12/14/23, 7:53 PM AHIP Final Exam Test Questions with answers
AHIP Final Exam Test Questions with answers
Mrs. West wears glasses and dentures and has enjoyed considerable pain relief from
arthritis through acupuncture. She is concerned about whether or not Medicare will cover
these items and services. What should you tell her?
- Medicare does not cover acupuncture, or, in general, glasses or dentures.
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?
- He could check with the manufacturers of his medications to see if they offer an
assistance program to help people with limited means 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.
Mr. Lombardi is interested in a Medicare Advantage (MA) PPO plan that you represent. It
is one of three plans operated by the same organization in Mr. Lombardi's area. The MA
PPO plan does not include drug coverage, but the other two plans do. Mr. Lombardi likes
the PPO plan that does not include drug coverage and intends to obtain his drug
coverage through a stand-alone Medicare prescription drug plan. What should you tell
him about this situation?
- He could enroll in one of the MA plans that include prescription drug coverage or a
Medigap plan and a stand-alone prescription drug plan, but he cannot enroll in the MA-
only PPO plan and a stand-alone prescription drug plan.
Mr. Torres has a small savings account. He would like to pay for his monthly Part D
premiums with an automatic monthly withdrawal from his savings account until it is
exhausted, and then have his premiums withheld from his Social Security check. What
should you tell him?
- In general, he must select a single Part D premium payment mechanism that will be
used throughout the year.
Agent Jennings makes a presentation on Medicare advertised as an educational event.
Agent Jennings distributes materials that are solely educational in nature. However, she
gives a brief presentation that mentions plan-specific premiums. Is this a prohibited
activity at an event that has been advertised as educational?
- Yes. When an event has been advertised as "educational," discussing plan-specific
premiums is impermissible.
Mrs. Mulcahy is concerned that she may not qualify for enrollment in a Medicare
prescription drug plan because, although she is entitled to Part A, she is not enrolled
under Medicare Part B. What should you tell her?
- Everyone who is entitled to Part A or enrolled under Part B is eligible to enroll in a
Medicare prescription drug plan. As long as Mrs. Mulcahy is entitled to Part A, she does
not need to enroll under Part B before enrolling in a prescription drug plan.
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, 12/14/23, 7:53 PM AHIP Final Exam Test Questions with answers
Mr. Jacob understands that there is a standard Medicare Part D prescription drug benefit,
but when he looks at information on various plans available in his area, he sees a wide
range in what they charge for deductibles, premiums and cost sharing. How can you
explain this to him?
- Medicare Part D drug plans may have different benefit structures, but on average, they
must all be at least as good as the standard model established by the government.
Ms. Moore 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?
- Medicare is a program for people age 65 or older and those under age 65 with certain
disabilities, end stage renal disease or Lou Gehrig's disease, so she will be eligible for
Medicare.
Agent Armstrong is employed by XYZ Agency, which is under contract with ABC Health
Plan, a Medicare Advantage (MA) plan that offers plans in multiple states. XYZ Agency
maintains a website marketing the MA plans with which it has contracts. Agent Armstrong
follows up with individuals who request more information about ABC MA plans via the
website and tries to persuade them to enroll in ABC plans. What statement best describes
the marketing and compliance rules that apply to Agent Armstrong?
- Agent Armstrong needs to be licensed and appointed in every state in which
beneficiaries to whom he markets ABC MA plans are located.
Mr. Schmidt would like to plan for retirement and has asked you what is covered under
Original Fee-for-Service (FFS) Medicare? What could you tell him?
- Part A, which covers hospital, skilled nursing facility, hospice and home health services
and Part B, which covers professional services such as those provided by a doctor are
covered under Original Medicare.
You are seeking to represent an individual Medicare Advantage plan and an individual
Part D plan in your state. You have completed the required training for each plan, but you
did not achieve a passing score on the tests that came after the training. What can you do
in this situation?
- You will not be able to represent any Medicare Advantage or Part D plan until you
complete the training and achieve an adequate score, although you will not have to take a
test if you exclusively market employer/union group plans and the companies do not
require testing.
Mr. Chen is enrolled in his employer's group health plan and will be retiring soon. He
would like to know his options since he has decided to drop his retiree coverage and is
eligible for Medicare. What should you tell him?
- Mr. Chen can disenroll from his employer-sponsored coverage to elect a Medicare
Advantage or Part D plan within 2 months of his disenrollment, but he should revaluate if
he really wants to drop his employer coverage.
Mr. Davis is 52 years old and has recently been diagnosed with end-stage renal disease
(ESRD) and will soon begin dialysis. He is wondering if he can obtain coverage under
Medicare. What should you tell him?
