2025/2026 AHIP Final Exam Questions
and Correct Answers (All Graded A+)
Richard |is |a |licensed |agent |who |represents |Spartan |Health |Plan |and |its |Medicare |Advantage |
(MA) |plans. |Richard |has |several |clients |who |have |recently |come |to |him |for |help |who |are |in |
their |initial |coverage |election |period |(ICEP) |and |are |interested |in |enrolling |in |one |of |Spartan |
Health |Plan's |MA |plans. |Alice |will |soon |turn |65 |and |retire. |Alice |has |coverage |through |Spartan |
Health |Plan |offered |by |her |employer. |Bob |had |health |coverage |through |Spartan |but |dropped |
the |coverage |when |he |retired |early |to |travel |overseas. |Bob, |who |has |just |turned |age |65, |is |
now |back |in |the |United |States. |Charlotte, |who |will |turn |65 |next |month, |has |coverage |through |
Athena |Health |plan |- |a |company |Richard |also |represents. |Who |qualifies |for |the |opt-in |
simplified |enrollment |mechanism? |- |ANS |-Alice |and |Charlotte |because |each |of |them |currently |
have |health |coverage |and |is |in |their |initial |coverage |election |period |(ICEP).
Alice |is |enrolled |in |a |MA-PD |plan. |She |makes |a |permanent |move |across |the |country |and |
wonders |what |her |options |are |for |continuing |MA-PD |coverage. |What |would |you |say |to |her |in |
regard |to |a |special |enrollment |period |(SEP)? |- |ANS |-She |is |likely |to |qualify |for |a |SEP. |She |can |
choose |an |effective |date |of |up |to |three |months |after |the |month |in |which |the |enrollment |form
|is |received |by |the |new |plan, |but |the |effective |date |may |not |be |earlier |than |the |date |of |her |
permanent |move.
Ms. |Morris |will |turn |65 |on |June |10th. |She |has |never |previously |qualified |for |Medicare. |She |is |
entitled |to |Medicare |Part |A |and |intends |to |enroll |in |Part |B. |She |wants |to |know |if |she |is |eligible
|to |enroll |in |a |Medicare |Advantage |plan |that |includes |prescription |drug |coverage. |What |do |you
|tell |her? |- |ANS |-Ms. |Morris |can |enroll |in |an |MA-PD |plan |now |since |her |initial |election |period |
(IEP) |for |Part |D |prescription |drug |coverage |and |initial |coverage |period |are |occurring |together |
beginning |March |1st |and |ending |September |30th.
Mr. |Lopez, |who |is |fairly |well-off |financially, |would |like |to |enroll |in |a |Medicare |prescription |drug
|plan |you |represent |and |simply |give |you |a |check |to |cover |his |premiums |for |the |entire |year. |
What |should |you |tell |him? |- |ANS |-Enrollees |should |pay |using |automatic |withdrawal |from |a |
and Correct Answers (All Graded A+)
Richard |is |a |licensed |agent |who |represents |Spartan |Health |Plan |and |its |Medicare |Advantage |
(MA) |plans. |Richard |has |several |clients |who |have |recently |come |to |him |for |help |who |are |in |
their |initial |coverage |election |period |(ICEP) |and |are |interested |in |enrolling |in |one |of |Spartan |
Health |Plan's |MA |plans. |Alice |will |soon |turn |65 |and |retire. |Alice |has |coverage |through |Spartan |
Health |Plan |offered |by |her |employer. |Bob |had |health |coverage |through |Spartan |but |dropped |
the |coverage |when |he |retired |early |to |travel |overseas. |Bob, |who |has |just |turned |age |65, |is |
now |back |in |the |United |States. |Charlotte, |who |will |turn |65 |next |month, |has |coverage |through |
Athena |Health |plan |- |a |company |Richard |also |represents. |Who |qualifies |for |the |opt-in |
simplified |enrollment |mechanism? |- |ANS |-Alice |and |Charlotte |because |each |of |them |currently |
have |health |coverage |and |is |in |their |initial |coverage |election |period |(ICEP).
Alice |is |enrolled |in |a |MA-PD |plan. |She |makes |a |permanent |move |across |the |country |and |
wonders |what |her |options |are |for |continuing |MA-PD |coverage. |What |would |you |say |to |her |in |
regard |to |a |special |enrollment |period |(SEP)? |- |ANS |-She |is |likely |to |qualify |for |a |SEP. |She |can |
choose |an |effective |date |of |up |to |three |months |after |the |month |in |which |the |enrollment |form
|is |received |by |the |new |plan, |but |the |effective |date |may |not |be |earlier |than |the |date |of |her |
permanent |move.
Ms. |Morris |will |turn |65 |on |June |10th. |She |has |never |previously |qualified |for |Medicare. |She |is |
entitled |to |Medicare |Part |A |and |intends |to |enroll |in |Part |B. |She |wants |to |know |if |she |is |eligible
|to |enroll |in |a |Medicare |Advantage |plan |that |includes |prescription |drug |coverage. |What |do |you
|tell |her? |- |ANS |-Ms. |Morris |can |enroll |in |an |MA-PD |plan |now |since |her |initial |election |period |
(IEP) |for |Part |D |prescription |drug |coverage |and |initial |coverage |period |are |occurring |together |
beginning |March |1st |and |ending |September |30th.
Mr. |Lopez, |who |is |fairly |well-off |financially, |would |like |to |enroll |in |a |Medicare |prescription |drug
|plan |you |represent |and |simply |give |you |a |check |to |cover |his |premiums |for |the |entire |year. |
What |should |you |tell |him? |- |ANS |-Enrollees |should |pay |using |automatic |withdrawal |from |a |
