AHIP 2025 FINAL EXAM QUESTIONS WITH ANSWER 2025-2026

Q. All plans must cover at least the standard Part D coverage or its actuarial equivalent. Which
of the following statements best describes some of the costs a beneficiary would incur for
prescription drugs under the standard coverage?
A. Standard Part D coverage would require payment of an annual deductible, and once past
the catastrophic coverage threshold, the beneficiary pays whichever is greater of either
the co-pays for generic and brand name drugs or coinsurance of 5%.
Q. Your colleague works at a third-party marketing organization (TMO) and she said she did not
need to take the Medicare training for brokers and agents or pass a test to market Medicare
plans since her contract is with the TMO, not the plans that have the products she sells. What
could you say to her?
A. You could tell her she is wrong, and that only agents selling employer/union group plans
are permitted an exemption from testing, but some employer/union group plans may
require testing to promote agent compliance with CMS marketing requirements.
Q. Mrs. Radford asks whether there are any special eligibility requirements for Medicare
Advantage. What should you tell her?
A. Mrs. Radford must be entitled to Part A and enrolled in Part B to enroll in Medicare
Advantage.
Q. 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?
A. He could check with the manufacturers of his medications to see if they offer an
assistance program to help people with limited means to 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.
Q. Mrs. Lyons is in good health, uses a single prescription, and lives independently in her own
home. She is attracted by the idea of maintaining control over a Medical Savings Account (MSA)
but is not sure if the plan associated with the account will fit her needs. What specific piece of
information about a Medicare MSA plan would it be important for her to know, prior to
enrolling in such a plan?
A. All MSAs cover Part A and Part B benefits, but not Part D prescription drug benefits,
which could be obtained by also enrolling in a separate prescription drug plan.