AHIP final exam 100 QUESTIONS AND ANSWERS EXAM 2024-2025 | ACTUAL
EXAM WITH A STUDY GUIDE AND PRACTICE EXAM | ACCURATE REAL EXAM
QUESTIONS AND ANSWERS | GUARANTEED PASS | LATEST UPDATE
Mrs. Shields is covered by Original Medicare. She sustained a hip fracture and is being
successfully treated for that condition. However, she and her physicians feel that after
her lengthy hospital stay, she will need a month or two of nursing and rehabilitative
care. What should you tell them about Original Medicare's coverage of care in a skilled
nursing facility? - CORRECT ANSWER Medicare will cover Mrs. Shield's skilled
nursing services provided during the first 20 days of her stay, after which she would
have a copay until she has been in the facility for 100 days.
Agent Harriet Walker has recently begun marketing Medicare Advantage and related
products aimed at meeting the needs of senior citizens. Client Mildred Jones has
expressed interest in a Medicare Advantage plan. It is now the beginning of September.
If you were in Agent Walker's position, what would you do? - CORRECT ANSWER
Inquire whether the client qualifies for a special enrollment period, and if not, solicit an
enrollment application once the annual open enrollment election period begins on
October 15th.
Which of the following individuals are likely to qualify for a special election period (SEP)
for either a MA and/or Part D due to a change of residence?
I. Edward (enrolled in MA and Part D) moves to a new home within the same
neighborhood in his existing plan's service area.
II. Fiona (enrolled in MA and Part D) moves cross-country to an area outside her
existing plan's service area.
III. Gilbert moves into a plan service area where there is now a Part D plan available to
him from a service area where no Part D plan was available.
IV. Henry makes a permanent move to a new state providing him with new MA and Part
D options. - CORRECT ANSWER II, III, and IV only.
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.
Mr. Liu turns 65 on June 19. He has never previously qualified for Medicare so his first
Medicare eligibility date will be June 1. Mr. Liu's ICEP and Part D IEP begin on March 1
and end on September 30. He wants prescription drug coverage with his Part A and
Part B benefits. What advice can you provide him? - CORRECT ANSWER He can
enroll in a MA-PD as long as he enrolls in Part B and is entitled to Part A.
,Mr. and Mrs. Nunez attended one of your sales presentations. They've asked you to
come to their home to clear up a few questions. During the presentation, Mrs. Nunez
feels tired and tells you that her husband can finish things up. She goes to bed. At the
end of your discussion, Mr. Nunez says that he wants to enroll both himself and his
wife. What should you do? - CORRECT ANSWER As long as she can do so, only
Mrs. Nunez can sign her enrollment form. Mrs. Nunez will have to wake up to sign her
form or do so at another time.
Mr. Anderson is a very organized individual and has filled out and brought to you an
enrollment form on October 10 for a new plan available on January 1 next year. He is
currently enrolled in Original Medicare. What should you do? - CORRECT ANSWER
Tell Mr. Anderson that you cannot accept any enrollment forms until the annual election
period begins.
Mr. Ford enrolled in an MA-only plan in mid-November during the Annual Election
Period (AEP). On December 1, he calls you up and says that he has changed his mind
and would like to enroll in a MA-PD plan. What enrollment rules would apply in this
case? - CORRECT ANSWER He can make as many enrollment changes as he
likes during the Annual Election Period and the last choice made before the end of the
period will be the effective one as of January 1.
Mrs. Pierce would like to enroll in a Medicare Cost plan that offers Part D prescription
drug coverage. She comes to you for advice about when she can enroll in a plan you
have previously discussed. What should you tell her? - CORRECT ANSWER
Enrollment in Cost plans offering Part D coverage is available only during enrollment
periods under the Part D program, and Cost plans must accept enrollments during
these periods.
Mr. Rodriguez is currently enrolled in a MA plan, but his plan doesn't sufficiently cover
his prescription drug needs. He is interested in changing plans during the upcoming MA
Open Enrollment Period. What are his options during the MA OEP? - CORRECT
ANSWER He can switch to a MA-PD plan.
Ms. Lee is enrolled in an MA-PD plan but will be moving out of the plan's service area
next month. She is worried that she will not be able to enroll in another plan available in
her new residence until the Annual Election Period. What should you tell her? -
CORRECT ANSWER She is eligible for a special election period (SEP) that begins
either the month before her permanent move, if the plan is notified in advance, or the
month she provides notice of the move, and this period typically lasts an additional two
months.
Mr. Block is currently enrolled in a Medicare Advantage plan that includes drug
coverage. He found a stand-alone Medicare prescription drug plan in his area that offers
better coverage than that available through his MA-PD plan and in addition, has a low
premium. It won't cost him much more and, because he has the means to do so, he
, wishes to enroll in the stand-alone prescription drug plan in addition to his MA-PD plan.
What should you tell him? - CORRECT ANSWER If Mr. Block enrolls in the stand-
alone Medicare prescription drug plan, he will be disenrolled from the Medicare
Advantage plan.
