AHIP MODULES 1-5 LATEST 2026/2027
ALL STUDY QUESTIONS WITH
VERIFIED ANSWERS GUARANTEED
PASS | ASSURED A+
,AHIP MODULES 1-5 LATEST 2026/2027 ALL STUDY
QUESTIONS WITH VERIFIED ANSWERS
GUARANTEED PASS | ASSURED A+
Agent Mendez wishes to solicit Medicare Advantage prospects through e-mail and asks you for
advice as to whether this is possible. What should you tell her? - Answer>>> Marketing
representatives may initiate electronic contact through e-mail but an opt-out process must be
provided.
Ms. Ramos is enrolled in a Medicare Advantage plan that includes prescription drug plan (PDP)
coverage. She is traveling and wishes to fill two of the prescriptions that she has lost. How would
you advise her? - Answer>>> She may fill prescriptions for covered drugs at non-network
pharmacies, but likely at a higher cost than paid at an in-network pharmacy.
You have approached a hospital administrator about marketing in her facility. The administrator
is uncomfortable with the suggestion. How could you address her concerns? - Answer>>> Tell
her that Medicare guidelines allow you to conduct marketing activities in common areas of a
provider's facility.
Mrs. Sharma has Original Medicare and would like to enroll in a Private Fee-for-Service (PFFS)
plan. All types of PFFS plans are available in her area. Which options could Mrs. Sharma
consider before selecting a PFFS plan? - Answer>>> A Medicare Advantage Prescription Drug
(MA-PD) PFFS plan that combines medical benefits and Part D prescription drug coverage, a
PFFS plan offering only medical benefits, or a PFFS plan in combination with a stand-alone
prescription drug plan.
Mr. Dalton is in excellent health, lives in his own home, and has a sizeable income from his
investments. He has a friend enrolled in a Medicare Advantage Special Needs Plan (SNP). His
friend has mentioned that the SNP charges very low cost-sharing amounts and Mr. Dalton would
like to join that plan. What should you tell him? - Answer>>> SNPs limit enrollment to certain
subpopulations of beneficiaries. Given his current situation, he is unlikely to qualify and would
not be able to enroll in the SNP.
, Ms. Kumar plans to retire when she turns 65 in a few months. She is in excellent health and will
have considerable income when she retires. She is concerned that her income will make it
impossible for her to qualify for Medicare. What could you tell her to address her concern? -
Answer>>> Medicare is a program for people age 65 or older and those under age 65 with
certain disabilities, end-stage renal disease, and Lou Gehrig's disease so she will be eligible for
Medicare.
Henrietta Ross is an elderly individual enrolled in a fully integrated dual-eligible (FIDE) special
needs plan (SNP). Henrietta's daughter Gladys asks you to explain what a FIDE-SNP offers her
mother. What do you say? - Answer>>> FIDE-SNPs provide individuals access to Medicare and
Medicaid benefits under a single organization that has both a Medicare Advantage and Medicaid
managed care contract with CMS.
Mrs. Ellis recently turned 66 and decided after many years of work to retire and begin receiving
Social Security benefits. Shortly thereafter Mrs. Ellis received a letter informing her that she had
been automatically enrolled in Medicare Part B. She wants to understand what this means. What
should you tell Mrs. Ellis? - Answer>>> Part B primarily covers physician services. She will be
paying a monthly premium and, except for many preventive and screening tests, generally will
have 20% co-payments for these services, in addition to an annual deductible.
Dr. Elizabeth Morgan does not contract with the ABC PFFS plan but accepts the plan's terms and
conditions for payment. Mary Rodgers sees Dr. Morgan for treatment. How much may Dr.
Morgan charge? - Answer>>> Dr. Morgan can charge Mary Rogers no more than the cost
sharing specified in the PFFS plan's terms and condition of payment which may include balance
billing up to 15% of the Medicare rate.
Mr. Pham is a Qualified Medicare Beneficiary (QMB). He enrolls in a Medicare Advantage
HMO. Shortly thereafter, Mr. Pham visits his primary care provider (PCP), Dr. Maria Sanchez.
Mr. Pham complains of a bad cold and receives care - a Medicare-covered service. The normal
copayment is $40. How much may Dr. Sanchez collects? - Answer>>> The minimal copayment
that would apply under Medicaid, regardless of what the plan requires of other enrollees.
