AHIP Medicare Certification EXAMS WITH
CORRECT SOLUTIONS /PASS GUIDE
1. 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? - ANSWER-You must have her sign a scope of
appointment form, indicating which products she wishes to discuss.
You may then proceed with the discussion.
2. Agent Julia Horne has recently begun marketing Medicare Advantage
and related products aimed at meeting the needs of senior citizens.
Client Mary Bean has expressed interest in a Medicare Advantage
plan. It is now the beginning of September. If you were in Agent
Horne's position, what would you do? - ANSWER-Inquire 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.
3. Avery recently lost her employer's group health and drug coverage
and now she wants to enroll in a PPO that does not include drug
coverage. What should you tell her about obtaining drug coverage? -
ANSWER-She can enroll in the PPO, but she will not be able to
purchase a stand-alone Medicare Part D prescription drug plan.
4. Conrad is 64, retiring soon, and considering enrollment in his
employer-sponsored MA retiree group health plan that includes drug
coverage with nominal copays. He heard about a neighbor's MA-PD
plan that you represent and because he takes numerous prescription
drugs, he is considering signing up for it. What should you tell him? -
ANSWER-He should compare the benefits in his employer-sponsored
retiree group health plan with the benefits in his neighbor's MA-PD
plan to determine which one will provide sufficient coverage for his
prescription needs.
, 5. During a sales presentation to Ms. Barbosa for a Medicare Advantage
plan that has a 5-star rating in customer service and care
coordination, and received an overall plan performance rating of a 4-
star, which of the following would be the best statement to say to her?
- ANSWER-The Medicare Advantage Plan received a 5-star rating in
customer service and care coordination with an overall performance
rating of 4 stars.
6. Hank's Fish Store, Inc. is a small company with just 15 employees
located in Florida. Hank, the store owner, has provided excellent
health benefits to the store's workforce. Nash, one of the store's long-
time employees, will soon be reaching age 65 and eligible for
Medicare. Nash is in good health. He intends to remain an active full-
time employee, working several years after becoming eligible for
Medicare. What type(s) of retiree health benefit will Hank's Fish Store
be able to offer Nash? - ANSWER-Hank's can continue to offer Nash
the same employee health benefit plan, or, if Nash enrolls in Medicare
Part B, it can enroll him in a Medicare Advantage plan that is offered to
the public.
7. If you are to comply with Medicare's guidance regarding educational
events, which of the following would be acceptable activities? -
ANSWER-You may distribute business cards to individuals who request
information on how to contact you for further details on the plan(s)
you represent.
8. Jason is experiencing paranoid delusions and his physician feels that
he should be hospitalized. What should you tell Jason (or his
representative) about the - ANSWER-Medicare will cover a total of 190
days of inpatient psychiatric care during Jason's entire lifetime.
9. Jenny Lind is a Medicare beneficiary who switched from Original
Medicare to a MA MSA (medical savings account) plan. During the past
year, Jenny has become dissatisfied with the MA MSA plan and now
CORRECT SOLUTIONS /PASS GUIDE
1. 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? - ANSWER-You must have her sign a scope of
appointment form, indicating which products she wishes to discuss.
You may then proceed with the discussion.
2. Agent Julia Horne has recently begun marketing Medicare Advantage
and related products aimed at meeting the needs of senior citizens.
Client Mary Bean has expressed interest in a Medicare Advantage
plan. It is now the beginning of September. If you were in Agent
Horne's position, what would you do? - ANSWER-Inquire 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.
3. Avery recently lost her employer's group health and drug coverage
and now she wants to enroll in a PPO that does not include drug
coverage. What should you tell her about obtaining drug coverage? -
ANSWER-She can enroll in the PPO, but she will not be able to
purchase a stand-alone Medicare Part D prescription drug plan.
4. Conrad is 64, retiring soon, and considering enrollment in his
employer-sponsored MA retiree group health plan that includes drug
coverage with nominal copays. He heard about a neighbor's MA-PD
plan that you represent and because he takes numerous prescription
drugs, he is considering signing up for it. What should you tell him? -
ANSWER-He should compare the benefits in his employer-sponsored
retiree group health plan with the benefits in his neighbor's MA-PD
plan to determine which one will provide sufficient coverage for his
prescription needs.
, 5. During a sales presentation to Ms. Barbosa for a Medicare Advantage
plan that has a 5-star rating in customer service and care
coordination, and received an overall plan performance rating of a 4-
star, which of the following would be the best statement to say to her?
- ANSWER-The Medicare Advantage Plan received a 5-star rating in
customer service and care coordination with an overall performance
rating of 4 stars.
6. Hank's Fish Store, Inc. is a small company with just 15 employees
located in Florida. Hank, the store owner, has provided excellent
health benefits to the store's workforce. Nash, one of the store's long-
time employees, will soon be reaching age 65 and eligible for
Medicare. Nash is in good health. He intends to remain an active full-
time employee, working several years after becoming eligible for
Medicare. What type(s) of retiree health benefit will Hank's Fish Store
be able to offer Nash? - ANSWER-Hank's can continue to offer Nash
the same employee health benefit plan, or, if Nash enrolls in Medicare
Part B, it can enroll him in a Medicare Advantage plan that is offered to
the public.
7. If you are to comply with Medicare's guidance regarding educational
events, which of the following would be acceptable activities? -
ANSWER-You may distribute business cards to individuals who request
information on how to contact you for further details on the plan(s)
you represent.
8. Jason is experiencing paranoid delusions and his physician feels that
he should be hospitalized. What should you tell Jason (or his
representative) about the - ANSWER-Medicare will cover a total of 190
days of inpatient psychiatric care during Jason's entire lifetime.
9. Jenny Lind is a Medicare beneficiary who switched from Original
Medicare to a MA MSA (medical savings account) plan. During the past
year, Jenny has become dissatisfied with the MA MSA plan and now
