AHIP Final Exam Test Questions
1. 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.
2. 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.
3. 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
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,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.
4.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.
5. Agent Jennings makes a presentation on Medicare
advertised as an ed- ucational event. Agent Jennings
distributes materials that are solely edu- cational 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.
6. 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
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, 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.
7. Mr. Jacob understands that there is a standard Medicare Part
D prescrip- tion 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.
8. 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.
9. 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.
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1. 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.
2. 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.
3. 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
1/8
,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.
4.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.
5. Agent Jennings makes a presentation on Medicare
advertised as an ed- ucational event. Agent Jennings
distributes materials that are solely edu- cational 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.
6. 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
2/8
, 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.
7. Mr. Jacob understands that there is a standard Medicare Part
D prescrip- tion 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.
8. 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.
9. 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.
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