Mr. Singh would like drug coverage but does not want to be enrolled in a Medicare Advantage
plan. What should you tell him? - Answer>>> Mr. Singh can enroll in a stand-alone prescription
ALL STUDY QUESTIONS WITH
VERIFIED ANSWERS GUARANTEED
PASS | ASSURED A+
,AHIP MODULES 1-5 LATEST 2026/2027 ALL STUDY
QUESTIONS WITH VERIFIED ANSWERS
GUARANTEED PASS | ASSURED A+
Agent Mendez wishes to solicit Medicare Advantage prospects through e-mail and asks you for
advice as to whether this is possible. What should you tell her? - Answer>>> Marketing
representatives may initiate electronic contact through e-mail but an opt-out process must be
provided.
Ms. Ramos is enrolled in a Medicare Advantage plan that includes prescription drug plan (PDP)
coverage. She is traveling and wishes to fill two of the prescriptions that she has lost. How would
you advise her? - Answer>>> She may fill prescriptions for covered drugs at non-network
pharmacies, but likely at a higher cost than paid at an in-network pharmacy.
You have approached a hospital administrator about marketing in her facility. The administrator
is uncomfortable with the suggestion. How could you address her concerns? - Answer>>> Tell
her that Medicare guidelines allow you to conduct marketing activities in common areas of a
provider's facility.
Mrs. Sharma has Original Medicare and would like to enroll in a Private Fee-for-Service (PFFS)
plan. All types of PFFS plans are available in her area. Which options could Mrs. Sharma
consider before selecting a PFFS plan? - Answer>>> A Medicare Advantage Prescription Drug
(MA-PD) PFFS plan that combines medical benefits and Part D prescription drug coverage, a
PFFS plan offering only medical benefits, or a PFFS plan in combination with a stand-alone
prescription drug plan.
Mr. Dalton is in excellent health, lives in his own home, and has a sizeable income from his
investments. He has a friend enrolled in a Medicare Advantage Special Needs Plan (SNP). His
friend has mentioned that the SNP charges very low cost-sharing amounts and Mr. Dalton would
like to join that plan. What should you tell him? - Answer>>> SNPs limit enrollment to certain
subpopulations of beneficiaries. Given his current situation, he is unlikely to qualify and would
not be able to enroll in the SNP.
, Ms. Kumar plans to retire when she turns 65 in a few months. She is in excellent health and will
have considerable income when she retires. She is concerned that her income will make it
impossible for her to qualify for Medicare. What could you tell her to address her concern? -
Answer>>> Medicare is a program for people age 65 or older and those under age 65 with
certain disabilities, end-stage renal disease, and Lou Gehrig's disease so she will be eligible for
Medicare.
Henrietta Ross is an elderly individual enrolled in a fully integrated dual-eligible (FIDE) special
needs plan (SNP). Henrietta's daughter Gladys asks you to explain what a FIDE-SNP offers her
mother. What do you say? - Answer>>> FIDE-SNPs provide individuals access to Medicare and
Medicaid benefits under a single organization that has both a Medicare Advantage and Medicaid
managed care contract with CMS.
Mrs. Ellis recently turned 66 and decided after many years of work to retire and begin receiving
Social Security benefits. Shortly thereafter Mrs. Ellis received a letter informing her that she had
been automatically enrolled in Medicare Part B. She wants to understand what this means. What
should you tell Mrs. Ellis? - Answer>>> Part B primarily covers physician services. She will be
paying a monthly premium and, except for many preventive and screening tests, generally will
have 20% co-payments for these services, in addition to an annual deductible.
Dr. Elizabeth Morgan does not contract with the ABC PFFS plan but accepts the plan's terms and
conditions for payment. Mary Rodgers sees Dr. Morgan for treatment. How much may Dr.
Morgan charge? - Answer>>> Dr. Morgan can charge Mary Rogers no more than the cost
sharing specified in the PFFS plan's terms and condition of payment which may include balance
billing up to 15% of the Medicare rate.
Mr. Pham is a Qualified Medicare Beneficiary (QMB). He enrolls in a Medicare Advantage
HMO. Shortly thereafter, Mr. Pham visits his primary care provider (PCP), Dr. Maria Sanchez.
Mr. Pham complains of a bad cold and receives care - a Medicare-covered service. The normal
copayment is $40. How much may Dr. Sanchez collects? - Answer>>> The minimal copayment
that would apply under Medicaid, regardless of what the plan requires of other enrollees.
Mr. Singh would like drug coverage but does not want to be enrolled in a Medicare Advantage
plan. What should you tell him? - Answer>>> Mr. Singh can enroll in a stand-alone prescription
