Updated New AHIP Certification/ AHIP
2023 Final Exam with Accurate Answers/
AHIP Exam 2023-2024 Rated A+
Agent Willis had several clients who disenrolled from the plans he represents during the
AEP to try new Medicare Advantage plans. Agent Willis believes that the choices they
made are not ideal for them and would like to get their business back during the
Medicare Advantage Open Enrollment Period (MA-OEP). What can agent Willis do? ----
---- Correct Answer --------- He can wait until October and send them information about
the plans he represents.
Mr. Greco is in excellent health, lives in his own home, and has a sizeable income from
his investments. He has a friend enrolled in a Medicare Advantage Special Needs Plan
(SNP). His friend has mentioned that the SNP charges very low cost-sharing amounts
and Mr. Greco would like to join that plan. What should you tell him? -------- Correct
Answer --------- SNPs limit enrollment to certain sub populations of beneficiaries. Given
his current situation, he is unlikely to qualify and would not be able to enroll in the SNP.
Mrs. Patterson is a new enrollee in the HealthBest Medicare Advantage (MA-PD) plan.
She is new to this type of coverage and asks you what materials, if any, she should
expect to receive. How would you reply? -------- Correct Answer --------- 1. Plan ratings
information, summary of benefits, and pre-enrollment checklist
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? -------- Correct Answer --------- 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.
Another agent working for your agency claims that because you are not employed by
the Medicare Advantage plans that you represent, you are not subject to the same
requirements as the plans themselves. How should you respond to such a statement? --
------ Correct Answer --------- Your coworker is not correct. Marketing on behalf of a plan
is considered marketing by the plan and requires that all contracted and employed
agents comply with all Medicare marketing rules.
This year you have decided to focus your efforts on marketing to employer group plans.
One employer provides you with a list of their retirees and asks you to contact them to
explain the characteristics of the plan they have selected. What should you do? --------
Correct Answer --------- You may go ahead and call them.
, Mr. Patel is in good health and is preparing a budget in anticipation of his retirement
when he turns 66. He wants to understand the health care costs he might be exposed to
under Medicare if he were to require hospitalization as a result of an illness. In general
terms, what could you tell him about his costs for inpatient hospital services under
Original Medicare? -------- Correct Answer --------- Under Original Medicare, there is a
single deductible amount due for the first 60 days of any inpatient hospital stay, after
which it converts into a per-day amount through day 90. After day 90, he would pay a
daily amount up to 60 days over his lifetime, after which he would be
responsible for all costs
Which of the following statements about Medicare Part D are correct?
I. Part D plans must enroll any eligible beneficiary who applies regardless of health
status except in limited circumstances.
II. Private fee-for-service (PFFS) plans are not required to use a pharmacy network but
may choose to have one.
III. Beneficiaries enrolled in a MA-Medical Savings Account (MSA) plan may only obtain
Part D benefits through a standalone PDP.
IV. Beneficiaries enrolled in a MA-PPO may obtain Part D benefits through a standalone
PDP or through their plan. -------- Correct Answer --------- I, II AND III ONLY
Mr. Albert has heard about something called the Star Rating system for Medicare
Advantage plans. He asks you to explain it to him since he is interested in enrolling in a
plan that is newly available in his area. After you explain that it is the way for consumers
to judge plan performance, what else would you say? -------- Correct Answer ---------
??????
Beneficiaries who live in the service area of a 5-star plan and are enrolled in an MA or
PDP plan, or beginning in 2013, a Cost plan
Beneficiaries who live in the service area of a 5-star plan, are enrolled in Original
Medicare, and meet the eligibility requirements for Medicare Advantage or Part D plans
The SEP is available each year beginning on December 8 and may be used once
through November 30 of the following year. For example, the SEP for calendar year
2018 can be
used from December 8, 2017 through November 30, 2018.
Disenroll from an MA plan, PDP or Cost plan or
leave Original Medicare
Enroll in a 5-star MA plan, PDP or Cost plan
Eligible individuals may enroll in a 5-star plan
through 1-800-MEDICARE, Medicare.gov, or
directly through the 5-star plan.
