AHIP EXAM 2023/2024 CURRENT LATEST
UPDATED Q&A VERIFIED ANSWERS
GUARANTEED PASS
Mrs. Berkowitz wants to enroll in a Medicare Advantage plan that does not include drug
coverage and also enroll in a stand-alone Medicare prescription drug plan. Under what
circumstances can she do this?
If the Medicare Advantage plan is a Private Fee-for-Service (PFFS) plan that does not offer drug
coverage or a Medical Savings Account, Mrs. Berkowitz can do this.
Ms. Goldstein is required by the plan she represents to obtain enrollment forms that have carbon
copies in the back. She gives one to the beneficiary, sends another to the plan and retains the
third. What should she do with her copies of the enrollment forms?
She should make every effort to safeguard the beneficiary information on those enrollment
forms.
Mr. Lopez takes several high cost prescription drugs. He would like to enroll in a standalone Part
D prescription drug plan that is available in his area. In what type of Medicare Health Plan can
he enroll?
Private Fee-for-Service (PFFS) plan that does not include drug coverage.
Mr. Block is currently enrolled in a Medicare Advantage plan that includes drug coverage. He
found a stand-alone Medicare prescription drug plan in his area that offers better coverage than
that available through his MA-PD plan and in addition has a low premium. It won't cost him
much more and, because he has the means to do so, he wishes to enroll in the stand-alone
prescription drug plan in addition to his MA-PD plan. What should you tell him?
If Mr. Block enrolls in the stand-alone Medicare prescription drug plan, he will be disenrolled
from the Medicare Advantage plan.
Mrs. Chen will be 65 soon, has been a citizen for twelve years, has been employed full time, and
paid taxes during that entire period. She is concerned that she will not qualify for coverage under
part A because she was not born in the United States. What should you tell her?
Most individuals who are citizens and over age 65 are covered under Part A by virtue of having
paid Medicare taxes while working, though some may be covered as a result of paying monthly
premiums.
Mrs. Lopez is enrolled in a Medicare Advantage cost plan. She has recently lost creditable
coverage previously available through her husband's employer. She is interested in enrolling in a
Medicare Part D prescription drug plan (PDP). What should you tell her?
, If a Part D benefit is offered through her plan she must enroll in this plan.
Mr. Schmidt would like to plan for retirement and has asked you what is covered under Original
Fee-for-Service (FFS) Medicare? What could you tell him?
Part A, which covers hospital, skilled nursing facility, hospice and home health services and Part
B, which covers professional services such as those provided by a doctor are covered under
Original Medicare.
Mrs. Wellington is enrolled in Parts A and B of Original Medicare. A friend recently told her
that there is an excellent Medicare Advantage (MA) plan with a five-star rating serving her area.
On January 15 she comes to you for advice as to what options, if any, she has. What should you
say regarding special enrollment periods (SEPs)?
Mrs. Wellington is eligible for a SEP that may be used once until November 30 to enroll in the
five-star plan.
Mr. Shapiro gets by on a very small fixed income. He has heard there may be extra help paying
for Part D prescription drugs for Medicare beneficiaries with limited income. He wants to know
whether he might qualify. What should you tell him?
The extra help is available to beneficiaries whose income and assets do not exceed annual limits
specified by the government.
A client wants to give you an enrollment application on October 1 prior to the beginning of the
Annual Election Period because he is leaving on vacation for two weeks and does not want to
forget about turning it in. What should you tell him?
You must tell him you are not permitted to take the form. If he sends the form directly to the
plan, the plan will process the enrollment on the day the Annual Election Period begins.
Agent Roderick enrolls retiree Mrs. Martinez in a medical savings account (MSA) Medicare
health plan. The MSA plan does not offer prescription drug coverage, so Agent Roderick also
enrolls Mrs. Martinez in a standalone prescription drug plan (PDP). What CMS compensation
rules apply to this situation?
This situation is considered a "dual enrollment," and CMS compensation rules are applied to the
two plans at once and independently of each other.
Which of the following steps may a Part D sponsor adopt for beneficiaries who are at risk of
misusing or abusing frequently abused drugs?
I. Identifying at risk individuals by using criteria that includes the number of opioid prescriptions
the beneficiary has and the number of prescribers who have written those prescriptions.
