AHIP CERTIFICATION EXAM MODULE 5
2022/2023(COMPLETE QUESTIONS AND ANSWERS)
1.Mrs. Walters is entitled to Part A and has medical coverage without drug coverage through an
employer retiree plan. She is not enrolled in Part B. Since the employer plan does not cover prescription
drugs, she wants to enroll in a Medicare prescription drug plan. Will she be able to?
(correct answers)Yes. Mrs. Walters must be entitled to Part A or enrolled in Part B to be eligible for
coverage under the Medicare prescription drug program. Correct
2.Mr. Sanchez is entitled to Part A, but has not enrolled in Part B because he has coverage through an
employer plan. If he wants to enroll in a Medicare Advantage plan, what will he have to do?
(correct answers)He will have to enroll in Part B. Correct
3.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?
(correct answers)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. Correct
4.Mr. Gonzalez is entitled to Part A, but has not yet enrolled in Part B. If he wants to enroll in a Medicare
Advantage (MA) plan, what will he have to do?
(correct answers)He will have to enroll in Part B prior to enrolling in a MA plan. Correct
5.Mrs. Berkowitz wants to enroll in a Medicare Advantage plan that does not include drug coverage and
also enroll in a stand-alone Medicare prescription drug plan. Under what circumstances can she do this?
(correct answers)If the Medicare Advantage plan is a Private Fee-for-Service (PFFS) plan that does not
offer drug coverage or a Medical Savings Account, Mrs. Berkowitz can do this. Correct
6.Mrs. Roberts 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. Roberts consider before selecting
a PFFS plan?
(correct answers)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. Correct
7.Which of the following individuals is most likely to be eligible to enroll in a Medicare Advantage or Part
D Plan?
(correct answers)Jose, a grandfather who was granted asylum and has worked in the United States for
many years. Correct
, 8.Mr. and Mrs. Nunez attended one of your sales presentations. They've asked you to come to their
home to clear up a few questions. During the presentation, Mrs. Nunez feels tired and tells you that her
husband can finish things up. She goes to bed. At the end of your discussion, Mr. Nunez says that he
wants to enroll both himself and his wife. What should you do? (correct answers)d. As long as she is able
to do so, only Mrs. Nunez can sign her enrollment form. Mrs. Nunez will have to wake up to sign her
form or do so at another time. Correct
You are visiting with Mr. Tully and his daughter at her request. He has advanced Alzheimer's and is
incapable of understanding the implications of choosing a Medicare Advantage or prescription drug
plan. Can his daughter fill out the enrollment form and sign it for him? (correct answers)c. Mr. Tully's
daughter can do so only, if she is authorized under state law as a court-appointed legal guardian, has
durable power of attorney for health care decisions, or is authorized under state surrogate consent laws
to make health decisions. Correct
You are meeting with Ms. Berlin and she has completed an enrollment form for a MA-PD plan you
represent. You notice that her handwriting is illegible and as a result, the spelling of her street looks
incorrect. She asks you to fill in the corrected street name. What should you do? (correct answers)c. You
may correct this information as long as you add your initials and date next to the correction Correct
Phiona works in the IT Department of BestCare Health Plan. Phiona is placed in charge of BestCare's
efforts to facilitate electronic enrollment in its Medicare Advantage plans. In setting up the enrollment
site, which of the following must Phiona consider?
I. If a legal representative is completing an electronic enrollment request, he or she must first upload
proof of his or her authority.
II. All data elements required to complete an enrollment request must be captured.
III. The process must include a clear and distinct step that requires the applicant to activate an "Enroll
Now" or "I Agree" type of button or tool.
IV. The mechanism must capture an accurate time and date stamp at the time the applicant enters the
online site. (correct answers)b. II and III only Correct
Mr. Block is currently enrolled in a Medicare Advantage plan that includes drug coverage. He found a
stand-alone Medicare prescription drug plan in his area that offers better coverage than that available
through his MA-PD plan and in addition has a low premium. It won't cost him much more and, because
he has the means to do so, he wishes to enroll in the stand-alone prescription drug plan in addition to
his MA-PD plan. What should you tell him? (correct answers)c. If Mr. Block enrolls in the stand-alone
Medicare prescription drug plan, he will be disenrolled from the Medicare Advantage plan. Correct
2022/2023(COMPLETE QUESTIONS AND ANSWERS)
1.Mrs. Walters is entitled to Part A and has medical coverage without drug coverage through an
employer retiree plan. She is not enrolled in Part B. Since the employer plan does not cover prescription
drugs, she wants to enroll in a Medicare prescription drug plan. Will she be able to?