Mr. Wendt suffers from diabetes which has gotten progressively worse during the last
year. He is currently enrolled in Original Medicare (Parts A and B) and a Part D
prescription drug plan and did not enroll in a Medicare Advantage (MA) plan during the
last annual open enrollment period (AEP) which has just closed. Mr. Wendt has heard
certain MA plans might provide him with more specialized coverage for his diabetes and
wants to know if he must wait until the next annual open enrollment period (AEP) before
enrolling in such a plan. What should you tell him? - CORRECT ANSWER If there
is a special needs plan (SNP) in Mr. Wendt's area that specializes in caring for
individuals with diabetes, he may enroll in the SNP at any time under a special election
period (SEP).
Mr. Yoo's employer has recently dropped comprehensive creditable prescription drug
coverage that was offered to company retirees. The company told Mr. Yoo that,
because he was affected by this change, he would qualify for a special election period.
Mr. Yoo contacted you to find out more about what this means. What can you tell him? -
CORRECT ANSWER It means that he qualifies for a one-time opportunity to enroll
in an MA-PD or Part D prescription drug plan.
Ms. Claggett is sixty-six (66) years old. She has been covered under Original Medicare
for the last six years due to her disability and has never been enrolled in a Medicare
Advantage or a Part D plan before. She wants to enroll in a Part D plan. She knows that
there is such a thing as the "Part D Initial Enrollment Period" (IEP) and has concluded
that, since she has never enrolled in such a plan before, she should be eligible to enroll
under this period. What should you tell her about how the Part D Initial Enrollment
Period applies to her situation? - CORRECT ANSWER Ms. Claggett has had two
IEPs and missed them both. The first occurred three months before and three months
after the month when she was first entitled to Part A OR enrolled in Part B. Because she
was eligible for Medicare before age 65, Ms. Claggett had a second IEP based on
turning age 65, which has also expired.
Ms. Thomas has worked for many years and is turning 68 in June. She is eligible for
Medicare Part A and did not enroll for Part B when first eligible because she has
insurance through her employer - Coffee Brew, Inc. She also did not enroll in Part D
because she had creditable coverage. She would like to retire in June and enroll in a
Medicare Advantage plan. She has been informed that her group coverage will end on
her retirement effective date. How would you advise Ms. Thomas? - CORRECT
ANSWER Ms. Thomas can enroll in Part B without a late penalty at any time she is
still covered by her employer group and 8 months after her last month of employer
group coverage without a penalty. However, because she wants to enroll in a MA plan
after retirement, she should make sure her Part B coverage is effective in time to use
EXAM WITH A STUDY GUIDE AND PRACTICE EXAM | ACCURATE REAL EXAM
QUESTIONS AND ANSWERS | GUARANTEED PASS | LATEST UPDATE
Mrs. Shields is covered by Original Medicare. She sustained a hip fracture and is being
successfully treated for that condition. However, she and her physicians feel that after
her lengthy hospital stay, she will need a month or two of nursing and rehabilitative
care. What should you tell them about Original Medicare's coverage of care in a skilled
nursing facility? - CORRECT ANSWER Medicare will cover Mrs. Shield's skilled
nursing services provided during the first 20 days of her stay, after which she would
have a copay until she has been in the facility for 100 days.
Agent Harriet Walker has recently begun marketing Medicare Advantage and related
products aimed at meeting the needs of senior citizens. Client Mildred Jones has
expressed interest in a Medicare Advantage plan. It is now the beginning of September.
If you were in Agent Walker's position, what would you do? - CORRECT ANSWER
Inquire whether the client qualifies for a special enrollment period, and if not, solicit an
enrollment application once the annual open enrollment election period begins on
October 15th.
Which of the following individuals are likely to qualify for a special election period (SEP)
for either a MA and/or Part D due to a change of residence?
I. Edward (enrolled in MA and Part D) moves to a new home within the same
neighborhood in his existing plan's service area.
II. Fiona (enrolled in MA and Part D) moves cross-country to an area outside her
existing plan's service area.
III. Gilbert moves into a plan service area where there is now a Part D plan available to
him from a service area where no Part D plan was available.
IV. Henry makes a permanent move to a new state providing him with new MA and Part
D options. - CORRECT ANSWER II, III, and IV only.
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.
Mr. Liu turns 65 on June 19. He has never previously qualified for Medicare so his first
Medicare eligibility date will be June 1. Mr. Liu's ICEP and Part D IEP begin on March 1
and end on September 30. He wants prescription drug coverage with his Part A and
Part B benefits. What advice can you provide him? - CORRECT ANSWER He can
enroll in a MA-PD as long as he enrolls in Part B and is entitled to Part A.
,Mr. and Mrs. Nunez attended one of your sales presentations. They've asked you to
come to their home to clear up a few questions. During the presentation, Mrs. Nunez
feels tired and tells you that her husband can finish things up. She goes to bed. At the
end of your discussion, Mr. Nunez says that he wants to enroll both himself and his
wife. What should you do? - CORRECT ANSWER As long as she can do so, only
Mrs. Nunez can sign her enrollment form. Mrs. Nunez will have to wake up to sign her
form or do so at another time.
