AHIP FINAL EXAM 2025 |50 VERIFIED
QUESTIONS &ANSWERS |LASTEST
STUDY GUIDE |UPDATED EDITION
Mrs. Turner is comparing her employer's retiree insurance to Original
Medicare and would like to know which of the following services Original
Medicare will cover if the appropriate criteria are met. What could you tell
her? - ANS✔✔-Original Medicare covers ambulance services.
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? - ANS✔✔-Mrs. Duarte should file an appeal of
this initial determination within 120 days of the date she received the MSN
in the mail.
Mrs. Geisler's neighbor told her she should look at her Part D options
during the annual Medicare enrollment period because the features of Part
D might have changed. Mrs. Geisler can't remember what Part D is so she
called you to ask what her neighbor was talking about. What could you tell
her? - ANS✔✔-Part D covers prescription drugs and she should look at her
premiums, formulary, and cost-sharing among other factors to see if they
have changed.
You are meeting with Mrs. Hall in her home. On her scope of appointment
form, she asked to discuss Medicare Advantage plans. During the meeting,
she asked to discuss a stand-alone prescription drug plan. She is leaving
the next day to visit her family for a week in another state, so she needs to
decide before she leaves. What must happen before that additional
discussion can take place? - ANS✔✔-Since Mrs. Hall specifically asked
that you discuss the stand-alone Part D plan, you may do so, as long as
, she signs a new scope of appointment form first, indicating that she wants
to discuss the Part D plan.
Agent Jennings makes a presentation on Medicare advertised as an
educational event. Agent Jennings distributes materials that are solely
educational. 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? - ANS✔✔-Yes. When an event has been
advertised as "educational," discussing plan-specific premiums is
impermissible.
By contacting plans available in your area, you have learned that the plan
you represent has a significantly lower monthly premium than the others.
Furthermore, you see that the plan you represent has a unique benefits
package. What should you do to make sure your clients know about these
pieces of information? - ANS✔✔-You may make comparisons between
plans if you can support them with studies or statistical data and such
comparisons are factually based and referenced.
Mr. Prentice has many clients who are Medicare beneficiaries. He should
review the Centers for Medicare & Medicaid Services (CMS)
Communication and Marketing Guidelines to ensure he is compliant with
which type of products. - ANS✔✔-Medicare Advantage (MA) and
Prescription Drug (PDP) plans.
A Medicare beneficiary has walked into your office and requested that you
sit down with her and discuss her options under the Medicare Advantage
program. Before engaging in such a discussion, what should you do? -
ANS✔✔-You must have her sign a scope of appointment form, indicating
which products she wishes to discuss. You may then proceed with the
discussion.
Next week you will be participating in your first "educational event" for
prospective enrollees. To be sure that you do not violate any of the
applicable guidelines, in what activities should you plan to engage? -
ANS✔✔-You should plan to ensure that the educational event is
informative and must not conduct a sales presentation or distribute or
accept enrollment forms at the event.
QUESTIONS &ANSWERS |LASTEST
STUDY GUIDE |UPDATED EDITION
Mrs. Turner is comparing her employer's retiree insurance to Original
Medicare and would like to know which of the following services Original
Medicare will cover if the appropriate criteria are met. What could you tell
her? - ANS✔✔-Original Medicare covers ambulance services.
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? - ANS✔✔-Mrs. Duarte should file an appeal of
this initial determination within 120 days of the date she received the MSN
in the mail.
Mrs. Geisler's neighbor told her she should look at her Part D options
during the annual Medicare enrollment period because the features of Part
D might have changed. Mrs. Geisler can't remember what Part D is so she
called you to ask what her neighbor was talking about. What could you tell
her? - ANS✔✔-Part D covers prescription drugs and she should look at her
premiums, formulary, and cost-sharing among other factors to see if they
have changed.
You are meeting with Mrs. Hall in her home. On her scope of appointment
form, she asked to discuss Medicare Advantage plans. During the meeting,
she asked to discuss a stand-alone prescription drug plan. She is leaving
the next day to visit her family for a week in another state, so she needs to
decide before she leaves. What must happen before that additional
discussion can take place? - ANS✔✔-Since Mrs. Hall specifically asked
that you discuss the stand-alone Part D plan, you may do so, as long as
, she signs a new scope of appointment form first, indicating that she wants
to discuss the Part D plan.
Agent Jennings makes a presentation on Medicare advertised as an
educational event. Agent Jennings distributes materials that are solely
educational. 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? - ANS✔✔-Yes. When an event has been
advertised as "educational," discussing plan-specific premiums is
impermissible.
By contacting plans available in your area, you have learned that the plan
you represent has a significantly lower monthly premium than the others.
Furthermore, you see that the plan you represent has a unique benefits
package. What should you do to make sure your clients know about these
pieces of information? - ANS✔✔-You may make comparisons between
plans if you can support them with studies or statistical data and such
comparisons are factually based and referenced.
Mr. Prentice has many clients who are Medicare beneficiaries. He should
review the Centers for Medicare & Medicaid Services (CMS)
Communication and Marketing Guidelines to ensure he is compliant with
which type of products. - ANS✔✔-Medicare Advantage (MA) and
Prescription Drug (PDP) plans.
A Medicare beneficiary has walked into your office and requested that you
sit down with her and discuss her options under the Medicare Advantage
program. Before engaging in such a discussion, what should you do? -
ANS✔✔-You must have her sign a scope of appointment form, indicating
which products she wishes to discuss. You may then proceed with the
discussion.
Next week you will be participating in your first "educational event" for
prospective enrollees. To be sure that you do not violate any of the
applicable guidelines, in what activities should you plan to engage? -
ANS✔✔-You should plan to ensure that the educational event is
informative and must not conduct a sales presentation or distribute or
accept enrollment forms at the event.
