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Exam (elaborations)

AHIP FINAL EXAM TEST QUESTIONS

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AHIP FINAL EXAM TEST QUESTIONS

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  • June 29, 2024
  • 8
  • 2023/2024
  • Exam (elaborations)
  • Questions & answers
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AHIP FINAL EXAM TEST QUESTIONS

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
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 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 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?: Yes. When an event has been
advertised as "educational," dis- cussing 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 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



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, 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 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 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.
12. 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?: Mr. 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.




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