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AHIP Final Exam Test Questions with answers
Mrs. West wears glasses and dentures and has enjoyed considerable pain relief from
arthritis through acupuncture. She is concerned about whether or not Medicare will cover
these items and services. What should you tell her?
- Medicare does not cover acupuncture, or, in general, glasses or dentures.
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?
- He could check with the manufacturers of his medications to see if they offer an
assistance program to help people with limited means 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.
Mr. Lombardi is interested in a Medicare Advantage (MA) PPO plan that you represent. It
is one of three plans operated by the same organization in Mr. Lombardi's area. The MA
PPO plan does not include drug coverage, but the other two plans do. Mr. Lombardi likes
the PPO plan that does not include drug coverage and intends to obtain his drug
coverage through a stand-alone Medicare prescription drug plan. What should you tell
him about this situation?
- He could enroll in one of the MA plans that include prescription drug coverage or a
Medigap plan and a stand-alone prescription drug plan, but he cannot enroll in the MA-
only PPO plan and a stand-alone prescription drug plan.
Mr. Torres has a small savings account. He would like to pay for his monthly Part D
premiums with an automatic monthly withdrawal from his savings account until it is
exhausted, and then have his premiums withheld from his Social Security check. What
should you tell him?
- In general, he must select a single Part D premium payment mechanism that will be
used throughout the year.
Agent Jennings makes a presentation on Medicare advertised as an educational event.
Agent Jennings distributes materials that are solely educational in nature. However, she
gives a brief presentation that mentions plan-specific premiums. Is this a prohibited
activity at an event that has been advertised as educational?
- Yes. When an event has been advertised as "educational," discussing plan-specific
premiums is impermissible.
Mrs. Mulcahy is concerned that she may not qualify for enrollment in a Medicare
prescription drug plan because, although she is entitled to Part A, she is not enrolled
under Medicare Part B. What should you tell her?
- Everyone who is entitled to Part A or enrolled under Part B is eligible to enroll in a
Medicare prescription drug plan. As long as Mrs. Mulcahy is entitled to Part A, she does
not need to enroll under Part B before enrolling in a prescription drug plan.
about:blank 1/11
, 12/14/23, 7:53 PM AHIP Final Exam Test Questions with answers
Mr. Jacob understands that there is a standard Medicare Part D prescription drug benefit,
but when he looks at information on various plans available in his area, he sees a wide
range in what they charge for deductibles, premiums and cost sharing. How can you
explain this to him?
- Medicare Part D drug plans may have different benefit structures, but on average, they
must all be at least as good as the standard model established by the government.
Ms. Moore 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?
- Medicare is a program for people age 65 or older and those under age 65 with certain
disabilities, end stage renal disease or Lou Gehrig's disease, so she will be eligible for
Medicare.
Agent Armstrong is employed by XYZ Agency, which is under contract with ABC Health
Plan, a Medicare Advantage (MA) plan that offers plans in multiple states. XYZ Agency
maintains a website marketing the MA plans with which it has contracts. Agent Armstrong
follows up with individuals who request more information about ABC MA plans via the
website and tries to persuade them to enroll in ABC plans. What statement best describes
the marketing and compliance rules that apply to Agent Armstrong?
- Agent Armstrong needs to be licensed and appointed in every state in which
beneficiaries to whom he markets ABC MA plans are located.
Mr. Schmidt would like to plan for retirement and has asked you what is covered under
Original Fee-for-Service (FFS) Medicare? What could you tell him?
- Part A, which covers hospital, skilled nursing facility, hospice and home health services
and Part B, which covers professional services such as those provided by a doctor are
covered under Original Medicare.
You are seeking to represent an individual Medicare Advantage plan and an individual
Part D plan in your state. You have completed the required training for each plan, but you
did not achieve a passing score on the tests that came after the training. What can you do
in this situation?
- You will not be able to represent any Medicare Advantage or Part D plan until you
complete the training and achieve an adequate score, although you will not have to take a
test if you exclusively market employer/union group plans and the companies do not
require testing.
Mr. Chen is enrolled in his employer's group health plan and will be retiring soon. He
would like to know his options since he has decided to drop his retiree coverage and is
eligible for Medicare. What should you tell him?
- Mr. Chen can disenroll from his employer-sponsored coverage to elect a Medicare
Advantage or Part D plan within 2 months of his disenrollment, but he should revaluate if
he really wants to drop his employer coverage.
Mr. Davis is 52 years old and has recently been diagnosed with end-stage renal disease
(ESRD) and will soon begin dialysis. He is wondering if he can obtain coverage under
Medicare. What should you tell him?
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