lOMoAR cPSD| 32635183
lOMoAR cPSD| 32635183
AHIP FINAL ACTUAL EXAM QUESTIONS AND CORRECT
ANSWERS 2023-2024 UPDATE ALREADY A GRADED WITH
EXPERT FEEDBACK |NEW!!
Final Exam - Attempt 1
1
Marks: 1 Which of the following is a correct statement about state laws as they pertain to marketing representatives?
Choose one a. Plans must contract only with marketing representatives who reside in the state where
answer. they intend to work.
b. State licensure laws are pre-empted and do not apply to marketing representatives
marketing MA and Part D plans
c. Plan sponsors can use any marketing representative, as long as they are licensed in at
least one state.
d. Medicare health plans must comply with requests for information from state insurance
departments investigating complaints about a marketing representative.
2
Marks: 1
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 Tom Smith tell
Mr. Moreno about the kinds of food that can be provided to potential enrollees who attend the sales presentation?
Choose one a. Any type of meal or food is allowed, as long as it is available to the general public and
answer. not just those who are eligible to enroll in the plans.
b. Any meal is allowed, as long as it is valued at less than $15.
c. A meal cannot be provided, but light snacks would be permitted.
d. Nothing may be provided to eat or drink during the sales presentation.
3
If a beneficiary is enrolled in a stand-alone prescription drug plan and wants to keep that plan, what type of Medicare
Marks: 1
health plan could the individual also enroll in, without being automatically disenrolled from the stand-alone
prescription drug plan?
Choose one a. The beneficiary could only choose an 1876 Cost Plan.
answer.
b. The beneficiary could only choose a Medicare Medical Savings Account (MSA) plan.
c. The beneficiary could enroll in a private fee-for-service (PFFS) plan that does not
include prescription drug coverage; an 1876 cost plan; or a Medicare Medical Savings
Account (MSA) plan
d. The beneficiary could only stay in a stand-alone prescription drug plan if he or she has
original fee-for-service Medicare
4
Marks: 1 1/15
,lOMoAR cPSD| 32635183
2/15
, lOMoAR cPSD| 32635183
You are working with a number of plans and community organizations to sponsor an educational event. When
putting together advertisements for this event, what should you do?
Choose one a. Plans may not participate in advertising such an event. All advertising must be done by
answer. community organizations.
b. You must only ensure that the advertisement is factually accurate.
c. You must state in the advertisement that it will be an educational event and that the
education will consist of specific information about the participating plans.
d. You must ensure that the advertisements indicate it is an educational event, otherwise it
will be considered a marketing event.
5
Marks: 1
Mrs. Allen has a rare condition for which two different brand name drugs are the only available treatment. She is
concerned that since no generic prescription drug is available and these drugs are very high cost, she will not be
able to find a Medicare Part D prescription drug plan that covers either one of them. What should you tell her?
Choose one a. When medication costs exceed a certain threshold amount, which rises each year, a
answer. Medicare prescription drug plan is permitted to exclude coverage for all but the least
expensive of the medications in a given category. Mrs. Allen will need to encourage her
physician to prescribe the least expensive of the two alternatives.
b. Medicare prescription drug plans are required to cover drugs in each therapeutic
category. She should be able to enroll in a Medicare prescription drug plan that covers the
medications she needs.
c. Medicare prescription drug plans are required to include only a certain percentage of
brand name drugs among those they cover. It may be possible that plans available in her
area have opted not to include in their formularies the brand name drugs she needs. She
may need to pay for this particular medication out of pocket.
d. Medicare prescription drug plans are allowed to restrict their coverage to generic drugs.
She will need to pay for her brand name medications out of pocket.
6
Marks: 1 Able, Baker, and Charles are engaged in the marketing to and enrollment of beneficiaries into Medicare health
plans. Mr. Able is an independent agent paid directly by a health plan. Ms. Baker is an independent agent paid
through a field marketing organization (FMO). Mr. Charles is an independent agent paid for his work by a third-party
marketing organization (TMO). How do the CMS compensation rules apply to these three agents?
Choose one a. Able is subject to CMS compensation rules because he is paid directly by a health plan.
answer. Agents Baker and Charles are not because they are paid by third parties.
b. Charles is subject to CMS compliance rules because he works for a TMO and CMS
applies an extra layer of scrutiny to such organizations. Able and Baker are not.
c. All three are treated as independent agents under CMS compensation rules.
d. Baker and Charles are subject to CMS compensation rules because they are paid by
third parties. Able is not because he is paid directly by a health plan.
