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2024 AHIP FINAL EXAM TEST QUESTIONS WITH ANSWERS
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2024 AHIP FINAL EXAM TEST QUESTIONS WITH ANSWERS
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2024 AHIP FINAL EXAM TESTQUESTIONS WITH ANSWERS
Mrs. Duarte is enrolled in Original Medicare Parts A and B. She has recently
reviewed her Medicare Summary Notice (MSN) and disagrees with a
determination that partially denied one of her claims for services. What
advice would you give her? - CORRECT-ANSWERSMrs. Duarte should file and
appeal of this initial determination within 120 days of the date she received
the MSN in the mail
Your friend's mother just moved to an assisted living facility and he asked if
you could present a program for the residents about the MA-PD plans you
market. What could you tell him? - CORRECT-ANSWERSYou appreciate the
opportunity and would be happy to schedule an appointment with anyone at
their request.
Mrs. Andrews asked how a Private Fee-for-Service (PFFS) plan might affect
her access to services since she receives some assistance for her health care
costs from the State. What should you tell her? - CORRECT-
ANSWERSMedicaid may provide additional benefits, but Medicaid will
coordinate benefits only with Medicaid participating providers.
Mrs. Schmidt is moving and a friend told her she might qualify for a "Special
Election Period" to enroll in a new Medicare Advantage plan. She contacted
you to ask what a Special Election Period is. What could you tell her? -
CORRECT-ANSWERSIt is a time period, outside of the Annual Election Period,
when a Medicare beneficiary can select a new or different Medicare
Advantage and/or Part D prescription drug plan. Typically the Special
Election Period is beneficiary specific and results from events, such as when
the beneficiary moves outside of the service area.
Mrs. Quinn has just turned 65, is in excellent health, and has a relatively high
income. She uses no medications and sees no reason to spend money on a
Medicare prescription drug plan if she does not need the coverage. What
could you tell her about the implications of such a decision? - CORRECT-
ANSWERSIf she does not sign up for a Medicare prescription drug plan as
soon as she is eligible to do so, if she does sign up at a later date, her
premium will be permanently increased by 1% of the national average
premium for every month that she was not covered.
, Mrs. Ramos is considering a Medicare Advantage PPO and has questions
about which providers she can go to for her health care. What should you tell
her? - CORRECT-ANSWERSMrs. Ramos can obtain care from any provider
who participates in Original Medicare, but generally will have a higher cost-
sharing amount if she sees a provider who/that is not part of the PPO
network.
Mr. Sanchez has just turned 65 and is entitled to Part A but has not enrolled
in Part B because he has coverage through an employer plan. If he wants to
enroll in a Medicare Advantage plan, what will he have to do? - CORRECT-
ANSWERSHe will have to enroll in Part B.
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. Moy? -
CORRECT-ANSWERSMedicare Supplemental Insurance would help cover his
Part A and Part B cost sharing in Original Fee-for-Service (FFS) Medicare as
well as possibly some services that Medicare does not cover.
Mrs. McIntire is enrolled in her state's Medicaid plan and has just become
eligible for Medicare as well. What can she expect will happen with respect
to her drug coverage? - CORRECT-ANSWERSUnless she chooses a Medicare
Part D prescription drug plan on her own, she will be automatically enrolled
in one available in her area.
Mrs. Young is currently enrolled in Original Medicare (Parts A and B), but she
has been working with Agent Neil Adams in the selection of a Medicare
Advantage (MA) plan. It is mid-September, and Mrs. Young is going on
vacation. Agent Adams is considering suggesting that he and Mrs. Young
complete the application together before she leaves. He will then submit the
paper application prior the start of the annual enrollment period (AEP). What
would you say If you were advising Agent Adams? - CORRECT-ANSWERSThis
is a bad idea. Agents are generally prohibited from soliciting or accepting an
enrollment form prior to the start of the AEP.
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 requirements as the plans themselves. How should you
respond to such a statement? - CORRECT-ANSWERSYour 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.
Agent Martinez wishes to solicit Medicare Advantage prospects through e-
mail and asks you for advice as to whether this is possible. What should you
tell her? - CORRECT-ANSWERSMarketing representatives may initiate
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