2025 AHIP FINAL COMPREHENSIVE
STUDY GUIDE 2026 FULL QUESTIONS
AND SOLUTIONS GRADED A+
◍ Mrs. West wears glasses and dentures and has enjoyed considerable pain
relief from arthritis through acupuncture. She is concerned about whether or
not Medicare will cover these items and services. What should you tell her?.
Answer: Medicare does not cover acupuncture, or, in general, glasses or
dentures.
◍ Mr. Bickford did not quite qualify for the extra help low-income subsidy
under the Medicare Part D Prescription Drug program and he is wondering
if there is any other option he has for obtaining help with his considerable
drug costs. What should you tell him?.
Answer: He could check with the manufacturers of his medications to see if
they offer an assistance program to help people with limited means obtain
the medications they need. Alternatively, he could check to see whether his
state has a pharmacy assistance program to help him with his expenses.
◍ 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 in one of the MA plans that include prescription
drug coverage or a Medigap plan and a stand-alone prescription drug plan,
but he cannot enroll in the MA-only PPO plan and a stand-alone
prescription drug plan.
, ◍ Agent Jennings makes a presentation on Medicare advertised as an
educational event. Agent Jennings distributes materials that are solely
educational in nature. However, she gives a brief presentation that mentions
plan-specific premiums. Is this a prohibited activity at an event that has been
advertised as educational?.
Answer: Yes. When an event has been advertised as "educational,"
discussing plan-specific premiums is impermissible.
◍ Mrs. Mulcahy is concerned that she may not qualify for enrollment in a
Medicare prescription drug plan because, although she is entitled to Part A,
she is not enrolled under Medicare Part
B. What should you tell her?.
Answer: Everyone who is entitled to Part A or enrolled under Part B is
eligible to enroll in a Medicare prescription drug plan. As long as Mrs.
Mulcahy is entitled to Part A, she does not need to enroll under Part B
before enrolling in a prescription drug plan.
◍ Mr. Jacob understands that there is a standard Medicare Part D prescription
drug benefit, but when he looks at information on various plans available in
his area, he sees a wide range in what they charge for deductibles, premiums
and cost sharing. How can you explain this to him?.
Answer: Medicare Part D drug plans may have different benefit structures,
but on average, they must all be at least as good as the standard model
established by the government.
◍ Ms. Moore 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 or Lou Gehrig's
disease, so she will be eligible for Medicare.
◍ Agent Armstrong is employed by XYZ Agency, which is under contract
with ABC Health Plan, a Medicare Advantage (MA) plan that offers plans
STUDY GUIDE 2026 FULL QUESTIONS
AND SOLUTIONS GRADED A+
◍ Mrs. West wears glasses and dentures and has enjoyed considerable pain
relief from arthritis through acupuncture. She is concerned about whether or
not Medicare will cover these items and services. What should you tell her?.
Answer: Medicare does not cover acupuncture, or, in general, glasses or
dentures.
◍ Mr. Bickford did not quite qualify for the extra help low-income subsidy
under the Medicare Part D Prescription Drug program and he is wondering
if there is any other option he has for obtaining help with his considerable
drug costs. What should you tell him?.
Answer: He could check with the manufacturers of his medications to see if
they offer an assistance program to help people with limited means obtain
the medications they need. Alternatively, he could check to see whether his
state has a pharmacy assistance program to help him with his expenses.
◍ 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 in one of the MA plans that include prescription
drug coverage or a Medigap plan and a stand-alone prescription drug plan,
but he cannot enroll in the MA-only PPO plan and a stand-alone
prescription drug plan.
, ◍ Agent Jennings makes a presentation on Medicare advertised as an
educational event. Agent Jennings distributes materials that are solely
educational in nature. However, she gives a brief presentation that mentions
plan-specific premiums. Is this a prohibited activity at an event that has been
advertised as educational?.
Answer: Yes. When an event has been advertised as "educational,"
discussing plan-specific premiums is impermissible.
◍ Mrs. Mulcahy is concerned that she may not qualify for enrollment in a
Medicare prescription drug plan because, although she is entitled to Part A,
she is not enrolled under Medicare Part
B. What should you tell her?.
Answer: Everyone who is entitled to Part A or enrolled under Part B is
eligible to enroll in a Medicare prescription drug plan. As long as Mrs.
Mulcahy is entitled to Part A, she does not need to enroll under Part B
before enrolling in a prescription drug plan.
◍ Mr. Jacob understands that there is a standard Medicare Part D prescription
drug benefit, but when he looks at information on various plans available in
his area, he sees a wide range in what they charge for deductibles, premiums
and cost sharing. How can you explain this to him?.
Answer: Medicare Part D drug plans may have different benefit structures,
but on average, they must all be at least as good as the standard model
established by the government.
◍ Ms. Moore 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 or Lou Gehrig's
disease, so she will be eligible for Medicare.
◍ Agent Armstrong is employed by XYZ Agency, which is under contract
with ABC Health Plan, a Medicare Advantage (MA) plan that offers plans
