AHIP FINAL EXAM TEST QUESTIONS
LATEST VERSION /AHIP FINAL EXAM
TEST REAL EXAM 2024 LATEST UPDATE
1. A consumer desires to provide you with an enrollment application on October 1 before
the beginning of the Annual Election Period because he's leaving on excursion for 2
weeks and does not need to forget approximately turning it in. What have to you inform
him? - ANSWER-You have to inform him you aren't authorized to take the form. If
he sends the shape directly to the plan, the plan will method the enrollment on the
day the Annual Election Period begins.
2. ABC is a Medicare Advantage (MA) plan sponsor. It would like to use its enrollees'
records to market non-health associated merchandise which include life insurance and
annuities. Which declaration great describes ABC's duty to its enrollees regarding
advertising such products? - ANSWER-It should obtain a HIPAA compliant
authorization from an enrollee that suggests the plan or plan sponsor may also
use their records for advertising purposes.
3. Agent Daniel Webber has nicely set up a income appointment to satisfy with patron
Edward Young at Agent Webber's workplace. At the agreed upon appointment time, Mr.
Young arrives together with his elderly neighbor - Clara Burton, who desires to learn
about her Medicare Advantage options. What must Agent Daniel Webber do? -
ANSWER-After executing a scope of appointment (SOA) with Clara Burton, meet
with Edward Young and Clara Burton to discuss their Medicare Advantage
alternatives.
4. Agent John Miller is meeting with Jerry Smith, a new prospect. Jerry is currently enrolled
in Medicare Parts A and B. Jerry has also bought a Medicare Supplement (Medigap)
plan which he has had for numerous years. However, the plan does now not offer drug
advantages. How would you advocate Agent John Miller to proceed? - ANSWER-Tell
prospect Jerry Smith that he must recollect including a standalone Part D
prescription drug insurance coverage to his gift coverage.
5. Agent Martinez needs to solicit Medicare Advantage prospects through email and asks
you for advice as to whether that is feasible. What ought to you tell her? -
ANSWER-Marketing representatives can also initiate digital contact thru electronic
mail but an opt-out manner must be supplied.
6. Agent Suma has lately had several clients request his help in finishing their paper
enrollment form. What advice could you give him? - ANSWER-In maximum times,
Agent Suma ought to be actually indicating his call on their paperwork as their
advertising and marketing consultant.
7. Another agent working on your business enterprise claims that due to the fact you are
not hired with the aid of the Medicare Advantage plans that you constitute, you aren't
, concern to the equal advertising and marketing requirements because the plans
themselves. How need to you reply to this kind of assertion? - ANSWER-Your coworker
isn't correct. Marketing on behalf of a plan is taken into consideration advertising
with the aid of the plan and calls for that each one contracted and hired agents
follow all Medicare advertising guidelines.
8. Another agent you realize has engaged in misconduct that has been demonstrated via
the plan she represented. What kind of penalty would possibly the plan impose on this
character? - ANSWER-The plan can also withhold commission, require retraining,
document the misconduct to a nation branch of coverage or terminate the
agreement.
9. Anthony Boniface grew to become 65 in 2023. He become now not receiving Social
Security or Railroad Retirement Benefits on his sixty fifth birthday. He turned into
interested by acquiring Medicare insurance and is eligible for top rate-free Part A. Before
he should sign up in Medicare, his entire region turned into impacted by using a
hurricane inflicting large flooding and intense wind harm. The Federal authorities
declared this to be a herbal disaster which has currently ended. During this era
Anthony's initial enrollment period expired. Anthony asks you how he can now attain
Medicare insurance. What must you are saying? - ANSWER-Anthony is eligible for a
special enrollment duration (SEP) because he missed an enrollment length
because of the impact of the Federally declared disaster. This SEP will permit
Anthony to join Part B up to six months after the give up of the emergency
declaration. Anthony might also join in premium-unfastened Part A at any time
and his Part A insurance might be retroactive for up to 6 months.
10.Charles McCarthy is a Medicare beneficiary who suffers from diabetes. Mr. McCarthy is
considering enrollment in a MA-PD plan which you constitute. He asks you whether or
not his insulin costs may be protected. What need to you assert? - ANSWER-Mr.
