1
AHIP FINAL PRACTICE EXAM LATEST UPDATE -2025/2026- 100+
QUESTIONS AND VERIFIED ANSWERS ALL THE BEST
Mr. Edwards, a marketing representative of the ACME Insurance Company,
scheduled a marketing event and expects about 40 people to attend. He has hired
a magician at a cost of $200 to entertain attendees. Can he do this in a way that
complies with guidance from the Medicare agency?
a. He can do this because the estimated number of attendees is based on the
venue size and response rate and the value of the gift does not exceed $15.
Mrs. Ramos is considering a Medicare Advantage PPO and has questions about
which providers she can go to for her health care. What should you tell her?
b. Mrs. Ramos can obtain care from any provider who participates in Original
Medicare, but generally will have a higher cost-sharing amount if she sees a
provider who/that is not a part of the PPO network.
Julia Harris is turning 66 in July, at which time she will retire. She has contacted
your office and requested a meeting so that she can learn about Medicare and the
products you represent. How should you respond?
c. Tell Julia that you will meet with her to explain Medicare and should she be
interested you can accept and submit an enrollment request, since this is an initial
enrollment qualifying her for a special enrollment period.
Mr. Rivera has Qualified Medicare Beneficiary (QMB) eligibility and is thus covered
by both Medicare and Medicaid. He decides to enroll in a Medicare Advantage
(MA) PPO plan. Later he sees an out-of-network doctor to receive a Medicare
, 2
covered service. How much The doctor may only collect from Mr. Rivera the cost
sharing allowable under the state's Medicaid program.may the doctor collect from
Mr. Rivera?
The doctor may only collect from Mr. Rivera the cost sharing allowable under the
state's Medicaid program.
During a sales presentation in Ms. Sullivan's home, she tells you that she has
heard about a type of Medicare health plan known as Private Fee-for-Service
(PFFS). She wants to know if this would be available to her. What should you tell
her about PFFS plans?
Choose one answer.
a. A PFFS plan is a type of Medicare Supplement plan and she may enroll in one if
it is available in her area.
b. A PFFS plan is exactly the same as Original Medicare, only offered by a private
entity and she may enroll in one if it is available in her area.
c. PFFS plans are designed to cover only prescription drugs and if that is the type
of coverage she wants, she may enroll in one if it is available in her area.
d. A PFFS plan is one of the various types of Medicare Advantage plans offered by
private entities and she may enroll in one if it is available in her area.
Question8
Marks: 1
During an appointment scheduled to discuss a Medicare Advantage Prescription
Drug plan (MA-PD), Mr. Peters asked his agent to describe a stand-alone
prescription drug plan (Part D plan) that his neighbor told him about. What should
his agent do?
Choose one answer.
, 3
a. Since Mr. Peters requested a description of the Part D plan, his agent must leave
the Part D plan brochure, but not an enrollment form, and would have to schedule
another appointment after at least 48 hours have passed to discuss the Part D
plan with Mr. Peters.
b. Since Mr. Peters requested a description of the Part D plan, his agent must have
Mr. Peters sign a new scope of appointment form that includes Part D, and then
the agent may discuss the Part D plan so Mr. Peters can compare plans and make
an informed enrollment choice during the appointment.
c. Since Mr. Peters requested a description of the Part D plan, his agent must
inform Mr. Peters that he can only sign up for the MA-PD plan and cannot receive
a brochure or any other information about the Part D plan now because he did
not agree in advance to discuss that plan
d. Since Mr. Peters requested a description of the Part D plan, his agent must
discuss both the Part D and the MA-PD plans and return after at least 48 hours to
complete the Part D plan enrollment form with Mr. Peters.
Mr. Davies is turning 65 next month. He would like to enroll in a Medicare health
plan, but does not want to be limited in terms of where he obtains his care. What
should you tell him about how a Medicare Cost Plan might fit his needs?
a. Cost plan enrollees can choose to receive Medicare covered services under the
plan's benefits by going to plan network providers and paying plan cost sharing, or
may receive services from non-network providers and pay cost-sharing due under
Original Medicare.
b. Ms. Lopez is considered a marketing representative of BestCare and thus is
obligated to comply with CMS marketing requirements, including those regarding
using only approved call scripts.
