AHIP CERTIFICATION
TEST2022/2023(PRACTICE QUESTIONS AND
ANSWERS)
Mrs. Chou likes a PFFS plan available in her area that does not offer drug coverage. She wants to enroll
in the plan and enroll in a stand-alone prescription drug plan. What should you tell her? (correct
answers)She could enroll in a PFFS plan and a stand-alone Medicare prescription drug plan.
Mrs. Geisler's neighbor told her she should look at her Part D options during the annual Medicare
enrollment period because features of Part D might have changed. Mrs. Geisler can't remember what
Part D is so she called you to ask what her neighbor was talking about. What could you tell her? (correct
answers)Part D covers prescription drugs and she should look at her premiums, formulary and cost-
sharing among other factors to see if they have changed.
Mr. Moreno invited his neighbor, Agent Tom Smith, to discuss Medicare Advantage (MA) and Part D
plans that Agent Smith sells at the regular Tuesday brunch the neighbors have for senior citizens. What
should Agent Smith tell Mr. Moreno about the kinds of food that can be provided to potential enrollees
who attend the sales presentation? (correct answers)A meal cannot be provided, but light snacks would
be permitted.
Mr. Rainey is experiencing paranoid delusions and his physician feels that he should be hospitalized.
What should you tell Mr. Rainey (or his representative) about the length of an inpatient psychiatric
hospital stay that Medicare will cover? (correct answers)Medicare will cover a total of 190 days of
inpatient psychiatric care during Mr. Rainey's entire lifetime.
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? (correct answers)He could check with the
manufacturers of his medications to see if they offer an assistance program to help people with limited
means to obtain the medications they need. Alternately, he could check to see whether his state has a
pharmacy assistance program to help him with expenses.
Mr. Wong is a single individual. He has a successful business career and is now able to retire with a
comfortable income. Mr. Wong's taxable income is in excess of $80,000. Mr. Wong has health coverage
through his employer but will sign-up for Medicare Part A, Part B and Part D when he leaves the
workforce. How would you advise him as he budgets for Medicare premiums? (correct answers)Due to
his participation in the workforce he will not have to pay a premium for Part A but he will pay higher
premiums for Part B and Part D due to the amount of his income.
During an appointment scheduled to discuss a Medicare Advantage Prescription Drug plan (MA-PD), Mr.
Peters asked his agent to describe a stand-alone prescription drug plan (Part D plan) that his neighbor
, told him about. What should his agent do? (correct answers)Since Mr. Peters requested a description of
the Part D plan, his agent must have Mr. Peters sign a new scope of appointment form that includes Part
D, and then the agent may discuss the Part D plan so Mr. Peters can compare plans and make an
informed enrollment choice during the appointment.
By contacting plans available in your area, you have learned that the plan you represent has a
significantly lower monthly premium than the others. Furthermore, you see that the plan you represent
has a unique benefit package. What should you do to make sure your clients know about these pieces of
information? (correct answers)You may make comparisons between plans if you can support them by
studies or statistical data and such comparisons are factually based.
Mrs. Fields wants to know whether applying for the Part D low income subsidy will be worth the time to
fill out the paperwork. What could you tell her? (correct answers)The Part D low income subsidy could
substantially lower her overall costs. She can apply by contacting her state Medicaid office or calling the
Social Security Administration.
Mr. Decaro has looked a Medicare prescription drug plans available in his area and noted a wide range
in premiums. He thought that all drug plans were required to offer the same standard benefits and
would like you to explain why there is such a range in premiums. What should you tell him? (correct
answers)Some prescription drug plans may have higher operating costs and/or may offer enhanced
coverage in return for an additional premium amount. He could look at plan designs to see if one of the
enhanced plans would serve his needs better than a plan based on the standard design.
Mrs. Wellington is enrolled in Parts A and B of Original Medicare. A friend recently told her that there is
an excellent Medicare Advantage (MA) plan with a five-star rating serving her area. On January 5 she
comes to you for advise as to what options, if any, she has. What should you say regarding special
enrollment periods (SEPs)? (correct answers)Mrs. Wellington is eligible for a SEP that may be used once
until November 30 to enroll in the five-star plan.
Mr. Landry is approaching his 65th birthday. He has signed up for Medicare Part A, but he did not enroll
in Part B because he has employer-sponsored coverage and intends to keep working for several more
years. But he is considering enrolling in Part D prescription drug coverage because he believes it is
superior to his employer plan. How would you advise him? (correct answers)Mr. Landry is eligible for
Part D since he has Part A, and his initial enrollment period (IEP) for Part D will continue for three
months after his 65th birthday.
Ms. Gates is dually eligible for Medicare and Medicaid. She is very concerned about being locked into a
specific Medicare prescription drug plan for the entire year. what should you tell her? (correct
answers)Individuals who are enrolled in Medicaid can change their Part D plans throughout the year, so
if she is not satisfied with her prescription drug plan, she can change to a different Part D plan. (NOTE:
On the AHIP test this is the best answer. However, She can change once per quarter for the first 9
months of the year)
TEST2022/2023(PRACTICE QUESTIONS AND
ANSWERS)
Mrs. Chou likes a PFFS plan available in her area that does not offer drug coverage. She wants to enroll
in the plan and enroll in a stand-alone prescription drug plan. What should you tell her? (correct
answers)She could enroll in a PFFS plan and a stand-alone Medicare prescription drug plan.
