FINAL EXAM - What’s Inside? Actual AHIP 2026 Final Exam...

2026 AHIP

FINAL EXAM

Actual Questions and Answers

What’s Inside?Actual AHIP 2026 Final Exam questions with verified and explained answers Fully aligned with the latest CMS & AHIP training modules Detailed coverage of all exam sections, Each question includes rationales and key references to reinforce understanding Content designed to mirror the official AHIP testing environment 1 / 4

**1. Mr. Capadona would like to purchase a Medicare Advantage (MA) plan and a Medigap plan to pick up costs not covered by that plan. What should you tell him?* *

• You can sell him a Medigap plan to help with costs not covered

under Medicare Advantage.

• It is illegal for you to sell Mr. Capadona a Medigap plan if he is

enrolled in an MA plan, and besides, Medigap only works with Original Medicare.

• Medigap plans are designed to work alongside Medicare

Advantage plans.

• He must disenroll from his MA plan before buying a Medigap

plan.

**Correct Answer:**

• It is illegal for you to sell Mr. Capadona a Medigap plan if he is

enrolled in an MA plan, and besides, Medigap only works with Original Medicare.

**Expert Rationale:**

Medigap plans are supplemental policies that fill gaps in Original Medicare (Parts A and B) coverage. Federal law prohibits issuance of a Medigap policy to anyone currently enrolled in a Medicare Advantage plan; Medigap cannot pay costs associated with MA.This ensures coordination of benefits and prevents duplicate coverage.

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**2. Agent John Miller is meeting with Jerry Smith, a new prospect. Jerry is currently enrolled in Medicare Parts A and B. Jerry has also purchased a Medicare Supplement (Medigap) plan which he has had for several years.However, the plan does not provide drug benefits. How would you advise Agent John Miller to proceed?* *

• Advise Jerry to switch to a Medicare Advantage plan for drug

coverage.

• Tell prospect Jerry Smith that he should consider adding a

standalone Part D prescription drug coverage policy to his present coverage.

• Inform Jerry that Medigap automatically covers prescription

drugs.

• Recommend canceling the Medigap plan.

**Correct Answer:**

• Tell prospect Jerry Smith that he should consider adding a

standalone Part D prescription drug coverage policy to his present coverage.

**Expert Rationale:**

Medigap plans sold after 2006 do not include prescription drug coverage. Beneficiaries needing drug coverage must enroll in a standalone Medicare Part D plan. This allows individuals to retain their Medigap coverage while accessing necessary medications through an appropriate channel. 3 / 4

--- **3. Mr. Wu is eligible for Medicare. He has limited financial resources but failed to qualify for the Part D low- income subsidy. Where might he turn for help with his prescription drug costs?**

• Apply for Medicaid to cover prescription costs.
• Seek assistance from pharmaceutical company discount

programs.

• Mr. Wu may still qualify for help in paying Part D costs through

his State Pharmaceutical Assistance Program (SPAP).

• Try to enroll in a Medigap plan with drug coverage.

**Correct Answer:**

• Mr. Wu may still qualify for help in paying Part D costs through

his State Pharmaceutical Assistance Program (SPAP).

**Expert Rationale:**

States may offer SPAPs to assist residents who do not qualify for the federal Low Income Subsidy but still need help with Part D drug costs. Eligibility and benefits vary by state, but these programs can provide meaningful financial support when other federal options aren’t available.---

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