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AHIP Final Exam Test Questions 2022/20231. 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 situation >>> 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
1 /8
,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 ed-
ucational event. Agent Jennings distributes materials that are solely edu-
cational 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, 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
2 /8
, 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
prescrip- tion 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 concerned 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
3 /8
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