Mrs. Geisler's neighbor told her she should look at her Part D options during the annual Medicare
enrollment period because features of Part D might have changed. Mrs. Geisler can't remember what
Part D is so she called you to ask what her neighbor was talking about. What could you tell her? (correct
answers)Part D covers prescription drugs and she should look at her premiums, formulary and cost-
sharing among other factors to see if they have changed.
Mr. Moreno invited his neighbor, Agent Tom Smith, to discuss Medicare Advantage (MA) and Part D
plans that Agent Smith sells at the regular Tuesday brunch the neighbors have for senior citizens. What
should Agent Smith tell Mr. Moreno about the kinds of food that can be provided to potential enrollees
who attend the sales presentation? (correct answers)A meal cannot be provided, but light snacks would
be permitted.
Mr. Rainey is experiencing paranoid delusions and his physician feels that he should be hospitalized.
What should you tell Mr. Rainey (or his representative) about the length of an inpatient psychiatric
hospital stay that Medicare will cover? (correct answers)Medicare will cover a total of 190 days of
inpatient psychiatric care during Mr. Rainey's entire lifetime.
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? (correct answers)He could check with the
manufacturers of his medications to see if they offer an assistance program to help people with limited
means to obtain the medications they need. Alternately, he could check to see whether his state has a
pharmacy assistance program to help him with expenses.
Mr. Wong is a single individual. He has a successful business career and is now able to retire with a
comfortable income. Mr. Wong's taxable income is in excess of $80,000. Mr. Wong has health coverage
through his employer but will sign-up for Medicare Part A, Part B and Part D when he leaves the
workforce. How would you advise him as he budgets for Medicare premiums? (correct answers)Due to
his participation in the workforce he will not have to pay a premium for Part A but he will pay higher
premiums for Part B and Part D due to the amount of his income.
During an appointment scheduled to discuss a Medicare Advantage Prescription Drug plan (MA-PD), Mr.
Peters asked his agent to describe a stand-alone prescription drug plan (Part D plan) that his neighbor
, told him about. What should his agent do? (correct answers)Since Mr. Peters requested a description of
the Part D plan, his agent must have Mr. Peters sign a new scope of appointment form that includes Part
D, and then the agent may discuss the Part D plan so Mr. Peters can compare plans and make an
informed enrollment choice during the appointment.
By contacting plans available in your area, you have learned that the plan you represent has a
significantly lower monthly premium than the others. Furthermore, you see that the plan you represent
has a unique benefit package. What should you do to make sure your clients know about these pieces of
information? (correct answers)You may make comparisons between plans if you can support them by
studies or statistical data and such comparisons are factually based.
Mrs. Fields wants to know whether applying for the Part D low income subsidy will be worth the time to
fill out the paperwork. What could you tell her? (correct answers)The Part D low income subsidy could
substantially lower her overall costs. She can apply by contacting her state Medicaid office or calling the
Social Security Administration.
Mr. Decaro has looked a Medicare prescription drug plans available in his area and noted a wide range
in premiums. He thought that all drug plans were required to offer the same standard benefits and
would like you to explain why there is such a range in premiums. What should you tell him? (correct
answers)Some prescription drug plans may have higher operating costs and/or may offer enhanced
coverage in return for an additional premium amount. He could look at plan designs to see if one of the
enhanced plans would serve his needs better than a plan based on the standard design.
Mrs. Wellington is enrolled in Parts A and B of Original Medicare. A friend recently told her that there is
an excellent Medicare Advantage (MA) plan with a five-star rating serving her area. On January 5 she
comes to you for advise as to what options, if any, she has. What should you say regarding special
enrollment periods (SEPs)? (correct answers)Mrs. Wellington is eligible for a SEP that may be used once
until November 30 to enroll in the five-star plan.
Mr. Landry is approaching his 65th birthday. He has signed up for Medicare Part A, but he did not enroll
in Part B because he has employer-sponsored coverage and intends to keep working for several more
years. But he is considering enrolling in Part D prescription drug coverage because he believes it is
superior to his employer plan. How would you advise him? (correct answers)Mr. Landry is eligible for
Part D since he has Part A, and his initial enrollment period (IEP) for Part D will continue for three
months after his 65th birthday.
Ms. Gates is dually eligible for Medicare and Medicaid. She is very concerned about being locked into a
specific Medicare prescription drug plan for the entire year. what should you tell her? (correct
answers)Individuals who are enrolled in Medicaid can change their Part D plans throughout the year, so
if she is not satisfied with her prescription drug plan, she can change to a different Part D plan. (NOTE:
On the AHIP test this is the best answer. However, She can change once per quarter for the first 9
months of the year)