Ms. Lopez is an independent agent under contract with MarketCo, a third-party
marketing organization. MarketCo has a contract with BestCare health plan, a
Medicare Advantage (MA) organization, to offer marketing services through its
AHIP FINAL PRACTICE EXAM LATEST UPDATE -2025/2026- 100+
QUESTIONS AND VERIFIED ANSWERS ALL THE BEST
Mr. Edwards, a marketing representative of the ACME Insurance Company,
scheduled a marketing event and expects about 40 people to attend. He has hired
a magician at a cost of $200 to entertain attendees. Can he do this in a way that
complies with guidance from the Medicare agency?
a. He can do this because the estimated number of attendees is based on the
venue size and response rate and the value of the gift does not exceed $15.
Mrs. Ramos is considering a Medicare Advantage PPO and has questions about
which providers she can go to for her health care. What should you tell her?
b. Mrs. Ramos can obtain care from any provider who participates in Original
Medicare, but generally will have a higher cost-sharing amount if she sees a
provider who/that is not a part of the PPO network.
Julia Harris is turning 66 in July, at which time she will retire. She has contacted
your office and requested a meeting so that she can learn about Medicare and the
products you represent. How should you respond?
c. Tell Julia that you will meet with her to explain Medicare and should she be
interested you can accept and submit an enrollment request, since this is an initial
enrollment qualifying her for a special enrollment period.
Mr. Rivera has Qualified Medicare Beneficiary (QMB) eligibility and is thus covered
by both Medicare and Medicaid. He decides to enroll in a Medicare Advantage
(MA) PPO plan. Later he sees an out-of-network doctor to receive a Medicare
, 2
covered service. How much The doctor may only collect from Mr. Rivera the cost
sharing allowable under the state's Medicaid program.may the doctor collect from
Mr. Rivera?
The doctor may only collect from Mr. Rivera the cost sharing allowable under the
state's Medicaid program.
During a sales presentation in Ms. Sullivan's home, she tells you that she has
heard about a type of Medicare health plan known as Private Fee-for-Service
(PFFS). She wants to know if this would be available to her. What should you tell
her about PFFS plans?
Choose one answer.
a. A PFFS plan is a type of Medicare Supplement plan and she may enroll in one if
it is available in her area.
b. A PFFS plan is exactly the same as Original Medicare, only offered by a private
entity and she may enroll in one if it is available in her area.
c. PFFS plans are designed to cover only prescription drugs and if that is the type
of coverage she wants, she may enroll in one if it is available in her area.
d. A PFFS plan is one of the various types of Medicare Advantage plans offered by
private entities and she may enroll in one if it is available in her area.
Question8
Marks: 1
During an appointment scheduled to discuss a Medicare Advantage Prescription
Drug plan (MA-PD), Mr. Peters asked his agent to describe a stand-alone
prescription drug plan (Part D plan) that his neighbor told him about. What should
his agent do?
Choose one answer.
, 3
a. Since Mr. Peters requested a description of the Part D plan, his agent must leave
the Part D plan brochure, but not an enrollment form, and would have to schedule
another appointment after at least 48 hours have passed to discuss the Part D
plan with Mr. Peters.
b. Since Mr. Peters requested a description of the Part D plan, his agent must have
Mr. Peters sign a new scope of appointment form that includes Part D, and then
the agent may discuss the Part D plan so Mr. Peters can compare plans and make
an informed enrollment choice during the appointment.
c. Since Mr. Peters requested a description of the Part D plan, his agent must
inform Mr. Peters that he can only sign up for the MA-PD plan and cannot receive
a brochure or any other information about the Part D plan now because he did
not agree in advance to discuss that plan
d. Since Mr. Peters requested a description of the Part D plan, his agent must
discuss both the Part D and the MA-PD plans and return after at least 48 hours to
complete the Part D plan enrollment form with Mr. Peters.
Mr. Davies is turning 65 next month. He would like to enroll in a Medicare health
plan, but does not want to be limited in terms of where he obtains his care. What
should you tell him about how a Medicare Cost Plan might fit his needs?
a. Cost plan enrollees can choose to receive Medicare covered services under the
plan's benefits by going to plan network providers and paying plan cost sharing, or
may receive services from non-network providers and pay cost-sharing due under
Original Medicare.
b. Ms. Lopez is considered a marketing representative of BestCare and thus is
obligated to comply with CMS marketing requirements, including those regarding
using only approved call scripts.
Ms. Lopez is an independent agent under contract with MarketCo, a third-party
marketing organization. MarketCo has a contract with BestCare health plan, a
Medicare Advantage (MA) organization, to offer marketing services through its
