AHIP final exam 400 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
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 a. Cost plan enrollees can choose to
receive Medicare covered services under the plan's benefits by going to
plan network providers and paying plan cost sharing, or may receive
services from non-network providers and pay cost-sharing due under
Original Medicare.
b. Ms. Lopez is considered a marketing representative of BestCare and
thus is obligated to comply with CMS marketing requirements, including
those regarding using only approved call scripts. - CORRECT ANSWER
Ms. Lopez is an independent agent under contract with MarketCo, a third-
party marketing organization. MarketCo has a contract with BestCare
health plan, a Medicare Advantage (MA) organization, to offer marketing
services through its contracted agents and agencies. Ms. Lopez returns
calls to individuals who contact MarketCo in response to its mailers
promoting BestCare health plan. Which of the following best describes the
responsibilities of Ms. Lopez?
a. Ms. Lopez is considered a marketing representative of BestCare but is
exempt from the marketing rules regarding approved call scripts because
she works directly for MarketCo.
b. Ms. Lopez is considered a marketing representative of BestCare and
thus is obligated to comply with CMS marketing requirements, including
those regarding using only approved call scripts.
c. Ms. Lopez no longer needs to be concerned about state licensure since
she is marketing an MA product subject to federal rules.
,d. Ms. Lopez needs to maintain state licensure, but because she is working
for a third-party marketing organization she is exempt from CMS training
requirements that apply to BestCare captive agents.
Mr. Edwards, a marketing representative of the ACME Insurance Company,
scheduled a marketing event and expects about 40 people to attend. He
has hired a magician at a cost of $200 to entertain attendees. Can he do
this in a way that complies with guidance from the Medicare agency? -
CORRECT ANSWER a. He can do this because the estimated number of
attendees is based on the venue size and response rate and the value of
the gift does not exceed $15.
Mrs. Ramos is considering a Medicare Advantage PPO and has questions
about which providers she can go to for her health care. What should you
tell her? - CORRECT ANSWER b. Mrs. Ramos can obtain care from any
provider who participates in Original Medicare, but generally will have a
higher cost-sharing amount if she sees a provider who/that is not a part
of the PPO network.
Julia Harris is turning 66 in July, at which time she will retire. She has
contacted your office and requested a meeting so that she can learn about
Medicare and the products you represent. How should you respond? -
CORRECT ANSWER c. Tell Julia that you will meet with her to explain
Medicare and should she be interested you can accept and submit an
enrollment request, since this is an initial enrollment qualifying her for a
special enrollment period.
Mr. Rivera has Qualified Medicare Beneficiary (QMB) eligibility and is thus
covered by both Medicare and Medicaid. He decides to enroll in a Medicare
Advantage (MA) PPO plan. Later he sees an out-of-network doctor to
receive a Medicare covered service. How much The doctor may only
collect from Mr. Rivera the cost sharing allowable under the state's
Medicaid program.may the doctor collect from Mr. Rivera? - CORRECT
ANSWER The doctor may only collect from Mr. Rivera the cost sharing
allowable under the state's Medicaid program.
During a sales presentation in Ms. Sullivan's home, she tells you that she
has heard about a type of Medicare health plan known as Private Fee-for-
,Service (PFFS). She wants to know if this would be available to her. What
should you tell her about PFFS plans? - CORRECT ANSWER
Choose one answer. - CORRECT ANSWER
- CORRECT ANSWER a. A PFFS plan is a type of Medicare Supplement
plan and she may enroll in one if it is available in her area.
- CORRECT ANSWER b. A PFFS plan is exactly the same as Original
Medicare, only offered by a private entity and she may enroll in one if it is
available in her area.
- CORRECT ANSWER c. PFFS plans are designed to cover only
prescription drugs and if that is the type of coverage she wants, she may
enroll in one if it is available in her area.
- CORRECT ANSWER d. A PFFS plan is one of the various types of
Medicare Advantage plans offered by private entities and she may enroll
in one if it is available in her area.