McCarthy's insulin expenses for a one-month deliver cannot be greater than $35 in
any coverage section below the prescription drug plan starting in 2023.
11.Daniel is a center-earnings Medicare beneficiary. He has continual bronchitis, placing
him at severe threat for pneumonia. Otherwise, he has no problems functioning. Which
kind of SNP is in all likelihood to be most appropriate for him? - ANSWER-C-SNP
12.Dr. Elizabeth Brennan does now not agreement with the ABC PFFS plan however
accepts the plan's phrases and conditions for price. Mary Rodgers sees Dr. Brennan for
remedy. How a great deal might also Dr. Brennan charge? - ANSWER-Dr. Brennan can
rate Mary Rogers no greater than the value sharing certain in the PFFS plan's
terms and condition of fee which may also include stability billing up to 15%of the
Medicare charge.
13.Edna, Felix, George, and Harriet are Medicare beneficiaries. Edna lives in a place that
has suffered from main flooding that has been declared a main disaster by way of both
the Federal authorities and her country. As a end result of handling the flooding issues
and being evacuated from her domestic, Edna overlooked her chance to enroll in MA
during her Initial Coverage Election Period. Felix lives in a place with a Medicare
Advantage plan with a four-superstar score that he would like to enroll in. George
dropped his Medigap coverage six months in the past while he first enrolled in a
, Medicare Advantage plan. He now desires to go back to Original Medicare. Harriet has
currently developed diabetes and would like to enroll in a Medicare Advantage plan that
focuses on care for those with that disease. Which, if any, of these people could qualify
for a special election length (SEP)? - ANSWER-Edna might qualify for a SEP due to
the fact authorities officers have declared a main disaster for her region and he or
she did now not enroll in MA in the course of her ICEP because of the emergency.
George would qualify for an SEP because he enrolled in Medicare Advantage (MA)
plan for the first time and would now like to go back to Original Medicare inside
the first 12 months of his enrollment. Harriet could additionally qualify for a SEP to
sign up for a C-SNP due to the fact she has developed a persistent condition. Felix
might now not qualify for a SEP considering he seeks to sign up for a 4-superstar
now not a five-superstar MA plan.
14.Edward IP suffered from serious kidney disorder. As a result. Edward became eligible for
Medicare coverage due to quit-level renal ailment (ESRD). A near relative donated their
kidney and Edward effectively underwent transplant surgical operation twelve months in
the past. Edward is now age 50 and asks you if his Medicare insurance will maintain,
what must you are saying? - ANSWER-Individuals eligible for Medicare based on
ESRD generally lose eligibility 36 months after the month in which the character
gets a kidney transplant except they may be eligible for Medicare on some other
foundation along with age or incapacity. Edward might also, however, stay
enrolled in Part B however totally for coverage of immunosuppressive drugs if he
has no different fitness care coverage that would cover the medication.
15.Evan Marsh is a newly appointed agent. Evan intends to conduct an educational session
on Medicare at a senior residents middle close to his domestic. He has marketed the
session as an educational occasion. Evan asks you what is permissible at such an
event. What need to you say? - ANSWER-Evan may additionally offer a meal as long
as its value is $15 or much less in step with attendee and he might also make
available enterprise reply playing cards (BRCs).
16.Hector Hernandez is an independent agent. Hector sells plans on behalf of three
Medicare Advantage companies that provide a total of 10 plans but does now not
constitute all Medicare Advantage corporations offering plans which can be available in
his vicinity. Which of the following statements fine describes any steps Hector is required
to take? - ANSWER-During the first minute of a sales name, Hector should use a
disclaimer that announces "I do now not constitute each plan available for your
vicinity. I represent 3 organizations that offer 10 plans for your location. Please
contact Medicare.Gov, 1-800-MEDICARE, or your local State Health Insurance
Program to get statistics on all your options."
17.If a beneficiary is enrolled in a stand-by myself prescription drug plan and desires to
maintain that plan, what kind of Medicare fitness plan should the man or woman
additionally join in, without being routinely disenrolled from the stand-by myself
prescription drug plan? - ANSWER-The beneficiary may want to join in a personal
charge-for-provider (PFFS) plan that doesn't encompass prescription drug
coverage; a Cost plan; or a Medicare Medical Savings Account (MSA) plan.
