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Ahip study guide 2024||Latest 2024 verified by expert
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ANSWERSHEET2024 AHIP Study Guide
Directions: Log into the AHIP Medicare Training Link using this link
https://www.ahipmedicaretraining.com/clients/hpone/internal . The top right corner of your screen should
say HPOne (example below). If your screen does NOT match the correct photo below you are not logged in
properly. Please clear your cookies and cache and click on the link above again. If the HPOne logo is not in the
top right corner, please reach out to your Supervisor/Trainer.
In this document click the ‘ctrl’ and ‘f’ (ctrl + f) key at the same time on your keyboard. It will bring up a
search box. Type out a unique key word or phrase in each AHIP question to verify if the answer is in the study
guide. (Ex. Duarte)
If the question is not in the study guide, you will need to find the answer in the applicable Module. Best
practice is to first identify what Module the answer may be found in based off the subject of the question.
(Ex. If question is about Medicare eligibility, Module 1 would be the most appropriate location from the
Training Roadmap outlined below) Once in the Module, review the order of the Training Roadmap to quickly
determine where the question might be referenced in the pages. Note: you can (ctrl + f) in the Modules
Use chart below for Module reference:
AHIP Modules: Training Roadmap:
Module 1 – Overview Medicare • Medicare Program Basics
Program Basics (60 slides) • Original Medicare: Eligibility, Enrollment, Entitlement, and Premiums
• Help for Individuals with Limited Income
• Medicare Part A Benefits and Original Medicare Cost Sharing
• Original Medicare and Part D
• Original Medicare Beneficiary Protections
• Medigap Coverage
Module 2 – Part C and Other Medicare • Medicare Advantage Plans
Health Plans (58 slides) • MA Plan Types: Coordinated Care Plans
• Special Needs Plans
• MA Plan Types: Private Fee-for-Service (PFFS) Plans
• MA Plan Types: Medical Savings Account (MSA) Plans
• Medicare Advantage Employer/Union Plans
• Medicare Advantage: Eligibility, Costs, and Benefits
• Medicare Advantage Plans and Dual Eligible Beneficiaries
• Medicare Advantage and Prescription Drugs
Page 1 of 16 July 6, 2023
, 2024 AHIP Study Guide
• Other Type of Medicare Health Plans
Module 3 – Medicare Part D • Medicare Part D Basics Eligibility
Prescription Drug Coverage (54 slides) • Covered Drugs
• Part D Standard and Alternative Benefits
• “True Out-of-Pocket” Costs (TrOOP)
• Part D Premiums and Late Enrollment Penalties
• Part D Drug Management Tools and Formulary Requirements
• Part D Enrollee Rights
• Part D Assistance Programs
Module 4 – Communications and • New rules for marketing 2024 products
Marketing Rules for Medicare • Applicability of rules concerning marketing and communications
Advantage and Part D Plans (102 slides) • Marketing Representatives: agents/brokers and third party marketing
organizations
• Key terms and general background information
• Regulation of communications activities and materials
• Marketing communications – contacting beneficiaries
• Rules related to sales and educational events
• Marketing at individual appointments
• Use of social media to market
• Required practices
• Accessing and using certain plan materials
• Plan ratings and call recordings
• Prohibited activities
• Marketing during the open enrollment period
• Marketing in healthcare settings
• Plan oversight and enforcement of marketing requirements
• Marketing Representative Compensation
• Frequently asked questions
Module 5 – Enrollment Guidance • Enrollment periods
Medicare Advantage and Part D Plans • Election periods
(72 slides) • Enrollment Periods MA Open Enrollment Period
• Special Election Periods (SEPs)
• Open Enrollment Period for Institutionalized Individuals
• Enrollment requests
• Beneficiary acknowledgements and enrollee discrimination
prohibitions
• Post-enrollment activities and rules
• Disenrollment
Study Guide Questions
Note: the questions below are not in test order
Page 2 of 16 July 6, 2023
, 2024 AHIP Study Guide
Questions Answers
Mrs. Gonzalez is enrolled in Original Medicare and has a ✓ Mrs. Gonzalez cannot purchase a Medigap plan that covers
Medigap policy as well, but it provides no drug coverage. drugs, but she could keep her Medigap policy and enroll in a
She would like to keep the coverage she has but replace her Part D prescription drug plan.
existing Medigap plan with one that provides drug
coverage. What should you tell her?
Edward IP suffered from serious kidney disease. As a result. ✓ Individuals eligible for Medicare based on ESRD generally
Edward became eligible for Medicare coverage due to end- lose eligibility 36 months after the month in which the
stage renal disease (ESRD). A close relative donated their individual receives a kidney transplant unless they are
kidney and Edward successfully underwent transplant eligible for Medicare on another basis such as age or
surgery 12 months ago. Edward is now age 50 and asks you disability. Edward may, however, remain enrolled in Part B
but solely for coverage of immunosuppressive drugs if he has
if his Medicare coverage will continue, what should you
no other health care coverage that would cover the drugs.
say?
Ms. Moore plans to retire when she turns 65 in a few ✓ Medicare is a program for people age 65 or older and those
months. She is in excellent health and will have under age 65 with certain disabilities, end-stage renal
considerable income when she retires. She is concerned disease, and Lou Gehrig’s disease so she will be eligible for
that her income will make it impossible for her to qualify for Medicare.
Medicare. What could you tell her to address her concern?
Ms. Henderson believes that she will qualify for Medicare ✓ To obtain Part B coverage, she must pay a standard monthly
Coverage when she turns 65, without paying any premiums, premium, though it is higher for individuals with higher
because she has been working for 40 years and paying incomes.
Medicare taxes. What should you tell her?
Anthony Boniface turned 65 in 2023. He was not receiving ✓ Anthony is eligible for a special enrollment period (SEP)
Social Security or Railroad Retirement Benefits on his because he missed an enrollment period due to the impact
65th birthday. He was interested in obtaining Medicare of the Federally declared disaster. This SEP will allow
coverage and is eligible for premium-free Part A. Before he Anthony to enroll in Part B up to six months after the end of
could enroll in Medicare, his entire area was impacted by a the emergency declaration. Anthony may enroll in premium-
free Part A at any time and his Part A coverage will be
hurricane causing massive flooding and severe wind
retroactive for up to 6 months.
damage. The Federal government declared this to be a
natural disaster which has recently ended. During this
period Anthony’s initial enrollment period expired. Anthony
asks you how he can now obtain Medicare coverage. What
should you say?
Mrs. Peňa is 66 years old, has coverage under an employer ✓ She may enroll at any time while she is covered under her
plan, and will retire next year. She heard she must enroll in employer plan, but she will have a special eight-month
Part B at the beginning of the year to ensure no gap in enrollment period after the last month on her employer plan
coverage. What can you tell her? that differs from the standard general enrollment period,
during which she may enroll in Medicare Part B.
Mr. Moy's wife has a Medicare Advantage plan, but he ✓ Medicare Supplemental Insurance would help cover his Part
wants to understand what coverage Medicare A and Part B deductibles or coinsurance in Original Fee-for-
Supplemental Insurance provides since his health care Service (FFS) Medicare as well as possibly some services that
needs are different from his wife’s needs. What could you Medicare does not cover.
tell Mr. Moy?
Shirly Thomas was enrolled in Medicaid during the Public ✓ Shirley is eligible for a Special Enrollment Period (SEP) for up
Health Emergency (PHE). This coverage has recently been to six months after the termination of her Medicaid
Page 3 of 16 July 6, 2023
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