AHIP Final Exam Test Questions
/AHIP final exam
{50 questions and Answers}
1. Mr. Moy's wife has a Medicare Advantage plan, but he wants to understand what
coverage Medicare Supplemental Insurance provides since his health care needs are
different from his wife's needs. What could you tell Mr...
4. Another agent working for your agency claims that because you are not employed by
the Medicare Advantage plans that you represent, you are not subject to the same
AHIP Final Exam Test Questions requirements as the plans themselves. How should you respond to such a statement?
/AHIP 2024-2025 final exam Your coworker is not correct. Marketing on behalf of a plan is considered marketing by the plan
and requires that all contracted and employed agents comply with all Medicare marketing rules.
{50 questions and Answers}
1. Mr. Moy's wife has a Medicare Advantage plan, but he wants to understand what
5. Agent Martinez wishes to solicit Medicare Advantage prospects through e-mail and
coverage Medicare Supplemental Insurance provides since his health care needs are
asks you for advice as to whether this is possible. What should you tell her?
different from his wife's needs. What could you tell Mr. Moy?
Marketing representatives may initiate electronic contact through e-mail but the subject line must
Medicare Supplemental Insurance would help cover his Part A and Part B cost sharing in Original
say "marketing" and an opt-out process must be provided.
Fee-for-Service (FFS) Medicare as well as possibly some services that Medicare does not cover.
6. During a sales presentation, your client asks you whether the Medicare agency
2. Mrs. McIntire is enrolled in her state's Medicaid plan and has just become eligible
recommends that she sign up for your plan or stay in Original Medicare. What should
for Medicare as well. What can she expect will happen with respect to her drug
you tell her?
coverage?
Tell her that the Medicare agency does not endorse or recommend any plan.
Unless she chooses a Medicare Part D prescription drug plan on her own, she will be automatically
enrolled in one available in her area.
7. Ms. Lewis understands that Medicare prescription drug plans may use various
3. Mrs. Young is currently enrolled in Original Medicare (Parts A and B), but she has
methods to control the use of specific drugs. She has heard about a technique called
been working with Agent Neil Adams in the selection of a Medicare Advantage (MA)
"step therapy" and is wondering if you can explain what that is. What should you tell
plan. It is mid-September, and Mrs. Young is going on vacation. Agent Adams is
her?
considering suggesting that he and Mrs. Young complete the application together
Step therapy involves using one or more lower priced drugs before trying a more expensive drug
before she leaves. He will then submit the paper application prior the start of the
when all are used to treat the same condition.
annual enrollment period (AEP). What would you say If you were advising Agent
Adams?
This is a bad idea. Agents are generally prohibited from soliciting or accepting an enrollment form
8. Mrs. Radford asks whether there are any special eligibility requirements for
prior to the start of the AEP.
Medicare Advantage. What should you tell her?
Mrs. Radford must be entitled to Part A and enrolled in Part B to enroll in Medicare Advantage.
, 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
9. Mr. Castillo, a naturalized citizen, previously enrolled in Medicare Part B but has drug plan. What should you tell him about this situation?
recently stopped paying his Part B premium. Mr. Castillo is still covered by Part A. He could enroll in one of the MA plans that include prescription drug coverage or a Medigap plan
He would like to enroll in a Medicare Advantage (MA) plan and is still covered by and a stand-alone prescription drug plan, but he cannot enroll in the MA-only PPO plan and a
Part A. What should you tell him? stand-alone prescription drug plan.
He is not eligible to enroll in a Medicare Advantage plan until he re-enrolls in Medicare Part B.
14. Mr. Torres has a small savings account. He would like to pay for his monthly Part D
10. You will be holding a sales event soon, at which you would like to offer door prizes to premiums with an automatic monthly withdrawal from his savings account until it is
attendees. Under guidelines from the Medicare agency, what types of gifts or prizes exhausted, and then have his premiums withheld from his Social Security check.
would not be allowed in this situation? What should you tell him?
Gift cards or gift certificates of $15 or less that can be readily converted to cash. In general, he must select a single Part D premium payment mechanism that will be used
throughout the year.
11. 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 15. Agent Jennings makes a presentation on Medicare advertised as an educational event.
cover these items and services. What should you tell her? Agent Jennings distributes materials that are solely educational in nature. However,
Medicare does not cover acupuncture, or, in general, glasses or dentures. 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
12. Mr. Bickford did not quite qualify for the extra help low-income subsidy under the impermissible.
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 16. Mrs. Mulcahy is concerned that she may not qualify for enrollment in a Medicare
to help people with limited means obtain the medications they need. Alternatively, he could check prescription drug plan because, although she is entitled to Part A, she is not enrolled
to see whether his state has a pharmacy assistance program to help him with his expenses. 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
13. Mr. Lombardi is interested in a Medicare Advantage (MA) PPO plan that you prescription drug plan. As long as Mrs. Mulcahy is entitled to Part A, she does not need to enroll
represent. It is one of three plans operated by the same organization in Mr. under Part B before enrolling in a prescription drug plan.
Lombardi's area. The MA PPO plan does not include drug coverage, but the other
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller BestKey. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $10.50. You're not tied to anything after your purchase.
