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AHIP Final Exam Test Questions
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? - ANSMedicare 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? - ANSHe 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? -
ANSHe 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? - ANSIn 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? - ANSYes. 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? - ANSEveryone 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? - ANSMedicare 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?
- ANSMedicare 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? - ANSAgent 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? - ANSPart 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? - ANSYou 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? - ANSMr. 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? - ANSHe may sign-up for Medicare at any time
however coverage usually begins on the fourth month after dialysis treatments start.
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