income will make it impossible for her to qualify for Medicare. What could
you tell her to address her concern? -
Answer
Medicare is a program for people age 65 or older and those under age 65 with
certain disabilities, end-stage renal disease, and Lou Gehrig's disease so she will be
eligible for Medicare.
Quiz_________________?
Mrs. Ellis recently turned 66 and decided after many years of work to retire and
begin receiving Social Security benefits. Shortly thereafter Mrs. Ellis received a
