AHIP FINAL EXAM TEST 2024/2025 WITH CORRECT
QUESTION AND ANSWERS GRADED A+
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? - ANS✔✔--Everyone who is entitled to
Part A or enrolled under Part B is eligible to enroll in a Medicare prescription drug plan. As long
as Mrs. Mulcahy is entitled to Part A, she does not need to enroll under Par t B before enrolling in
a prescription drug 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? - ANS✔✔--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? - ANS✔✔--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? - ANS✔✔--He could enroll in one of the MA 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.
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? - ANS✔✔--In general, he must select a single Part D premium
payment mechanism that will be used throughout the year.
Agent Jennings makes a presentation on Medicare advertised as an educational event.
Agent Jennings distributes materials that are solely educational 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? - ANS✔✔--Yes. When an
event has been advertised as "educational," discussing plan-specific premiums is impermissible.
.
Mr. Jacob understands that there is a standard Medicare Part D prescription 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? - ANS✔✔--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.
Mrs. Chen will be 65 soon, has been a citizen for twelve years, has been employed full
time, and paid taxes during that entire period. She is concerned that she will not qualify
for coverage under part A because she was not born in the United States. What should
you tell her? - ANS✔✔--Most individuals who are citizens and over age 65 are covered
under Part A by virtue of having paid Medicare taxes while working, though some may be
covered as a result of paying monthly premiums.
Ms. Edwards is enrolled in a Medicare Advantage plan that includes prescription drug
plan (PDP) coverage. She is traveling and wishes to fill two of her prescriptions that she
has lost. How would you advise her? - ANS✔✔--She may fill prescriptions for covered
Mr. Rockwell, age 67, is enrolled in Medicare Part A, but because he continues to work
and is covered by an employer health plan, he has not enrolled in Part B or Part D. He
receives a notice on June 1 that his employer is cutting back on prescription drug
benefits and that as of July 1 his coverage will no longer be creditable. He has come to
you for advice. What advice would you give Mr. Rockwell about special enrollment
periods (SEPs)? - ANS✔✔--Mr. Rockwell is eligible for a SEP due to his involuntary loss of
QUESTION AND ANSWERS GRADED A+
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? - ANS✔✔--Everyone who is entitled to
Part A or enrolled under Part B is eligible to enroll in a Medicare prescription drug plan. As long
as Mrs. Mulcahy is entitled to Part A, she does not need to enroll under Par t B before enrolling in
a prescription drug 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? - ANS✔✔--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? - ANS✔✔--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? - ANS✔✔--He could enroll in one of the MA 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.
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? - ANS✔✔--In general, he must select a single Part D premium
payment mechanism that will be used throughout the year.
Agent Jennings makes a presentation on Medicare advertised as an educational event.
Agent Jennings distributes materials that are solely educational 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? - ANS✔✔--Yes. When an
event has been advertised as "educational," discussing plan-specific premiums is impermissible.
.
Mr. Jacob understands that there is a standard Medicare Part D prescription 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? - ANS✔✔--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.
Mrs. Chen will be 65 soon, has been a citizen for twelve years, has been employed full
time, and paid taxes during that entire period. She is concerned that she will not qualify
for coverage under part A because she was not born in the United States. What should
you tell her? - ANS✔✔--Most individuals who are citizens and over age 65 are covered
under Part A by virtue of having paid Medicare taxes while working, though some may be
covered as a result of paying monthly premiums.
Ms. Edwards is enrolled in a Medicare Advantage plan that includes prescription drug
plan (PDP) coverage. She is traveling and wishes to fill two of her prescriptions that she
has lost. How would you advise her? - ANS✔✔--She may fill prescriptions for covered
Mr. Rockwell, age 67, is enrolled in Medicare Part A, but because he continues to work
and is covered by an employer health plan, he has not enrolled in Part B or Part D. He
receives a notice on June 1 that his employer is cutting back on prescription drug
benefits and that as of July 1 his coverage will no longer be creditable. He has come to
you for advice. What advice would you give Mr. Rockwell about special enrollment
periods (SEPs)? - ANS✔✔--Mr. Rockwell is eligible for a SEP due to his involuntary loss of
