AHIP Final UPDATED ACTUAL Exam Questions and CORRECT
Answers | Graded
Question 1.
b. Ms. Lopez is considered a marketing representative of BestCare and thus is obligated
to comply with CMS marketing requirements, including those regarding using only
approved call scripts.
Correct Answer: Ms. Lopez is an independent agent under contract with
MarketCo, a third-party marketing organization. MarketCo has a contract with
BestCare health plan, a Medicare Advantage (MA) organization, to offer
marketing services through its contracted agents and agencies. Ms. Lopez
returns calls to individuals who contact MarketCo in response to its mailers
promoting BestCare health plan. Which of the following best describes the
responsibilities of Ms. Lopez?
a. Ms. Lopez is considered a marketing representative of BestCare but is
exempt from the marketing rules regarding approved call scripts because she
works directly for MarketCo.
b. Ms. Lopez is considered a marketing representative of BestCare and thus is
obligated to comply with CMS marketing requirements, including those
regarding using only approved call scripts.
c. Ms. Lopez no longer needs to be concerned about state licensure since she
is marketing an MA product subject to federal rules.
d. Ms. Lopez needs to maintain state licensure, but because she is working for
a third- party marketing organization she is exempt from CMS training
requirements that apply to BestCare captive agents.
Question 2.
Mr. Edwards, a marketing representative of the ACME Insurance Company, scheduled a
marketing event and expects about 40 people to attend. He has hired a magician at a
cost of $200 to entertain attendees. Can he do this in a way that complies with guidance
from the Medicare agency?
Correct Answer: a. He can do this because the estimated number of attendees
is based on the venue size and response rate and the value of the gift does
not exceed $15.
Question 3.
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 Answer: b. Mrs. 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 a part of the PPO network.
,Question 4.
Julia Harris is turning 66 in July, at which time she will retire. She has contacted your
office and requested a meeting so that she can learn about Medicare and the products
you represent. How should you respond?
Correct Answer: c. Tell Julia that you will meet with her to explain Medicare
and should she be interested you can accept and submit an enrollment
request, since this is an initial enrollment qualifying her for a special
enrollment period.
Question 5.
Mr. Rivera has Qualified Medicare Beneficiary (QMB) eligibility and is thus covered by
both Medicare and Medicaid. He decides to enroll in a Medicare Advantage (MA) PPO
plan. Later he sees an out-of-network doctor to receive a Medicare covered service. How
much The doctor may only collect from Mr. Rivera the cost sharing allowable under the
state's Medicaid program.may the doctor collect from Mr. Rivera?
Correct Answer: The doctor may only collect from Mr. Rivera the cost sharing
allowable under the state's Medicaid program.
Question 6.
During a sales presentation in Ms. Sullivan's home, she tells you that she has heard
about a type of Medicare health plan known as Private Fee-for-Service (PFFS). She wants
to know if this would be available to her. What should you tell her about PFFS plans?
Correct Answer:
Question 7.
Choose one answer.
Correct Answer:
Question 8.
-✓✓a. A PFFS plan is a type of Medicare Supplement plan and she may enroll in one if it
is available in her area.
Question 9.
-✓✓b. A PFFS plan is exactly the same as Original Medicare, only offered by a private
entity and she may enroll in one if it is available in her area.
Question 10.
-✓✓c. PFFS plans are designed to cover only prescription drugs and if that is the type of
coverage she wants, she may enroll in one if it is available in her area.
,Question 11.
-✓✓d. A PFFS plan is one of the various types of Medicare Advantage plans offered by
private entities and she may enroll in one if it is available in her area.
Question 12.
Question8
Correct Answer:
Question 13.
Marks: 1
Correct Answer:
Question 14.
During an appointment scheduled to discuss a Medicare Advantage Prescription Drug
plan (MA-PD), Mr. Peters asked his agent to describe a stand-alone prescription drug
plan (Part D plan) that his neighbor told him about. What should his agent do?
Correct Answer:
Question 15.
