AHIP Exam Latest (2025/2026) | 100
Questions and Correct Answers |
Graded A+
Section 1: Overview
This document provides 100 verified questions and correct answers for the AHIP
Exam, updated for the 2025/2026 certification cycle. It is tailored to assist agents
and brokers in preparing for the open-book final exam, covering Medicare basics,
plan types, enrollment periods, CMS compliance, and marketing requirements as
of 2025.
Section 2: Exam Questions and Answers
1. What types of Medicare Advantage plans are available to beneficiaries?
A) PPO, HMO, MSA, Cost Plan, PFFS
B) HMO only
C) PPO and MSA only
D) Cost Plan and PFFS only
Correct Answer: A) PPO, HMO, MSA, Cost Plan, PFFS
2. Which individuals are eligible for Medicare-Medicaid Plans (MMPs)?
A) Those enrolled in Medicare Part A only
B) Medicare and Medicaid dual eligibles, including Part D coverage
C) Individuals under age 65 without disabilities
D) Those with employer-sponsored plans only
Correct Answer: B) Medicare and Medicaid dual eligibles, including Part D
coverage
3. What is a key feature of a Medicare Cost Plan?
A) Requires only Part A enrollment
,B) Allows non-network provider visits with higher coinsurance and deductibles
C) Limits enrollment to HMO periods
D) Excludes Part D prescription drug coverage
Correct Answer: B) Allows non-network provider visits with higher coinsurance
and deductibles
4. When can individuals with End-Stage Renal Disease (ESRD) enroll in Medicare?
A) Only during the Annual Enrollment Period (AEP)
B) Anytime, with coverage beginning the fourth month after dialysis starts
C) During a Special Enrollment Period (SEP) for employment changes
D) Only at age 65
Correct Answer: B) Anytime, with coverage beginning the fourth month after
dialysis starts
5. What are the dates for the General Enrollment Period (GEP) for those not
enrolling in Part B when first eligible?
A) April 1 to June 30
B) January 1 to March 31, with coverage starting July 1
C) October 15 to December 7
D) March 1 to May 31
Correct Answer: B) January 1 to March 31, with coverage starting July 1
6. What is the Initial Enrollment Period (IEP) for Medicare Part B?
A) 3 months before the 65th birthday, the birthday month, and 3 months after
B) Only the month of the 65th birthday
C) 6 months before and 6 months after age 65
D) The entire year of turning 65
Correct Answer: A) 3 months before the 65th birthday, the birthday month, and
3 months after
, 7. Mr. Jones is 66 and has Part A only. He wants Part B. When can he enroll
without penalty?
A) Only during the AEP (Oct 15 – Dec 7)
B) During the General Enrollment Period (Jan 1 – Mar 31) but may face a late
penalty
C) Any time because he has Part A
D) During his IEP, which has expired, so he must wait for a SEP
Correct Answer: B) During the General Enrollment Period (Jan 1 – Mar 31) but
may face a late penalty
8. What is the penalty for late enrollment in Part B?
A) 10% of the premium for each 12-month period without coverage
B) 1% per month of delay
C) A flat $50 per month
D) No penalty after age 70
Correct Answer: A) 10% of the premium for each 12-month period without
coverage
9. Which statement about Medicare Supplement (Medigap) plans is true?
A) They cover prescription drugs
B) They work with Medicare Advantage plans
C) They are sold by private insurers and fill gaps in Original Medicare
D) They are free for low-income beneficiaries
Correct Answer: C) They are sold by private insurers and fill gaps in Original
Medicare
10. When is the Medigap Open Enrollment Period?
A) The 6 months starting the month you are 65 or older and enrolled in Part B
B) Any time after age 65
C) Only during AEP
D) The 3 months before your 65th birthday
Questions and Correct Answers |
Graded A+
Section 1: Overview
This document provides 100 verified questions and correct answers for the AHIP
Exam, updated for the 2025/2026 certification cycle. It is tailored to assist agents
and brokers in preparing for the open-book final exam, covering Medicare basics,
plan types, enrollment periods, CMS compliance, and marketing requirements as
of 2025.
Section 2: Exam Questions and Answers
1. What types of Medicare Advantage plans are available to beneficiaries?
A) PPO, HMO, MSA, Cost Plan, PFFS
B) HMO only
C) PPO and MSA only
D) Cost Plan and PFFS only
Correct Answer: A) PPO, HMO, MSA, Cost Plan, PFFS
2. Which individuals are eligible for Medicare-Medicaid Plans (MMPs)?
A) Those enrolled in Medicare Part A only
B) Medicare and Medicaid dual eligibles, including Part D coverage
C) Individuals under age 65 without disabilities
D) Those with employer-sponsored plans only
Correct Answer: B) Medicare and Medicaid dual eligibles, including Part D
coverage
3. What is a key feature of a Medicare Cost Plan?
A) Requires only Part A enrollment
,B) Allows non-network provider visits with higher coinsurance and deductibles
C) Limits enrollment to HMO periods
D) Excludes Part D prescription drug coverage
Correct Answer: B) Allows non-network provider visits with higher coinsurance
and deductibles
4. When can individuals with End-Stage Renal Disease (ESRD) enroll in Medicare?
A) Only during the Annual Enrollment Period (AEP)
B) Anytime, with coverage beginning the fourth month after dialysis starts
C) During a Special Enrollment Period (SEP) for employment changes
D) Only at age 65
Correct Answer: B) Anytime, with coverage beginning the fourth month after
dialysis starts
5. What are the dates for the General Enrollment Period (GEP) for those not
enrolling in Part B when first eligible?
A) April 1 to June 30
B) January 1 to March 31, with coverage starting July 1
C) October 15 to December 7
D) March 1 to May 31
Correct Answer: B) January 1 to March 31, with coverage starting July 1
6. What is the Initial Enrollment Period (IEP) for Medicare Part B?
A) 3 months before the 65th birthday, the birthday month, and 3 months after
B) Only the month of the 65th birthday
C) 6 months before and 6 months after age 65
D) The entire year of turning 65
Correct Answer: A) 3 months before the 65th birthday, the birthday month, and
3 months after
, 7. Mr. Jones is 66 and has Part A only. He wants Part B. When can he enroll
without penalty?
A) Only during the AEP (Oct 15 – Dec 7)
B) During the General Enrollment Period (Jan 1 – Mar 31) but may face a late
penalty
C) Any time because he has Part A
D) During his IEP, which has expired, so he must wait for a SEP
Correct Answer: B) During the General Enrollment Period (Jan 1 – Mar 31) but
may face a late penalty
8. What is the penalty for late enrollment in Part B?
A) 10% of the premium for each 12-month period without coverage
B) 1% per month of delay
C) A flat $50 per month
D) No penalty after age 70
Correct Answer: A) 10% of the premium for each 12-month period without
coverage
9. Which statement about Medicare Supplement (Medigap) plans is true?
A) They cover prescription drugs
B) They work with Medicare Advantage plans
C) They are sold by private insurers and fill gaps in Original Medicare
D) They are free for low-income beneficiaries
Correct Answer: C) They are sold by private insurers and fill gaps in Original
Medicare
10. When is the Medigap Open Enrollment Period?
A) The 6 months starting the month you are 65 or older and enrolled in Part B
B) Any time after age 65
C) Only during AEP
D) The 3 months before your 65th birthday