LATEST VERSION /AHIP FINAL EXAM
TEST REAL EXAM 2024 LATEST UPDATE
1. A consumer desires to provide you with an enrollment application on October 1 before
the beginning of the Annual Election Period because he's leaving on excursion for 2
weeks and does not need to forget approximately turning it in. What have to you inform
him? - ANSWER-You have to inform him you aren't authorized to take the form. If
he sends the shape directly to the plan, the plan will method the enrollment on the
day the Annual Election Period begins.
2. ABC is a Medicare Advantage (MA) plan sponsor. It would like to use its enrollees'
records to market non-health associated merchandise which include life insurance and
annuities. Which declaration great describes ABC's duty to its enrollees regarding
advertising such products? - ANSWER-It should obtain a HIPAA compliant
authorization from an enrollee that suggests the plan or plan sponsor may also
use their records for advertising purposes.
3. Agent Daniel Webber has nicely set up a income appointment to satisfy with patron
Edward Young at Agent Webber's workplace. At the agreed upon appointment time, Mr.
Young arrives together with his elderly neighbor - Clara Burton, who desires to learn
about her Medicare Advantage options. What must Agent Daniel Webber do? -
ANSWER-After executing a scope of appointment (SOA) with Clara Burton, meet
with Edward Young and Clara Burton to discuss their Medicare Advantage
alternatives.
4. Agent John Miller is meeting with Jerry Smith, a new prospect. Jerry is currently enrolled
in Medicare Parts A and B. Jerry has also bought a Medicare Supplement (Medigap)
plan which he has had for numerous years. However, the plan does now not offer drug
advantages. How would you advocate Agent John Miller to proceed? - ANSWER-Tell
prospect Jerry Smith that he must recollect including a standalone Part D
prescription drug insurance coverage to his gift coverage.
5. Agent Martinez needs to solicit Medicare Advantage prospects through email and asks
you for advice as to whether that is feasible. What ought to you tell her? -
ANSWER-Marketing representatives can also initiate digital contact thru electronic
mail but an opt-out manner must be supplied.
6. Agent Suma has lately had several clients request his help in finishing their paper
enrollment form. What advice could you give him? - ANSWER-In maximum times,
Agent Suma ought to be actually indicating his call on their paperwork as their
advertising and marketing consultant.
7. Another agent working on your business enterprise claims that due to the fact you are
not hired with the aid of the Medicare Advantage plans that you constitute, you aren't
, concern to the equal advertising and marketing requirements because the plans
themselves. How need to you reply to this kind of assertion? - ANSWER-Your coworker
isn't correct. Marketing on behalf of a plan is taken into consideration advertising
with the aid of the plan and calls for that each one contracted and hired agents
follow all Medicare advertising guidelines.
8. Another agent you realize has engaged in misconduct that has been demonstrated via
the plan she represented. What kind of penalty would possibly the plan impose on this
character? - ANSWER-The plan can also withhold commission, require retraining,
document the misconduct to a nation branch of coverage or terminate the
agreement.
9. Anthony Boniface grew to become 65 in 2023. He become now not receiving Social
Security or Railroad Retirement Benefits on his sixty fifth birthday. He turned into
interested by acquiring Medicare insurance and is eligible for top rate-free Part A. Before
he should sign up in Medicare, his entire region turned into impacted by using a
hurricane inflicting large flooding and intense wind harm. The Federal authorities
declared this to be a herbal disaster which has currently ended. During this era
Anthony's initial enrollment period expired. Anthony asks you how he can now attain
Medicare insurance. What must you are saying? - ANSWER-Anthony is eligible for a
special enrollment duration (SEP) because he missed an enrollment length
because of the impact of the Federally declared disaster. This SEP will permit
Anthony to join Part B up to six months after the give up of the emergency
declaration. Anthony might also join in premium-unfastened Part A at any time
and his Part A insurance might be retroactive for up to 6 months.
10.Charles McCarthy is a Medicare beneficiary who suffers from diabetes. Mr. McCarthy is
considering enrollment in a MA-PD plan which you constitute. He asks you whether or
not his insulin costs may be protected. What need to you assert? - ANSWER-Mr.