Choose one answer.
Correct Answer:
Question 16.
-✓✓a. Since Mr. Peters requested a description of the Part D plan, his agent must leave
the Part D plan brochure, but not an enrollment form, and would have to schedule
another appointment after at least 48 hours have passed to discuss the Part D plan with
Mr. Peters.
•
Correct Answer: b. Since Mr. Peters requested a description of the Part D plan,
his agent must have Mr. Peters sign a new scope of appointment form that
includes Part D, and then the agent may discuss the Part D plan so Mr. Peters
can compare plans and make an informed enrollment choice during the
appointment.
Question 17.
-✓✓c. Since Mr. Peters requested a description of the Part D plan, his agent must inform
Mr. Peters that he can only sign up for the MA-PD plan and cannot receive a brochure or
any other information about the Part D plan now because he did not agree in advance to
discuss that plan
, Question 18.
-✓✓d. Since Mr. Peters requested a description of the Part D plan, his agent must
discuss both the Part D and the MA-PD plans and return after at least 48 hours to
complete the Part D plan enrollment form with Mr. Peters.
Question 19.
Question9
Correct Answer:
Question 20.
Marks: 1
Correct Answer:
Question 21.
Mr. Torres has a small savings account. He would like to pay for his monthly Part D
premiums with an automatic monthly withdrawal from his savings account until it is
exhausted, and then have his premiums withheld from his Social Security check. What
should you tell him?
Correct Answer:
Question 22.
Choose one answer.
Correct Answer:
Question 23.
-✓✓a. In general, he must select a single Part D premium payment mechanism that will
be used throughout the year.
Question 24.
-✓✓b. As long as he fills out the paperwork to begin withholding from his Social Security
check at least 63 days before such withholding should begin, he can change his method
of Part D premium payment and withholding will begin the month after his savings
account is exhausted.
Question 25.
-✓✓c. During 2017, many people experienced significant problems with deductions from
their Social Security check for their Part D premium. As a result, this method of payment
is no longer an option for Part D premium payments
Answers | Graded
Question 1.
b. Ms. Lopez is considered a marketing representative of BestCare and thus is obligated
to comply with CMS marketing requirements, including those regarding using only
approved call scripts.
Correct Answer: Ms. Lopez is an independent agent under contract with
MarketCo, a third-party marketing organization. MarketCo has a contract with
BestCare health plan, a Medicare Advantage (MA) organization, to offer
marketing services through its contracted agents and agencies. Ms. Lopez
returns calls to individuals who contact MarketCo in response to its mailers
promoting BestCare health plan. Which of the following best describes the
responsibilities of Ms. Lopez?
a. Ms. Lopez is considered a marketing representative of BestCare but is
exempt from the marketing rules regarding approved call scripts because she
works directly for MarketCo.
b. Ms. Lopez is considered a marketing representative of BestCare and thus is
obligated to comply with CMS marketing requirements, including those
regarding using only approved call scripts.
c. Ms. Lopez no longer needs to be concerned about state licensure since she
is marketing an MA product subject to federal rules.
d. Ms. Lopez needs to maintain state licensure, but because she is working for
a third- party marketing organization she is exempt from CMS training
requirements that apply to BestCare captive agents.
Question 2.
Mr. Edwards, a marketing representative of the ACME Insurance Company, scheduled a
marketing event and expects about 40 people to attend. He has hired a magician at a
cost of $200 to entertain attendees. Can he do this in a way that complies with guidance
from the Medicare agency?
Correct Answer: a. He can do this because the estimated number of attendees
is based on the venue size and response rate and the value of the gift does
not exceed $15.
Question 3.
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 Answer: b. Mrs. 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 a part of the PPO network.
,Question 4.
Julia Harris is turning 66 in July, at which time she will retire. She has contacted your
office and requested a meeting so that she can learn about Medicare and the products
you represent. How should you respond?