3/15
lOMoAR cPSD| 32635183
AHIP FINAL ACTUAL EXAM QUESTIONS AND CORRECT
ANSWERS 2023-2024 UPDATE ALREADY A GRADED WITH
EXPERT FEEDBACK |NEW!!
Final Exam - Attempt 1
1
Marks: 1 Which of the following is a correct statement about state laws as they pertain to marketing representatives?
Choose one a. Plans must contract only with marketing representatives who reside in the state where
answer. they intend to work.
b. State licensure laws are pre-empted and do not apply to marketing representatives
marketing MA and Part D plans
c. Plan sponsors can use any marketing representative, as long as they are licensed in at
least one state.
d. Medicare health plans must comply with requests for information from state insurance
departments investigating complaints about a marketing representative.
2
Marks: 1
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 Tom Smith tell
Mr. Moreno about the kinds of food that can be provided to potential enrollees who attend the sales presentation?
Choose one a. Any type of meal or food is allowed, as long as it is available to the general public and
answer. not just those who are eligible to enroll in the plans.
b. Any meal is allowed, as long as it is valued at less than $15.
c. A meal cannot be provided, but light snacks would be permitted.
d. Nothing may be provided to eat or drink during the sales presentation.
3
If a beneficiary is enrolled in a stand-alone prescription drug plan and wants to keep that plan, what type of Medicare
Marks: 1
health plan could the individual also enroll in, without being automatically disenrolled from the stand-alone
prescription drug plan?
Choose one a. The beneficiary could only choose an 1876 Cost Plan.
answer.
b. The beneficiary could only choose a Medicare Medical Savings Account (MSA) plan.
c. The beneficiary could enroll in a private fee-for-service (PFFS) plan that does not
include prescription drug coverage; an 1876 cost plan; or a Medicare Medical Savings
Account (MSA) plan
d. The beneficiary could only stay in a stand-alone prescription drug plan if he or she has
original fee-for-service Medicare
4
Marks: 1 1/15
,lOMoAR cPSD| 32635183
2/15
, lOMoAR cPSD| 32635183
You are working with a number of plans and community organizations to sponsor an educational event. When
putting together advertisements for this event, what should you do?
Choose one a. Plans may not participate in advertising such an event. All advertising must be done by
answer. community organizations.
b. You must only ensure that the advertisement is factually accurate.
c. You must state in the advertisement that it will be an educational event and that the
education will consist of specific information about the participating plans.
d. You must ensure that the advertisements indicate it is an educational event, otherwise it
will be considered a marketing event.
5
Marks: 1
Mrs. Allen has a rare condition for which two different brand name drugs are the only available treatment. She is
concerned that since no generic prescription drug is available and these drugs are very high cost, she will not be
able to find a Medicare Part D prescription drug plan that covers either one of them. What should you tell her?
Choose one a. When medication costs exceed a certain threshold amount, which rises each year, a
answer. Medicare prescription drug plan is permitted to exclude coverage for all but the least
expensive of the medications in a given category. Mrs. Allen will need to encourage her
physician to prescribe the least expensive of the two alternatives.
b. Medicare prescription drug plans are required to cover drugs in each therapeutic
category. She should be able to enroll in a Medicare prescription drug plan that covers the
medications she needs.
c. Medicare prescription drug plans are required to include only a certain percentage of
brand name drugs among those they cover. It may be possible that plans available in her
area have opted not to include in their formularies the brand name drugs she needs. She
may need to pay for this particular medication out of pocket.
d. Medicare prescription drug plans are allowed to restrict their coverage to generic drugs.
She will need to pay for her brand name medications out of pocket.
6
Marks: 1 Able, Baker, and Charles are engaged in the marketing to and enrollment of beneficiaries into Medicare health
plans. Mr. Able is an independent agent paid directly by a health plan. Ms. Baker is an independent agent paid
through a field marketing organization (FMO). Mr. Charles is an independent agent paid for his work by a third-party
marketing organization (TMO). How do the CMS compensation rules apply to these three agents?
Choose one a. Able is subject to CMS compensation rules because he is paid directly by a health plan.
answer. Agents Baker and Charles are not because they are paid by third parties.
b. Charles is subject to CMS compliance rules because he works for a TMO and CMS
applies an extra layer of scrutiny to such organizations. Able and Baker are not.
c. All three are treated as independent agents under CMS compensation rules.
d. Baker and Charles are subject to CMS compensation rules because they are paid by
third parties. Able is not because he is paid directly by a health plan.
3/15
