AHIP Final Exam Test Questions
Study online at https://quizlet.com/_a235nr
1. 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?: Medicare does not cover acupuncture, or, in general, glasses or dentures.
2. 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?: 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.
3. 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 situa-
tion?: 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.
4. 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?: In general, he must select a single Part D
premium payment mechanism that will be used throughout the year.
5. Agent Jennings makes a presentation on Medicare advertised as an educa-
tional 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?: Yes. When an event has been advertised as "educational," discussing plan-specific premiums is
impermissible.
6. 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,
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, AHIP Final Exam Test Questions
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she is not enrolled under Medicare Part B. What should you tell her?: 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.
7. 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?: 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.
8. 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 con-
cerned that her income will make it impossible for her to qualify for Medicare.
What could you tell her to address her concern?: 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.
9. 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?: Agent Armstrong needs to be licensed and
appointed in every state in which beneficiaries to whom he markets ABC MA plans are located.
10. 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?: 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.
11. 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?: You will not be able to represent any
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Study online at https://quizlet.com/_a235nr
1. 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?: Medicare does not cover acupuncture, or, in general, glasses or dentures.
2. 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?: 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.
3. 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 situa-
tion?: 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.
4. 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?: In general, he must select a single Part D
premium payment mechanism that will be used throughout the year.
5. Agent Jennings makes a presentation on Medicare advertised as an educa-
tional 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?: Yes. When an event has been advertised as "educational," discussing plan-specific premiums is
impermissible.
6. 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,
1/8
, AHIP Final Exam Test Questions
Study online at https://quizlet.com/_a235nr
she is not enrolled under Medicare Part B. What should you tell her?: 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.
7. 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?: 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.
8. 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 con-
cerned that her income will make it impossible for her to qualify for Medicare.
What could you tell her to address her concern?: 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.
9. 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?: Agent Armstrong needs to be licensed and
appointed in every state in which beneficiaries to whom he markets ABC MA plans are located.
10. 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?: 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.
11. 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?: You will not be able to represent any
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