(correct answers)Yes. Mrs. Walters must be entitled to Part A or enrolled in Part B to be eligible for
coverage under the Medicare prescription drug program. Correct
2.Mr. Sanchez is entitled to Part A, but has not enrolled in Part B because he has coverage through an
employer plan. If he wants to enroll in a Medicare Advantage plan, what will he have to do?
(correct answers)He will have to enroll in Part B. Correct
3.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?
(correct answers)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. Correct
4.Mr. Gonzalez is entitled to Part A, but has not yet enrolled in Part B. If he wants to enroll in a Medicare
Advantage (MA) plan, what will he have to do?
(correct answers)He will have to enroll in Part B prior to enrolling in a MA plan. Correct
5.Mrs. Berkowitz wants to enroll in a Medicare Advantage plan that does not include drug coverage and
also enroll in a stand-alone Medicare prescription drug plan. Under what circumstances can she do this?
(correct answers)If the Medicare Advantage plan is a Private Fee-for-Service (PFFS) plan that does not
offer drug coverage or a Medical Savings Account, Mrs. Berkowitz can do this. Correct
6.Mrs. Roberts 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. Roberts consider before selecting
a PFFS plan?
(correct answers)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. Correct
7.Which of the following individuals is most likely to be eligible to enroll in a Medicare Advantage or Part
D Plan?
(correct answers)Jose, a grandfather who was granted asylum and has worked in the United States for
many years. Correct
, 8.Mr. and Mrs. Nunez attended one of your sales presentations. They've asked you to come to their
home to clear up a few questions. During the presentation, Mrs. Nunez feels tired and tells you that her
husband can finish things up. She goes to bed. At the end of your discussion, Mr. Nunez says that he
wants to enroll both himself and his wife. What should you do? (correct answers)d. As long as she is able
to do so, only Mrs. Nunez can sign her enrollment form. Mrs. Nunez will have to wake up to sign her
form or do so at another time. Correct
You are visiting with Mr. Tully and his daughter at her request. He has advanced Alzheimer's and is
incapable of understanding the implications of choosing a Medicare Advantage or prescription drug
plan. Can his daughter fill out the enrollment form and sign it for him? (correct answers)c. Mr. Tully's
daughter can do so only, if she is authorized under state law as a court-appointed legal guardian, has
durable power of attorney for health care decisions, or is authorized under state surrogate consent laws
to make health decisions. Correct
You are meeting with Ms. Berlin and she has completed an enrollment form for a MA-PD plan you
represent. You notice that her handwriting is illegible and as a result, the spelling of her street looks
incorrect. She asks you to fill in the corrected street name. What should you do? (correct answers)c. You
may correct this information as long as you add your initials and date next to the correction Correct
Phiona works in the IT Department of BestCare Health Plan. Phiona is placed in charge of BestCare's
efforts to facilitate electronic enrollment in its Medicare Advantage plans. In setting up the enrollment
site, which of the following must Phiona consider?
I. If a legal representative is completing an electronic enrollment request, he or she must first upload
proof of his or her authority.
II. All data elements required to complete an enrollment request must be captured.
III. The process must include a clear and distinct step that requires the applicant to activate an "Enroll
Now" or "I Agree" type of button or tool.
IV. The mechanism must capture an accurate time and date stamp at the time the applicant enters the
online site. (correct answers)b. II and III only Correct
Mr. Block is currently enrolled in a Medicare Advantage plan that includes drug coverage. He found a
stand-alone Medicare prescription drug plan in his area that offers better coverage than that available
through his MA-PD plan and in addition has a low premium. It won't cost him much more and, because
he has the means to do so, he wishes to enroll in the stand-alone prescription drug plan in addition to
his MA-PD plan. What should you tell him? (correct answers)c. If Mr. Block enrolls in the stand-alone
Medicare prescription drug plan, he will be disenrolled from the Medicare Advantage plan. Correct
