2023 UPDATED NEW AHIP Certification/ AHIP
2023 Final Exam Answers Latest Versions
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? --------- Correct
Answer --------- 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.
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? --------- Correct Answer --------- He may sign-up for
Medicare at any time however coverage usually begins on the fourth month after
dialysis treatments start.
Mr. Johannsen is entitled to Medicare Part A and Part B. He gains the Part D low-
income subsidy. How does that affect his ability to enroll or disenroll in a Part D plan? ---
------ Correct Answer --------- He qualifies for a special election period and can enroll in
or disenroll from a Part D plan once during that period.
Mr. Lopez, who is fairly well-off financially, would like to enroll in a Medicare prescription
drug plan you represent and simply give you a check to cover his premiums for the
entire year. What should you tell him? --------- Correct Answer --------- Enrollees should
pay using automatic withdrawal from a bank account or credit or debit card, direct
monthly billing from the plan, or deductions from their Social Security check.
You have approached a hospital administrator about marketing in her facility. The
administrator is uncomfortable with the suggestion. How could you address her
concerns? --------- Correct Answer --------- Tell her that Medicare guidelines allow you to
conduct marketing activities in common areas of a provider's facility.
You have come to Mrs. Midler's home for a sales presentation. At the beginning of the
presentation, Mrs. Midler tells you that she has a copy of her medical record available
because she thinks this will help you understand her needs. She suggests that you will
know which questions to ask her about her health status in order to best assist her in
selecting a plan. What should you do? --------- Correct Answer --------- You can only ask
Mrs. Midler questions about conditions that affect eligibility, specifically, whether she
has end stage renal disease or one of the conditions that would qualify her for a special
needs plan.
Mrs. Reeves is newly eligible to enroll in a Medicare Advantage plan and her MA Initial
Coverage Election Period (ICEP) has just begun. Which of the following can she not do
during the ICEP? --------- Correct Answer --------- She can enroll in a Medigap plan to
supplement the benefits of the MA plan that she's also enrolling in.
, Mrs. Chi is age 75 and enjoys a comfortable but not extremely high-income level. She
wishes to enroll in a MA MSA plan that she heard about from her neighbor. She also
wants to have prescription drug coverage since her doctor recently prescribed several
expensive medications. Currently, she is enrolled in Original Medicare and a standalone
Part D plan. How would you advise Mrs. Chi? --------- Correct Answer --------- Mrs. Chi
may enroll in a MS MSA plan and remain in her current standalone Part D prescription
drug plan.
Alice is enrolled in a MA-PD plan. She makes a permanent move across the country
and wonders what her options are for continuing MA-PD coverage. What would you say
to her in regard to a special enrollment period (SEP)? --------- Correct Answer ---------
She is likely to qualify for a SEP. She can choose an effective date of up to three
months after the month in which the enrollment form is received by the new plan, but
the effective date may not be earlier than the date of her permanent move.
Which of the following individuals is most likely to be eligible to enroll in a part d plan? --
------- Correct Answer --------- Jose, a grandfather who was granted asylum and has
worked in the United States for many years.
When Myra first became eligible for Medicare, she enrolled in Original Medicare (Parts
A and B). She is now 67 and will turn 68 on July 1. She would now like to enroll in a
Medicare Advantage (MA) plan and approaches you about her options. What advice
would you give her? --------- Correct Answer --------- She should remain in Original
Medicare until the annual election period running from October 15 to December 7,
during which she can select an MA plan.
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? --------- Correct Answer --------
- 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? --------- Correct Answer --------- 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? --------- Correct Answer --------- He could enroll in one of the
2023 Final Exam Answers Latest Versions
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? --------- Correct
Answer --------- 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.
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? --------- Correct Answer --------- He may sign-up for
Medicare at any time however coverage usually begins on the fourth month after
dialysis treatments start.
Mr. Johannsen is entitled to Medicare Part A and Part B. He gains the Part D low-
income subsidy. How does that affect his ability to enroll or disenroll in a Part D plan? ---
------ Correct Answer --------- He qualifies for a special election period and can enroll in
or disenroll from a Part D plan once during that period.
Mr. Lopez, who is fairly well-off financially, would like to enroll in a Medicare prescription
drug plan you represent and simply give you a check to cover his premiums for the
entire year. What should you tell him? --------- Correct Answer --------- Enrollees should
pay using automatic withdrawal from a bank account or credit or debit card, direct
monthly billing from the plan, or deductions from their Social Security check.
You have approached a hospital administrator about marketing in her facility. The
administrator is uncomfortable with the suggestion. How could you address her
concerns? --------- Correct Answer --------- Tell her that Medicare guidelines allow you to
conduct marketing activities in common areas of a provider's facility.
You have come to Mrs. Midler's home for a sales presentation. At the beginning of the
presentation, Mrs. Midler tells you that she has a copy of her medical record available
because she thinks this will help you understand her needs. She suggests that you will
know which questions to ask her about her health status in order to best assist her in
selecting a plan. What should you do? --------- Correct Answer --------- You can only ask
Mrs. Midler questions about conditions that affect eligibility, specifically, whether she
has end stage renal disease or one of the conditions that would qualify her for a special
needs plan.
Mrs. Reeves is newly eligible to enroll in a Medicare Advantage plan and her MA Initial
Coverage Election Period (ICEP) has just begun. Which of the following can she not do
during the ICEP? --------- Correct Answer --------- She can enroll in a Medigap plan to
supplement the benefits of the MA plan that she's also enrolling in.
, Mrs. Chi is age 75 and enjoys a comfortable but not extremely high-income level. She
wishes to enroll in a MA MSA plan that she heard about from her neighbor. She also
wants to have prescription drug coverage since her doctor recently prescribed several
expensive medications. Currently, she is enrolled in Original Medicare and a standalone
Part D plan. How would you advise Mrs. Chi? --------- Correct Answer --------- Mrs. Chi
may enroll in a MS MSA plan and remain in her current standalone Part D prescription
drug plan.
Alice is enrolled in a MA-PD plan. She makes a permanent move across the country
and wonders what her options are for continuing MA-PD coverage. What would you say
to her in regard to a special enrollment period (SEP)? --------- Correct Answer ---------
She is likely to qualify for a SEP. She can choose an effective date of up to three
months after the month in which the enrollment form is received by the new plan, but
the effective date may not be earlier than the date of her permanent move.
Which of the following individuals is most likely to be eligible to enroll in a part d plan? --
------- Correct Answer --------- Jose, a grandfather who was granted asylum and has
worked in the United States for many years.
When Myra first became eligible for Medicare, she enrolled in Original Medicare (Parts
A and B). She is now 67 and will turn 68 on July 1. She would now like to enroll in a
Medicare Advantage (MA) plan and approaches you about her options. What advice
would you give her? --------- Correct Answer --------- She should remain in Original
Medicare until the annual election period running from October 15 to December 7,
during which she can select an MA plan.
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? --------- Correct Answer --------
- 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? --------- Correct Answer --------- 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? --------- Correct Answer --------- He could enroll in one of the
