Exam (elaborations)
AHIP Practice Exam 2024/2025 A+ grade assured
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AHIP Practice Exam 2024/2025 A+ grade assured
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AHIP Practice ExamMr. Carlini has heard that Medicare prescription drug plans are only offered through private
companies under a program known as Medicare Advantage (MA), not by the government. He
likes Original Medicare and does not want to sign up for an MA product, but he also wants
prescription drug coverage. What should you tell him? - ANSMr. Carlini can stay with Original
Medicare and also enroll in a Medicare prescription drug plan through a private company that
has contracted with the government to provide only such drug coverage to eligible Medicare
beneficiaries.
During a sales presentation to Ms Daley for a Medicare Advantage plan that has a 5-star rating
in customer service and care coordination, and received an overall plan performance of a 4-star,
which of the following would be the correct statement to say to her? - ANSThe Medicare
Advantage plan received a 5-star rating in customer service and care coordination with an
overall performance rating of 4-stars
Mrs. Pena is 66 years old, has coverage under an employer plan and will retire next year. She
heard she must enroll in Part B at the beginning of the year to ensure no gap in coverage. What
can you tell her? - ANSShe may enroll at any time while she is covered under her employer
plan, but she will have a special eight-month enrollment period that differs from the standard
general enrollment period, during which she may enroll in Medicare Part B
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.
Alice is a marketing representative employed by a health plan. Betty is a captive agent of a
health plan who markets to multiple plans and sponsors. Carl is a captive agent who markets to
only one plan/sponsor. Denise is an independent agent who markets to different types of
groups. Edward is an independent agent who markets only to employer and union groups. CMS
marketing representative compensation rules generally apply to: - ANSBetty and Denise, but not
Alice (the employee) or Carl or Edward (to whom exceptions apply).
Mrs. Valentino is currently enrolled in a Medicare Cost plan. This plan is no longer meeting her
needs, but it is now mid-year and past the annual election period (AEP). What would you say to
Mrs. Valentino regarding her options? - ANSMrs. Valentino can submit a written request to
Medicare to be disenrolled from the Cost plan and enroll in Original Medicare.
, When Myra first became eligible for Medicare, she enrolled in Original Medicare (Parts A and
B). She is now 67 and will turn 68 on July 1. She would now like to enroll in a Medicare
Advantage (MA) plan and approaches you about her options. What advice would you give her?
- ANSShe should remain in Original Medicare until the annual election period running from
October 15 to December 7, during which she can select an MA plan.
Mrs. Tanner is enrolled in a Medicare Advantage HMO that offers a point of service options. This
allows Mrs. Tanner to do which of the following? - ANSMrs. Tanner can go to non-plan doctors
for certain services without receiving prior approval
Agent Harriet Walker has recently begun marketing Medicare Advantage and related products
aimed at meeting the needs of senior citizens. Client Mildred Jones has expressed interest in a
Medicare Advantage plan. It is now the beginning of September. If you were in Agent Walker's
position, what would you do? - ANSInquire whether the client qualifies for a special enrollment
period, and if not, solicit an enrollment application once the annual open enrollment election
period begins on October 15th.
Mrs. Chen will be 65 soon, has been a citizen for twelve years, has been employed full time,
and paid taxes during that entire period. She is concerned that she will not qualify for coverage
under part A because she was not born in the United States. What should you tell her? -
ANSMost individuals who are citizens and over age 65 are covered under Part A by virtue of
having paid Medicare taxes while working, though some may be covered as a result of paying
monthly premiums.
Mr. Katz reached the Part D coverage gap in August last year. His prescriptions have not been
changed, he is keeping the same Part D plan and the benefits, cost-sharing, and coverage of
his drugs are all the same as last year. He asked what to expect for this year about his
out-of-pocket costs. What could you tell him? - ANSBecause he reached the coverage gap last
year, he will probably reah it again this year close to the same time.
ABC is a Medicare Advantage (MA) plan sponsor. It would like to use its enrollees' protected
health information to market non-health related products such as life insurance and annuities.
To do so it must obtain authorization from the enrollees. Which statement best describes the
authorization process? - ANSAuthorization may be obtained by directing a beneficiary to a
website to provide consent
Mrs. Henderson believes that she will qualify for Medicare coverage when she turns 65, without
paying any premiums, because she has been working for 40 years and paying Medicare taxes.
What should you tell her? - ANSIn order to obtain Part B coverage, she must pay a standard
monthly premium, though it is higher for individuals with higher incomes.
Mr. Buck has several family members who died from different cancers. He wants to know if
Medicare covers cancer screening. What should you tell him? - ANSMedicare covers periodic
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