AHIP (America’s Health Insurance Plans) Newest
2025 Final Exam Test Bank featuring 500 accurate
and verified questions covering Medicare
Advantage, Medicare Part D, fraud, waste, and
abuse (FWA), enrolment procedures, compliance
guidelines, and ethic
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? – 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? –
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? –
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? – 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? – 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? – 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
2025 Final Exam Test Bank featuring 500 accurate
and verified questions covering Medicare
Advantage, Medicare Part D, fraud, waste, and
abuse (FWA), enrolment procedures, compliance
guidelines, and ethic
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? – 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? –
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? –
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? – 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? – 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? – 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
