2025 AHIP FINAL CERTIFICATION
SCRIPT 2026 QUESTIONS WITH
SOLUTIONS GRADED A+
◍ Mrs. Paterson is concerned about the deductibles and co-payments
associated with Original Medicare. What can you tell her about Medigap as
an option to address this concern?.
Answer: Medigap plans help beneficiaries cover Original Medicare benefits,
but they coordinate with Original Medicare coverage.
◍ To obtain Part B coverage, she must pay a standard monthly premium,
though it is higher for individuals with higher incomes..
Answer: Mrs. Gonzalez cannot purchase a Medigap plan that covers drugs,
but she could keep her Medigap policy and enroll in a Part D prescription
drug plan.
◍ Which of the following individuals is most likely to be eligible to enroll in a
Part D Plan?a.Guy, who has illegally crossed the Canadian border.b.Jose, a
grandfather who was granted asylum and has worked in the United States
for many years.Correct: Jose, having been granted asylum, is legally present
in the United States thus meeting one of the criteria for Part D
eligibility.c.Betsy, a grandmother from overseas who has overstayed her
visa.d.Helena, an overseas college student who has overstayed her visa..
Answer: Jose, a grandfather who was granted asylum and has worked in the
United States for many years.
◍ What impact, if any, have recent regulatory changes had on Medigap plans?.
Answer: b.The Part B deductible is no longer covered for individuals newly
eligible for Medicare starting January 1, 2020.
◍ Mr. Kelly wants to know whether he is eligible to sign up for a Private
, fee-for-service (PFFS) plan. What questions would you need to ask to
determine his eligibility?.
Answer: You would need to ask Mr. Kelly if he is enrolled in Part A and
Part B and if he lives in the PFFS plan's service area.
◍ Mrs. Cantwell is enrolled in a prescription drug plan. She has heard about
something called True-Out-Pocket costs or "TrOOP" and asks you if any of
the following count toward reaching the catastrophic coverage phase. What
do you say?
I. Her annual PDP deductibleI
I. A drug manufacturer's discount for brand name drugs after her initial
coverage periodII
I. The off formulary drug her doctor prescribed but she pays for because the
plan denied her exception requestI
V. Her over-the-counter (OTC) allergy medication..
Answer: I and II only
◍ 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?.
Answer: 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.
◍ One of your clients, Lauren Nichols, has heard about a Medicare concept
from one of her neighbors called TrOO
P. She asks you to explain it. What do you say?.
Answer: TrOOP stands for true out-of-pocket expenses that count toward
the Medicare Part D catastrophic limit and include not only expenses paid
by a beneficiary but also in some instances drug manufacturer discounts.
◍ Mr. Wendt suffers from diabetes which has gotten progressively worse
SCRIPT 2026 QUESTIONS WITH
SOLUTIONS GRADED A+
◍ Mrs. Paterson is concerned about the deductibles and co-payments
associated with Original Medicare. What can you tell her about Medigap as
an option to address this concern?.
Answer: Medigap plans help beneficiaries cover Original Medicare benefits,
but they coordinate with Original Medicare coverage.
◍ To obtain Part B coverage, she must pay a standard monthly premium,
though it is higher for individuals with higher incomes..
Answer: Mrs. Gonzalez cannot purchase a Medigap plan that covers drugs,
but she could keep her Medigap policy and enroll in a Part D prescription
drug plan.
◍ Which of the following individuals is most likely to be eligible to enroll in a
Part D Plan?a.Guy, who has illegally crossed the Canadian border.b.Jose, a
grandfather who was granted asylum and has worked in the United States
for many years.Correct: Jose, having been granted asylum, is legally present
in the United States thus meeting one of the criteria for Part D
eligibility.c.Betsy, a grandmother from overseas who has overstayed her
visa.d.Helena, an overseas college student who has overstayed her visa..
Answer: Jose, a grandfather who was granted asylum and has worked in the
United States for many years.
◍ What impact, if any, have recent regulatory changes had on Medigap plans?.
Answer: b.The Part B deductible is no longer covered for individuals newly
eligible for Medicare starting January 1, 2020.
◍ Mr. Kelly wants to know whether he is eligible to sign up for a Private
, fee-for-service (PFFS) plan. What questions would you need to ask to
determine his eligibility?.
Answer: You would need to ask Mr. Kelly if he is enrolled in Part A and
Part B and if he lives in the PFFS plan's service area.
◍ Mrs. Cantwell is enrolled in a prescription drug plan. She has heard about
something called True-Out-Pocket costs or "TrOOP" and asks you if any of
the following count toward reaching the catastrophic coverage phase. What
do you say?
I. Her annual PDP deductibleI
I. A drug manufacturer's discount for brand name drugs after her initial
coverage periodII
I. The off formulary drug her doctor prescribed but she pays for because the
plan denied her exception requestI
V. Her over-the-counter (OTC) allergy medication..
Answer: I and II only
◍ 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?.
Answer: 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.
◍ One of your clients, Lauren Nichols, has heard about a Medicare concept
from one of her neighbors called TrOO
P. She asks you to explain it. What do you say?.
Answer: TrOOP stands for true out-of-pocket expenses that count toward
the Medicare Part D catastrophic limit and include not only expenses paid
by a beneficiary but also in some instances drug manufacturer discounts.
◍ Mr. Wendt suffers from diabetes which has gotten progressively worse