Mr. Anderson is a very organized individual and has filled out and brought to you an
enrollment form on October 10 for a new plan available on January 1 next year. He is
currently enrolled in Original Medicare. What should you do? - CORRECT ANSWER
Tell Mr. Anderson that you cannot accept any enrollment forms until the annual election
period begins.
Mr. Ford enrolled in an MA-only plan in mid-November during the Annual Election
Period (AEP). On December 1, he calls you up and says that he has changed his mind
and would like to enroll in a MA-PD plan. What enrollment rules would apply in this
case? - CORRECT ANSWER He can make as many enrollment changes as he
likes during the Annual Election Period and the last choice made before the end of the
period will be the effective one as of January 1.
Mrs. Pierce would like to enroll in a Medicare Cost plan that offers Part D prescription
drug coverage. She comes to you for advice about when she can enroll in a plan you
have previously discussed. What should you tell her? - CORRECT ANSWER
Enrollment in Cost plans offering Part D coverage is available only during enrollment
periods under the Part D program, and Cost plans must accept enrollments during
these periods.
Mr. Rodriguez is currently enrolled in a MA plan, but his plan doesn't sufficiently cover
his prescription drug needs. He is interested in changing plans during the upcoming MA
Open Enrollment Period. What are his options during the MA OEP? - CORRECT
ANSWER He can switch to a MA-PD plan.
Ms. Lee is enrolled in an MA-PD plan but will be moving out of the plan's service area
next month. She is worried that she will not be able to enroll in another plan available in
her new residence until the Annual Election Period. What should you tell her? -
CORRECT ANSWER She is eligible for a special election period (SEP) that begins
either the month before her permanent move, if the plan is notified in advance, or the
month she provides notice of the move, and this period typically lasts an additional two
months.
Mr. Block is currently enrolled in a Medicare Advantage plan that includes drug
coverage. He found a stand-alone Medicare prescription drug plan in his area that offers
better coverage than that available through his MA-PD plan and in addition, has a low
premium. It won't cost him much more and, because he has the means to do so, he
, wishes to enroll in the stand-alone prescription drug plan in addition to his MA-PD plan.
What should you tell him? - CORRECT ANSWER If Mr. Block enrolls in the stand-
alone Medicare prescription drug plan, he will be disenrolled from the Medicare
Advantage plan.
Mr. Wendt suffers from diabetes which has gotten progressively worse during the last
year. He is currently enrolled in Original Medicare (Parts A and B) and a Part D
prescription drug plan and did not enroll in a Medicare Advantage (MA) plan during the
last annual open enrollment period (AEP) which has just closed. Mr. Wendt has heard
certain MA plans might provide him with more specialized coverage for his diabetes and
wants to know if he must wait until the next annual open enrollment period (AEP) before
enrolling in such a plan. What should you tell him? - CORRECT ANSWER If there
is a special needs plan (SNP) in Mr. Wendt's area that specializes in caring for
individuals with diabetes, he may enroll in the SNP at any time under a special election
period (SEP).
Mr. Yoo's employer has recently dropped comprehensive creditable prescription drug
coverage that was offered to company retirees. The company told Mr. Yoo that,
because he was affected by this change, he would qualify for a special election period.
Mr. Yoo contacted you to find out more about what this means. What can you tell him? -
CORRECT ANSWER It means that he qualifies for a one-time opportunity to enroll
in an MA-PD or Part D prescription drug plan.
Ms. Claggett is sixty-six (66) years old. She has been covered under Original Medicare
for the last six years due to her disability and has never been enrolled in a Medicare
Advantage or a Part D plan before. She wants to enroll in a Part D plan. She knows that
there is such a thing as the "Part D Initial Enrollment Period" (IEP) and has concluded
that, since she has never enrolled in such a plan before, she should be eligible to enroll
under this period. What should you tell her about how the Part D Initial Enrollment
Period applies to her situation? - CORRECT ANSWER Ms. Claggett has had two
IEPs and missed them both. The first occurred three months before and three months
after the month when she was first entitled to Part A OR enrolled in Part B. Because she
was eligible for Medicare before age 65, Ms. Claggett had a second IEP based on
turning age 65, which has also expired.
Ms. Thomas has worked for many years and is turning 68 in June. She is eligible for
Medicare Part A and did not enroll for Part B when first eligible because she has
insurance through her employer - Coffee Brew, Inc. She also did not enroll in Part D
because she had creditable coverage. She would like to retire in June and enroll in a
Medicare Advantage plan. She has been informed that her group coverage will end on
her retirement effective date. How would you advise Ms. Thomas? - CORRECT
ANSWER Ms. Thomas can enroll in Part B without a late penalty at any time she is
still covered by her employer group and 8 months after her last month of employer
group coverage without a penalty. However, because she wants to enroll in a MA plan
after retirement, she should make sure her Part B coverage is effective in time to use