Question8 - CORRECT ANSWER
Marks: 1 - CORRECT ANSWER
During an appointment scheduled to discuss a Medicare Advantage
Prescription Drug plan (MA-PD), Mr. Peters asked his agent to describe a
stand-alone prescription drug plan (Part D plan) that his neighbor told him
about. What should his agent do? - CORRECT ANSWER
Choose one answer. - CORRECT ANSWER
- CORRECT ANSWER a. Since Mr. Peters requested a description of the
Part D plan, his agent must leave the Part D plan brochure, but not an
enrollment form, and would have to schedule another appointment after at
least 48 hours have passed to discuss the Part D plan with Mr. Peters.
- CORRECT ANSWER b. Since Mr. Peters requested a description of the
Part D plan, his agent must have Mr. Peters sign a new scope of
, appointment form that includes Part D, and then the agent may discuss
the Part D plan so Mr. Peters can compare plans and make an informed
enrollment choice during the appointment.
- CORRECT ANSWER c. Since Mr. Peters requested a description of the
Part D plan, his agent must inform Mr. Peters that he can only sign up for
the MA-PD plan and cannot receive a brochure or any other information
about the Part D plan now because he did not agree in advance to discuss
that plan
- CORRECT ANSWER d. Since Mr. Peters requested a description of the
Part D plan, his agent must discuss both the Part D and the MA-PD plans
and return after at least 48 hours to complete the Part D plan enrollment
form with Mr. Peters.
Question9 - CORRECT ANSWER
Marks: 1 - CORRECT ANSWER
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
Choose one answer. - CORRECT ANSWER
- CORRECT ANSWER a. In general, he must select a single Part D
premium payment mechanism that will be used throughout the year.
- CORRECT ANSWER b. As long as he fills out the paperwork to begin
withholding from his Social Security check at least 63 days before such
withholding should begin, he can change his method of Part D premium
payment and withholding will begin the month after his savings account is
exhausted.
- CORRECT ANSWER c. During 2017, many people experienced
significant problems with deductions from their Social Security check for
ACTUAL EXAM WITH A STUDY GUIDE AND PRACTICE EX4AM |
ACCURATE REAL EXAM QUESTIONS AND ANSWERS | GUARANTEED
PASS | LATEST UPDATE
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 a. Cost plan enrollees can choose to
receive Medicare covered services under the plan's benefits by going to
plan network providers and paying plan cost sharing, or may receive
services from non-network providers and pay cost-sharing due under
Original Medicare.
b. Ms. Lopez is considered a marketing representative of BestCare and
thus is obligated to comply with CMS marketing requirements, including
those regarding using only approved call scripts. - CORRECT ANSWER
Ms. Lopez is an independent agent under contract with MarketCo, a third-
party marketing organization. MarketCo has a contract with BestCare
health plan, a Medicare Advantage (MA) organization, to offer marketing
services through its contracted agents and agencies. Ms. Lopez returns
calls to individuals who contact MarketCo in response to its mailers
promoting BestCare health plan. Which of the following best describes the
responsibilities of Ms. Lopez?
a. Ms. Lopez is considered a marketing representative of BestCare but is
exempt from the marketing rules regarding approved call scripts because
she works directly for MarketCo.
b. Ms. Lopez is considered a marketing representative of BestCare and
thus is obligated to comply with CMS marketing requirements, including
those regarding using only approved call scripts.
c. Ms. Lopez no longer needs to be concerned about state licensure since
she is marketing an MA product subject to federal rules.
,d. Ms. Lopez needs to maintain state licensure, but because she is working
for a third-party marketing organization she is exempt from CMS training
requirements that apply to BestCare captive agents.
Mr. Edwards, a marketing representative of the ACME Insurance Company,
scheduled a marketing event and expects about 40 people to attend. He
has hired a magician at a cost of $200 to entertain attendees. Can he do
this in a way that complies with guidance from the Medicare agency? -
CORRECT ANSWER a. He can do this because the estimated number of
attendees is based on the venue size and response rate and the value of
the gift does not exceed $15.
