AHIP final exam 109 QUESTIONS AND ANSWERS EXAM 2024-2025 | ACTUAL
EXAM WITH A STUDY GUIDE AND PRACTICE EX4AM | ACCURATE REAL EXAM
QUESTIONS AND ANSWERS | GUARANTEED PASS | LATEST UPDATE
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
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? -
CORRECT ANSWER 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? - CORRECT ANSWER Yes.
When an event has been advertised as "educational," discussing plan-
specific premiums is impermissible.
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? -
CORRECT ANSWER 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 Part
B before enrolling in a prescription drug plan.
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?
- CORRECT ANSWER 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.
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.
Agent Armstrong is employed by XYZ Agency, which is under contract with
ABC Health Plan, a Medicare Advantage (MA) plan that offers plans in
multiple states. XYZ Agency maintains a website marketing the MA plans
with which it has contracts. Agent Armstrong follows up with individuals
who request more information about ABC MA plans via the website and
tries to persuade them to enroll in ABC plans. What statement best
, describes the marketing and compliance rules that apply to Agent
Armstrong? - CORRECT ANSWER Agent Armstrong needs to be licensed
and appointed in every state in which beneficiaries to whom he markets
ABC MA plans are located.
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.
You are seeking to represent an individual Medicare Advantage plan and
an individual Part D plan in your state. You have completed the required
training for each plan, but you did not achieve a passing score on the tests
that came after the training. What can you do in this situation? - CORRECT
ANSWER You will not be able to represent any Medicare Advantage or
Part D plan until you complete the training and achieve an adequate score,
although you will not have to take a test if you exclusively market
employer/union group plans and the companies do not require testing.
Mr. Chen is enrolled in his employer's group health plan and will be
retiring soon. He would like to know his options since he has decided to
drop his retiree coverage and is eligible for Medicare. What should you tell
him? - CORRECT ANSWER Mr. Chen can disenroll from his employer-
sponsored coverage to elect a Medicare Advantage or Part D plan within 2
months of his disenrollment, but he should revaluate if he really wants to
drop his employer coverage.
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
EXAM WITH A STUDY GUIDE AND PRACTICE EX4AM | ACCURATE REAL EXAM
QUESTIONS AND ANSWERS | GUARANTEED PASS | LATEST UPDATE
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
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? -
CORRECT ANSWER 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? - CORRECT ANSWER Yes.
When an event has been advertised as "educational," discussing plan-
specific premiums is impermissible.
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? -
CORRECT ANSWER 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 Part
B before enrolling in a prescription drug plan.
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?
- CORRECT ANSWER 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.
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.
Agent Armstrong is employed by XYZ Agency, which is under contract with
ABC Health Plan, a Medicare Advantage (MA) plan that offers plans in
multiple states. XYZ Agency maintains a website marketing the MA plans
with which it has contracts. Agent Armstrong follows up with individuals
who request more information about ABC MA plans via the website and
tries to persuade them to enroll in ABC plans. What statement best
, describes the marketing and compliance rules that apply to Agent
Armstrong? - CORRECT ANSWER Agent Armstrong needs to be licensed
and appointed in every state in which beneficiaries to whom he markets
ABC MA plans are located.
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.
You are seeking to represent an individual Medicare Advantage plan and
an individual Part D plan in your state. You have completed the required
training for each plan, but you did not achieve a passing score on the tests
that came after the training. What can you do in this situation? - CORRECT
ANSWER You will not be able to represent any Medicare Advantage or
Part D plan until you complete the training and achieve an adequate score,
although you will not have to take a test if you exclusively market
employer/union group plans and the companies do not require testing.
Mr. Chen is enrolled in his employer's group health plan and will be
retiring soon. He would like to know his options since he has decided to
drop his retiree coverage and is eligible for Medicare. What should you tell
him? - CORRECT ANSWER Mr. Chen can disenroll from his employer-
sponsored coverage to elect a Medicare Advantage or Part D plan within 2
months of his disenrollment, but he should revaluate if he really wants to
drop his employer coverage.
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
