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1. Agent Roderick enrolls retiree Mrs. Martinez in a med- This situation is consid-
ical savings account (MSA) Medicare health plan. The ered a "dual enrollment,"
MSA plan does not offer prescription drug coverage, so and CMS compensation
Agent Roderick also enrolls Mrs. Martinez in a stand- rules are applied to the
alone prescription drug plan (PDP). What CMS com- two plans at once and in-
pensation rules apply to this situation? dependently of each other.
a. Regular CMS and renewal compensation rules apply
to the PDP enrollment, but compensation is limited to
$100 for the MSA health plan enrollment to recom-
pense CMS for contributions made to the enrollee's
MSA account.
b. MSA Medicare health plans are subject to special
rules limiting initial year compensation to 50 percent
of the fair market value (FMV) published annually by
CMS. Regular initial year enrollment rules apply to the
PDP.
c. When an MSA Medicare health plan is combined with
a PDP, initial and renewal year(s) compensation is paid
only for the MSA enrollment to recompense CMS for
contributions made to th
2. Ms. Chase is interested in discussing various Medicare MA plans have a maximum
Advantage (MA) Plans available in her area with you. out-of-pocket limit, known
She has heard that MA plans have something called as the "MOOP", for Part A
a "maximum out-of-pocket" limit. She asks you to ex- and Part B benefits. Once a
plain what this means. What do you say? plan member pays a spec-
ified amount of cost-shar-
a. Each year, CMS specifies an optional MOOP, which ing, the health plan cov-
health plans can exceed or lower.
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b. Original Medicare, not MA plans, have a maximum ers 100 percent of covered
out-of-pocket limit, for Part A and Part B benefits. medical services.
c. MA plans have a maximum out-of-pocket limit,
known as the "MOOP" for Part A and Part B bene-
fits. Once a plan member pays a specified amount
of cost-sharing, the health plan covers 80 percent of
covered medical services.
d. MA plans have a maximum out-of-pocket limit,
known as the "MOOP", for Part A and Part B bene-
fits. Once a plan member pays a specified amount of
cost-sharing, the health plan covers 100 percent of
covered medical services.
3. Agent Marvin Millner wants to reach out to his current Marvin should consult
clients for referrals. What advice would you give to with the health plans
Marvin? he represents to de-
termine whether those
a. CMS guidelines limit the value of gifts provided in plans impose require-
exchange for referrals to a value of $50 or less. ments around beneficiary
referrals
b. Marvin should understand that under CMS guide-
lines he can no longer provide gifts, even of minimal
value, in exchange for referrals.
c. Marvin should consult with the health plans he rep-
resents to determine whether those plans impose re-
quirements around beneficiary referrals.
d. CMS guidelines limit the value of gifts provided in
exchange for referrals to a value of $100 or less.
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4. Mr. Perry is entitled to Medicare Part A but has not yet He is eligible for the Part
enrolled in Part B, even though he is 69 years old. He D prescription drug ben-
would like to enroll in a Medicare Part D prescription efit because he is entitled
drug plan but is concerned that he will have to sign up to Part A and he does not
for Part B as well in order to qualify for enrollment in a have to be enrolled in Part
Part D plan. What should you tell him? B
a. He need not be entitled to Part A or enrolled in
Part B to be eligible for the Part D prescription drug
benefit. He must only be aged 65 or older to qualify for
enrollment in Part D, so he can go ahead and enroll in
a Part D prescription drug plan.
b. He is eligible for the Part D prescription drug benefit
because he is entitled to Part A and he does not have
to be enrolled in Part B.
c. He does not have to enroll in Part B but, must pay a
penalty for his failure to do so when he first turned 65.
After that, he can enroll in a Part D prescription drug
plan.
d. He will have to enroll in Part B
5. Mr. Moreno invited his neighbor, Agent Tom Smith, to A meal cannot be provid-
discuss Medicare Advantage (MA) and Part D plans ed, but light snacks would
that Agent Smith sells at the regular Tuesday brunch be permitted.
the neighbors have for senior citizens. What should
Agent Tom Smith tell Mr. Moreno about the kinds of
food that can be provided to potential enrollees who
attend the sales presentation?
