AHIP MEDICARE ENROLLMENT COMPLIANCE ACTUAL EXAM
2025| 181 QUESTIONS WITH ACCURATE SOLUTIONS
1. What is the general rule regarding the selection of a Part D premium
payment mechanism?
He must select a single Part D premium payment mechanism
that will be used throughout the year.
He can change his payment method every month.
He can use multiple payment methods simultaneously.
He must pay the premium in full at the beginning of the year.
2. Anita Magri will turn age 65 in August 2020. Anita intends to enroll in
Original Medicare Part A and Part B. She would also like to enroll in a
Medicare Supplement (Medigap) plan. Anita's older neighbor Mel has
told her about the Medigap Part F plan in which he is enrolled. It not only
provides foreign travel emergency benefits but also covers his Medicare
Part B deductible. Anita comes to you for advice. What should you tell
her?
You are sorry to disappoint Anita but a Medigap Part F plan is
no longer available to those who turn age 65 after January 1,
2020. Anita might instead consider other Medigap plans that
offer foreign travel benefits but do not cover the Part B
deductible.
You would be happy to help Anita enroll in a Medigap plan but
before she can do so, she must also enroll in a Medicare Part D
prescription drug plan.
You are sorry to disappoint Anita but Medigap plans are no
longer available to those who turn age 65 after January 1, 2020.
Anita should instead consider a Medicare Advantage plan.
You would be happy to help Anita enroll in a Medigap Part F plan
will provide foreign travel benefits as well as cover her Part B
,deductible.
,3. Mrs. Lopez is enrolled in a cost plan for her Medicare benefits. She has
recently lost creditable coverage previously available through her
husband's employer. She is interested in enrolling in a Medicare Part D
prescription drug plan (PDP). What should you tell her?
If a Part D benefit is offered through her plan she may choose to
enroll in that plan or a standalone PDP.
If a Part D benefit is offered through her plan she must enroll in
this plan.
Mrs. Lopez must enroll in either a HMO or PPO Medicare
Advantage plan in order to obtain Part D coverage.
Mrs. Lopez must first seek COBRA benefits under her husband's
plan before she can apply for Part D coverage.
4. What is the primary requirement for an individual to qualify for Medicare
Part A coverage?
Having paid Medicare taxes while working
Being born in the United States
Being a full-time employee
Having a specific income level
5. Why is it important for Mr. Torres to choose only one payment method
for his Part D premiums?
Choosing one payment method ensures consistent payment
and compliance with Medicare regulations.
It allows him to save money on premiums.
It enables him to receive additional benefits.
It simplifies the enrollment process.
, 6. A patient is not filling their blood pressure medication. After speaking
with the patient, it is determined that they are having difficulty paying for
the medications. Which of the following Medicare plans can assist the
patient with prescription medication costs?
Part A
Part B
Part C
Part D
7. Describe the conditions under which it is permissible to offer gifts to
potential enrollees according to CMS guidelines.
Gifts can be offered without any restrictions.
Gifts must be $20 or less each, with no annual limit.
Gifts can be offered as long as each is $10 or less, and the total
value does not exceed $20 in a year.
Gifts can only be offered at marketing events.
8. If Mrs. Hernandez decides to enroll in the Medicare Prescription
Payment Plan in June, what implications does this have for her coverage?
She will have coverage for the remainder of the plan year.
She will have to wait until the next plan year to receive coverage.
She will only receive partial coverage for the year.
She will lose her existing coverage.
9. If Mr. Zachow's request for a formulary exception is denied, what
alternative options could he consider to manage his medication needs?
Explore other Part D plans that include the medication in their
formulary.
Stop taking all medications immediately.
2025| 181 QUESTIONS WITH ACCURATE SOLUTIONS
1. What is the general rule regarding the selection of a Part D premium
payment mechanism?
He must select a single Part D premium payment mechanism
that will be used throughout the year.
He can change his payment method every month.
He can use multiple payment methods simultaneously.
He must pay the premium in full at the beginning of the year.
2. Anita Magri will turn age 65 in August 2020. Anita intends to enroll in
Original Medicare Part A and Part B. She would also like to enroll in a
Medicare Supplement (Medigap) plan. Anita's older neighbor Mel has
told her about the Medigap Part F plan in which he is enrolled. It not only
provides foreign travel emergency benefits but also covers his Medicare
Part B deductible. Anita comes to you for advice. What should you tell
her?
You are sorry to disappoint Anita but a Medigap Part F plan is
no longer available to those who turn age 65 after January 1,
2020. Anita might instead consider other Medigap plans that
offer foreign travel benefits but do not cover the Part B
deductible.
You would be happy to help Anita enroll in a Medigap plan but
before she can do so, she must also enroll in a Medicare Part D
prescription drug plan.
You are sorry to disappoint Anita but Medigap plans are no
longer available to those who turn age 65 after January 1, 2020.
Anita should instead consider a Medicare Advantage plan.
You would be happy to help Anita enroll in a Medigap Part F plan
will provide foreign travel benefits as well as cover her Part B
,deductible.
,3. Mrs. Lopez is enrolled in a cost plan for her Medicare benefits. She has
recently lost creditable coverage previously available through her
husband's employer. She is interested in enrolling in a Medicare Part D
prescription drug plan (PDP). What should you tell her?
If a Part D benefit is offered through her plan she may choose to
enroll in that plan or a standalone PDP.
If a Part D benefit is offered through her plan she must enroll in
this plan.
Mrs. Lopez must enroll in either a HMO or PPO Medicare
Advantage plan in order to obtain Part D coverage.
Mrs. Lopez must first seek COBRA benefits under her husband's
plan before she can apply for Part D coverage.
4. What is the primary requirement for an individual to qualify for Medicare
Part A coverage?
Having paid Medicare taxes while working
Being born in the United States
Being a full-time employee
Having a specific income level
5. Why is it important for Mr. Torres to choose only one payment method
for his Part D premiums?
Choosing one payment method ensures consistent payment
and compliance with Medicare regulations.
It allows him to save money on premiums.
It enables him to receive additional benefits.
It simplifies the enrollment process.
, 6. A patient is not filling their blood pressure medication. After speaking
with the patient, it is determined that they are having difficulty paying for
the medications. Which of the following Medicare plans can assist the
patient with prescription medication costs?
Part A
Part B
Part C
Part D
7. Describe the conditions under which it is permissible to offer gifts to
potential enrollees according to CMS guidelines.
Gifts can be offered without any restrictions.
Gifts must be $20 or less each, with no annual limit.
Gifts can be offered as long as each is $10 or less, and the total
value does not exceed $20 in a year.
Gifts can only be offered at marketing events.
8. If Mrs. Hernandez decides to enroll in the Medicare Prescription
Payment Plan in June, what implications does this have for her coverage?
She will have coverage for the remainder of the plan year.
She will have to wait until the next plan year to receive coverage.
She will only receive partial coverage for the year.
She will lose her existing coverage.
9. If Mr. Zachow's request for a formulary exception is denied, what
alternative options could he consider to manage his medication needs?
Explore other Part D plans that include the medication in their
formulary.
Stop taking all medications immediately.