Mr. Davies is turning 65 next month. He would like to enroll in a Medicare health plan,
but does not want to be limited in terms of where he obtains his care. What should you
tell him about how a Medicare Cost Plan might fit his needs? -------- Correct Answer -----
---- Cost plan enrollees can choose to receive Medicare covered services under the
2023 Final Exam with Accurate Answers/
AHIP Exam 2023-2024 Rated A+
Agent Willis had several clients who disenrolled from the plans he represents during the
AEP to try new Medicare Advantage plans. Agent Willis believes that the choices they
made are not ideal for them and would like to get their business back during the
Medicare Advantage Open Enrollment Period (MA-OEP). What can agent Willis do? ----
---- Correct Answer --------- He can wait until October and send them information about
the plans he represents.
Mr. Greco is in excellent health, lives in his own home, and has a sizeable income from
his investments. He has a friend enrolled in a Medicare Advantage Special Needs Plan
(SNP). His friend has mentioned that the SNP charges very low cost-sharing amounts
and Mr. Greco would like to join that plan. What should you tell him? -------- Correct
Answer --------- SNPs limit enrollment to certain sub populations of beneficiaries. Given
his current situation, he is unlikely to qualify and would not be able to enroll in the SNP.
Mrs. Patterson is a new enrollee in the HealthBest Medicare Advantage (MA-PD) plan.
She is new to this type of coverage and asks you what materials, if any, she should
expect to receive. How would you reply? -------- Correct Answer --------- 1. Plan ratings
information, summary of benefits, and pre-enrollment checklist
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? -------- Correct Answer --------- 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.
Another agent working for your agency claims that because you are not employed by
the Medicare Advantage plans that you represent, you are not subject to the same
requirements as the plans themselves. How should you respond to such a statement? --
------ Correct Answer --------- Your coworker is not correct. Marketing on behalf of a plan
is considered marketing by the plan and requires that all contracted and employed
agents comply with all Medicare marketing rules.
This year you have decided to focus your efforts on marketing to employer group plans.
One employer provides you with a list of their retirees and asks you to contact them to
explain the characteristics of the plan they have selected. What should you do? --------
Correct Answer --------- You may go ahead and call them.
, Mr. Patel is in good health and is preparing a budget in anticipation of his retirement
when he turns 66. He wants to understand the health care costs he might be exposed to
under Medicare if he were to require hospitalization as a result of an illness. In general
terms, what could you tell him about his costs for inpatient hospital services under
Original Medicare? -------- Correct Answer --------- Under Original Medicare, there is a
single deductible amount due for the first 60 days of any inpatient hospital stay, after
which it converts into a per-day amount through day 90. After day 90, he would pay a
daily amount up to 60 days over his lifetime, after which he would be
responsible for all costs
Which of the following statements about Medicare Part D are correct?
I. Part D plans must enroll any eligible beneficiary who applies regardless of health
status except in limited circumstances.
II. Private fee-for-service (PFFS) plans are not required to use a pharmacy network but
may choose to have one.
III. Beneficiaries enrolled in a MA-Medical Savings Account (MSA) plan may only obtain
Part D benefits through a standalone PDP.
IV. Beneficiaries enrolled in a MA-PPO may obtain Part D benefits through a standalone
PDP or through their plan. -------- Correct Answer --------- I, II AND III ONLY
Mr. Albert has heard about something called the Star Rating system for Medicare
Advantage plans. He asks you to explain it to him since he is interested in enrolling in a
plan that is newly available in his area. After you explain that it is the way for consumers
to judge plan performance, what else would you say? -------- Correct Answer ---------
??????
Beneficiaries who live in the service area of a 5-star plan and are enrolled in an MA or
PDP plan, or beginning in 2013, a Cost plan
Beneficiaries who live in the service area of a 5-star plan, are enrolled in Original
Medicare, and meet the eligibility requirements for Medicare Advantage or Part D plans
The SEP is available each year beginning on December 8 and may be used once
through November 30 of the following year. For example, the SEP for calendar year
2018 can be
used from December 8, 2017 through November 30, 2018.
Disenroll from an MA plan, PDP or Cost plan or
leave Original Medicare
Enroll in a 5-star MA plan, PDP or Cost plan
Eligible individuals may enroll in a 5-star plan
through 1-800-MEDICARE, Medicare.gov, or
directly through the 5-star plan.
Mr. Davies is turning 65 next month. He would like to enroll in a Medicare health plan,
but does not want to be limited in terms of where he obtains his care. What should you
tell him about how a Medicare Cost Plan might fit his needs? -------- Correct Answer -----
---- Cost plan enrollees can choose to receive Medicare covered services under the