McCarthy's insulin expenses for a one-month deliver cannot be greater than $35 in
any coverage section below the prescription drug plan starting in 2023.
11.Daniel is a center-earnings Medicare beneficiary. He has continual bronchitis, placing
him at severe threat for pneumonia. Otherwise, he has no problems functioning. Which
kind of SNP is in all likelihood to be most appropriate for him? - ANSWER-C-SNP
12.Dr. Elizabeth Brennan does now not agreement with the ABC PFFS plan however
accepts the plan's phrases and conditions for price. Mary Rodgers sees Dr. Brennan for
remedy. How a great deal might also Dr. Brennan charge? - ANSWER-Dr. Brennan can
rate Mary Rogers no greater than the value sharing certain in the PFFS plan's
terms and condition of fee which may also include stability billing up to 15%of the
Medicare charge.
13.Edna, Felix, George, and Harriet are Medicare beneficiaries. Edna lives in a place that
has suffered from main flooding that has been declared a main disaster by way of both
the Federal authorities and her country. As a end result of handling the flooding issues
and being evacuated from her domestic, Edna overlooked her chance to enroll in MA
during her Initial Coverage Election Period. Felix lives in a place with a Medicare
Advantage plan with a four-superstar score that he would like to enroll in. George
dropped his Medigap coverage six months in the past while he first enrolled in a
, Medicare Advantage plan. He now desires to go back to Original Medicare. Harriet has
currently developed diabetes and would like to enroll in a Medicare Advantage plan that
focuses on care for those with that disease. Which, if any, of these people could qualify
for a special election length (SEP)? - ANSWER-Edna might qualify for a SEP due to
the fact authorities officers have declared a main disaster for her region and he or
she did now not enroll in MA in the course of her ICEP because of the emergency.
George would qualify for an SEP because he enrolled in Medicare Advantage (MA)
plan for the first time and would now like to go back to Original Medicare inside
the first 12 months of his enrollment. Harriet could additionally qualify for a SEP to
sign up for a C-SNP due to the fact she has developed a persistent condition. Felix
might now not qualify for a SEP considering he seeks to sign up for a 4-superstar
now not a five-superstar MA plan.
14.Edward IP suffered from serious kidney disorder. As a result. Edward became eligible for
Medicare coverage due to quit-level renal ailment (ESRD). A near relative donated their
kidney and Edward effectively underwent transplant surgical operation twelve months in
the past. Edward is now age 50 and asks you if his Medicare insurance will maintain,
what must you are saying? - ANSWER-Individuals eligible for Medicare based on
ESRD generally lose eligibility 36 months after the month in which the character
gets a kidney transplant except they may be eligible for Medicare on some other
foundation along with age or incapacity. Edward might also, however, stay
enrolled in Part B however totally for coverage of immunosuppressive drugs if he
has no different fitness care coverage that would cover the medication.
15.Evan Marsh is a newly appointed agent. Evan intends to conduct an educational session
on Medicare at a senior residents middle close to his domestic. He has marketed the
session as an educational occasion. Evan asks you what is permissible at such an
event. What need to you say? - ANSWER-Evan may additionally offer a meal as long
as its value is $15 or much less in step with attendee and he might also make
available enterprise reply playing cards (BRCs).
16.Hector Hernandez is an independent agent. Hector sells plans on behalf of three
Medicare Advantage companies that provide a total of 10 plans but does now not
constitute all Medicare Advantage corporations offering plans which can be available in
his vicinity. Which of the following statements fine describes any steps Hector is required
to take? - ANSWER-During the first minute of a sales name, Hector should use a
disclaimer that announces "I do now not constitute each plan available for your
vicinity. I represent 3 organizations that offer 10 plans for your location. Please
contact Medicare.Gov, 1-800-MEDICARE, or your local State Health Insurance
Program to get statistics on all your options."
17.If a beneficiary is enrolled in a stand-by myself prescription drug plan and desires to
maintain that plan, what kind of Medicare fitness plan should the man or woman
additionally join in, without being routinely disenrolled from the stand-by myself
prescription drug plan? - ANSWER-The beneficiary may want to join in a personal
charge-for-provider (PFFS) plan that doesn't encompass prescription drug
coverage; a Cost plan; or a Medicare Medical Savings Account (MSA) plan.