II. Locking an at-risk beneficiary into one pharmacy.
III. Locking an at-risk beneficiary into one prescriber.
UPDATED Q&A VERIFIED ANSWERS
GUARANTEED PASS
Mrs. Berkowitz wants to enroll in a Medicare Advantage plan that does not include drug
coverage and also enroll in a stand-alone Medicare prescription drug plan. Under what
circumstances can she do this?
If the Medicare Advantage plan is a Private Fee-for-Service (PFFS) plan that does not offer drug
coverage or a Medical Savings Account, Mrs. Berkowitz can do this.
Ms. Goldstein is required by the plan she represents to obtain enrollment forms that have carbon
copies in the back. She gives one to the beneficiary, sends another to the plan and retains the
third. What should she do with her copies of the enrollment forms?
She should make every effort to safeguard the beneficiary information on those enrollment
forms.
Mr. Lopez takes several high cost prescription drugs. He would like to enroll in a standalone Part
D prescription drug plan that is available in his area. In what type of Medicare Health Plan can
he enroll?
Private Fee-for-Service (PFFS) plan that does not include drug coverage.
Mr. Block is currently enrolled in a Medicare Advantage plan that includes drug coverage. He
found a stand-alone Medicare prescription drug plan in his area that offers better coverage than
that available through his MA-PD plan and in addition has a low premium. It won't cost him
much more and, because he has the means to do so, he wishes to enroll in the stand-alone
prescription drug plan in addition to his MA-PD plan. What should you tell him?
If Mr. Block enrolls in the stand-alone Medicare prescription drug plan, he will be disenrolled
from the Medicare Advantage plan.
Mrs. Chen will be 65 soon, has been a citizen for twelve years, has been employed full time, and
paid taxes during that entire period. She is concerned that she will not qualify for coverage under
part A because she was not born in the United States. What should you tell her?
Most individuals who are citizens and over age 65 are covered under Part A by virtue of having
paid Medicare taxes while working, though some may be covered as a result of paying monthly
premiums.
Mrs. Lopez is enrolled in a Medicare Advantage cost plan. She has recently lost creditable
coverage previously available through her husband's employer. She is interested in enrolling in a
Medicare Part D prescription drug plan (PDP). What should you tell her?
, If a Part D benefit is offered through her plan she must enroll in this plan.
Mr. Schmidt would like to plan for retirement and has asked you what is covered under Original
Fee-for-Service (FFS) Medicare? What could you tell him?
Part A, which covers hospital, skilled nursing facility, hospice and home health services and Part
B, which covers professional services such as those provided by a doctor are covered under
Original Medicare.
Mrs. Wellington is enrolled in Parts A and B of Original Medicare. A friend recently told her
that there is an excellent Medicare Advantage (MA) plan with a five-star rating serving her area.
On January 15 she comes to you for advice as to what options, if any, she has. What should you
say regarding special enrollment periods (SEPs)?
Mrs. Wellington is eligible for a SEP that may be used once until November 30 to enroll in the
five-star plan.
Mr. Shapiro gets by on a very small fixed income. He has heard there may be extra help paying
for Part D prescription drugs for Medicare beneficiaries with limited income. He wants to know
whether he might qualify. What should you tell him?
The extra help is available to beneficiaries whose income and assets do not exceed annual limits
specified by the government.
A client wants to give you an enrollment application on October 1 prior to the beginning of the
Annual Election Period because he is leaving on vacation for two weeks and does not want to
forget about turning it in. What should you tell him?
You must tell him you are not permitted to take the form. If he sends the form directly to the
plan, the plan will process the enrollment on the day the Annual Election Period begins.
Agent Roderick enrolls retiree Mrs. Martinez in a medical savings account (MSA) Medicare
health plan. The MSA plan does not offer prescription drug coverage, so Agent Roderick also
enrolls Mrs. Martinez in a standalone prescription drug plan (PDP). What CMS compensation
rules apply to this situation?
This situation is considered a "dual enrollment," and CMS compensation rules are applied to the
two plans at once and independently of each other.
Which of the following steps may a Part D sponsor adopt for beneficiaries who are at risk of
misusing or abusing frequently abused drugs?
I. Identifying at risk individuals by using criteria that includes the number of opioid prescriptions
the beneficiary has and the number of prescribers who have written those prescriptions.
II. Locking an at-risk beneficiary into one pharmacy.
III. Locking an at-risk beneficiary into one prescriber.