Mrs. Ramos is considering a Medicare Advantage PPO and has questions
about which providers she can go to for her health care. What should you
tell her? - CORRECT ANSWER b. Mrs. Ramos can obtain care from any
provider who participates in Original Medicare, but generally will have a
higher cost-sharing amount if she sees a provider who/that is not a part
of the PPO network.
Julia Harris is turning 66 in July, at which time she will retire. She has
contacted your office and requested a meeting so that she can learn about
Medicare and the products you represent. How should you respond? -
CORRECT ANSWER c. Tell Julia that you will meet with her to explain
Medicare and should she be interested you can accept and submit an
enrollment request, since this is an initial enrollment qualifying her for a
special enrollment period.
Mr. Rivera has Qualified Medicare Beneficiary (QMB) eligibility and is thus
covered by both Medicare and Medicaid. He decides to enroll in a Medicare
Advantage (MA) PPO plan. Later he sees an out-of-network doctor to
receive a Medicare covered service. How much The doctor may only
collect from Mr. Rivera the cost sharing allowable under the state's
Medicaid program.may the doctor collect from Mr. Rivera? - CORRECT
ANSWER The doctor may only collect from Mr. Rivera the cost sharing
allowable under the state's Medicaid program.
During a sales presentation in Ms. Sullivan's home, she tells you that she
has heard about a type of Medicare health plan known as Private Fee-for-
,Service (PFFS). She wants to know if this would be available to her. What
should you tell her about PFFS plans? - CORRECT ANSWER
Choose one answer. - CORRECT ANSWER
- CORRECT ANSWER a. A PFFS plan is a type of Medicare Supplement
plan and she may enroll in one if it is available in her area.
- CORRECT ANSWER b. A PFFS plan is exactly the same as Original
Medicare, only offered by a private entity and she may enroll in one if it is
available in her area.
- CORRECT ANSWER c. PFFS plans are designed to cover only
prescription drugs and if that is the type of coverage she wants, she may
enroll in one if it is available in her area.
- CORRECT ANSWER d. A PFFS plan is one of the various types of
Medicare Advantage plans offered by private entities and she may enroll
in one if it is available in her area.
Question8 - CORRECT ANSWER
Marks: 1 - CORRECT ANSWER
During an appointment scheduled to discuss a Medicare Advantage
Prescription Drug plan (MA-PD), Mr. Peters asked his agent to describe a
stand-alone prescription drug plan (Part D plan) that his neighbor told him
about. What should his agent do? - CORRECT ANSWER
Choose one answer. - CORRECT ANSWER
- CORRECT ANSWER a. Since Mr. Peters requested a description of the
Part D plan, his agent must leave the Part D plan brochure, but not an
enrollment form, and would have to schedule another appointment after at
least 48 hours have passed to discuss the Part D plan with Mr. Peters.
- CORRECT ANSWER b. Since Mr. Peters requested a description of the
Part D plan, his agent must have Mr. Peters sign a new scope of
, appointment form that includes Part D, and then the agent may discuss
the Part D plan so Mr. Peters can compare plans and make an informed
enrollment choice during the appointment.
- CORRECT ANSWER c. Since Mr. Peters requested a description of the
Part D plan, his agent must inform Mr. Peters that he can only sign up for
the MA-PD plan and cannot receive a brochure or any other information
about the Part D plan now because he did not agree in advance to discuss
that plan
- CORRECT ANSWER d. Since Mr. Peters requested a description of the
Part D plan, his agent must discuss both the Part D and the MA-PD plans
and return after at least 48 hours to complete the Part D plan enrollment
form with Mr. Peters.
Question9 - CORRECT ANSWER
Marks: 1 - CORRECT ANSWER
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
Choose one answer. - CORRECT ANSWER
- CORRECT ANSWER a. In general, he must select a single Part D
premium payment mechanism that will be used throughout the year.
- CORRECT ANSWER b. As long as he fills out the paperwork to begin
withholding from his Social Security check at least 63 days before such
withholding should begin, he can change his method of Part D premium
payment and withholding will begin the month after his savings account is
exhausted.
- CORRECT ANSWER c. During 2017, many people experienced
significant problems with deductions from their Social Security check for