a. A meal cannot be provided, but light snacks would
Study online at https://quizlet.com/_hh10xp
1. Agent Roderick enrolls retiree Mrs. Martinez in a med- This situation is consid-
ical savings account (MSA) Medicare health plan. The ered a "dual enrollment,"
MSA plan does not offer prescription drug coverage, so and CMS compensation
Agent Roderick also enrolls Mrs. Martinez in a stand- rules are applied to the
alone prescription drug plan (PDP). What CMS com- two plans at once and in-
pensation rules apply to this situation? dependently of each other.
a. Regular CMS and renewal compensation rules apply
to the PDP enrollment, but compensation is limited to
$100 for the MSA health plan enrollment to recom-
pense CMS for contributions made to the enrollee's
MSA account.
b. MSA Medicare health plans are subject to special
rules limiting initial year compensation to 50 percent
of the fair market value (FMV) published annually by
CMS. Regular initial year enrollment rules apply to the
PDP.
c. When an MSA Medicare health plan is combined with
a PDP, initial and renewal year(s) compensation is paid
only for the MSA enrollment to recompense CMS for
contributions made to th
2. Ms. Chase is interested in discussing various Medicare MA plans have a maximum
Advantage (MA) Plans available in her area with you. out-of-pocket limit, known
She has heard that MA plans have something called as the "MOOP", for Part A
a "maximum out-of-pocket" limit. She asks you to ex- and Part B benefits. Once a
plain what this means. What do you say? plan member pays a spec-
ified amount of cost-shar-
a. Each year, CMS specifies an optional MOOP, which ing, the health plan cov-
health plans can exceed or lower.
, 2026 Ahip Extras
Study online at https://quizlet.com/_hh10xp
b. Original Medicare, not MA plans, have a maximum ers 100 percent of covered
out-of-pocket limit, for Part A and Part B benefits. medical services.
c. MA plans have a maximum out-of-pocket limit,
known as the "MOOP" for Part A and Part B bene-
fits. Once a plan member pays a specified amount
of cost-sharing, the health plan covers 80 percent of
covered medical services.
d. MA plans have a maximum out-of-pocket limit,
known as the "MOOP", for Part A and Part B bene-
fits. Once a plan member pays a specified amount of
cost-sharing, the health plan covers 100 percent of
covered medical services.
3. Agent Marvin Millner wants to reach out to his current Marvin should consult
clients for referrals. What advice would you give to with the health plans
Marvin? he represents to de-
termine whether those
a. CMS guidelines limit the value of gifts provided in plans impose require-
exchange for referrals to a value of $50 or less. ments around beneficiary
referrals
b. Marvin should understand that under CMS guide-
lines he can no longer provide gifts, even of minimal
value, in exchange for referrals.
c. Marvin should consult with the health plans he rep-
resents to determine whether those plans impose re-
quirements around beneficiary referrals.
d. CMS guidelines limit the value of gifts provided in
exchange for referrals to a value of $100 or less.
, 2026 Ahip Extras
Study online at https://quizlet.com/_hh10xp
4. Mr. Perry is entitled to Medicare Part A but has not yet He is eligible for the Part
enrolled in Part B, even though he is 69 years old. He D prescription drug ben-
would like to enroll in a Medicare Part D prescription efit because he is entitled
drug plan but is concerned that he will have to sign up to Part A and he does not
for Part B as well in order to qualify for enrollment in a have to be enrolled in Part
Part D plan. What should you tell him? B
a. He need not be entitled to Part A or enrolled in
Part B to be eligible for the Part D prescription drug
benefit. He must only be aged 65 or older to qualify for
enrollment in Part D, so he can go ahead and enroll in
a Part D prescription drug plan.
b. He is eligible for the Part D prescription drug benefit
because he is entitled to Part A and he does not have
to be enrolled in Part B.
c. He does not have to enroll in Part B but, must pay a
penalty for his failure to do so when he first turned 65.
After that, he can enroll in a Part D prescription drug
plan.
d. He will have to enroll in Part B
5. Mr. Moreno invited his neighbor, Agent Tom Smith, to A meal cannot be provid-
discuss Medicare Advantage (MA) and Part D plans ed, but light snacks would
that Agent Smith sells at the regular Tuesday brunch be permitted.
the neighbors have for senior citizens. What should
Agent Tom Smith tell Mr. Moreno about the kinds of
food that can be provided to potential enrollees who
attend the sales presentation?
a. A meal cannot be provided, but light snacks would