Correct Answer: c. Tell Julia that you will meet with her to explain Medicare
and should she be interested you can accept and submit an enrollment
request, since this is an initial enrollment qualifying her for a special
enrollment period.
Question 5.
Mr. Rivera has Qualified Medicare Beneficiary (QMB) eligibility and is thus covered by
both Medicare and Medicaid. He decides to enroll in a Medicare Advantage (MA) PPO
plan. Later he sees an out-of-network doctor to receive a Medicare covered service. How
much The doctor may only collect from Mr. Rivera the cost sharing allowable under the
state's Medicaid program.may the doctor collect from Mr. Rivera?
Correct Answer: The doctor may only collect from Mr. Rivera the cost sharing
allowable under the state's Medicaid program.
Question 6.
During a sales presentation in Ms. Sullivan's home, she tells you that she has heard
about a type of Medicare health plan known as Private Fee-for-Service (PFFS). She wants
to know if this would be available to her. What should you tell her about PFFS plans?
Correct Answer:
Question 7.
Choose one answer.
Correct Answer:
Question 8.
-✓✓a. A PFFS plan is a type of Medicare Supplement plan and she may enroll in one if it
is available in her area.
Question 9.
-✓✓b. A PFFS plan is exactly the same as Original Medicare, only offered by a private
entity and she may enroll in one if it is available in her area.
Question 10.
-✓✓c. PFFS plans are designed to cover only prescription drugs and if that is the type of
coverage she wants, she may enroll in one if it is available in her area.
,Question 11.
-✓✓d. A PFFS plan is one of the various types of Medicare Advantage plans offered by
private entities and she may enroll in one if it is available in her area.
Question 12.
Question8
Correct Answer:
Question 13.
Marks: 1
Correct Answer:
Question 14.
During an appointment scheduled to discuss a Medicare Advantage Prescription Drug
plan (MA-PD), Mr. Peters asked his agent to describe a stand-alone prescription drug
plan (Part D plan) that his neighbor told him about. What should his agent do?
Correct Answer:
Question 15.
Choose one answer.
Correct Answer:
Question 16.
-✓✓a. Since Mr. Peters requested a description of the Part D plan, his agent must leave
the Part D plan brochure, but not an enrollment form, and would have to schedule
another appointment after at least 48 hours have passed to discuss the Part D plan with
Mr. Peters.
•
Correct Answer: b. Since Mr. Peters requested a description of the Part D plan,
his agent must have Mr. Peters sign a new scope of appointment form that
includes Part D, and then the agent may discuss the Part D plan so Mr. Peters
can compare plans and make an informed enrollment choice during the
appointment.
Question 17.
-✓✓c. Since Mr. Peters requested a description of the Part D plan, his agent must inform
Mr. Peters that he can only sign up for the MA-PD plan and cannot receive a brochure or
any other information about the Part D plan now because he did not agree in advance to
discuss that plan
, Question 18.
-✓✓d. Since Mr. Peters requested a description of the Part D plan, his agent must
discuss both the Part D and the MA-PD plans and return after at least 48 hours to
complete the Part D plan enrollment form with Mr. Peters.
Question 19.
Question9
Correct Answer:
Question 20.
Marks: 1
Correct Answer:
Question 21.
Mr. Torres has a small savings account. He would like to pay for his monthly Part D
premiums with an automatic monthly withdrawal from his savings account until it is
exhausted, and then have his premiums withheld from his Social Security check. What
should you tell him?
Correct Answer:
Question 22.
Choose one answer.
Correct Answer:
Question 23.
-✓✓a. In general, he must select a single Part D premium payment mechanism that will
be used throughout the year.
Question 24.
-✓✓b. As long as he fills out the paperwork to begin withholding from his Social Security
check at least 63 days before such withholding should begin, he can change his method
of Part D premium payment and withholding will begin the month after his savings
account is exhausted.
Question 25.
-✓✓c. During 2017, many people experienced significant problems with deductions from
their Social Security check for their Part D premium. As a result, this method of payment
is no longer an option for Part D premium payments
