AHIP PRACTICE EXAM|| 50 QUESTIONS
AND ANSWERS 100% CORRECT
Mr. Carlini has heard that Medicare prescription drug plans are only offered through
private companies under a program known as Medicare Advantage (MA), not by the
government. He likes Original Medicare and does not want to sign up for an MA
product, but he also wants prescription drug coverage. What should you tell him? -
ANSWER-Mr. Carlini can stay with Original Medicare and also enroll in a Medicare
prescription drug plan through a private company that has contracted with the
government to provide only such drug coverage to eligible Medicare beneficiaries.
During a sales presentation to Ms Daley for a Medicare Advantage plan that has a 5-
star rating in customer service and care coordination, and received an overall plan
performance of a 4-star, which of the following would be the correct 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
Mrs. Pena is 66 years old, has coverage under an employer plan and will retire next
year. She heard she must enroll in Part B at the beginning of the year to ensure no gap
in coverage. What can you tell her? - ANSWER-She may enroll at any time while she is
covered under her employer plan, but she will have a special eight-month enrollment
period that differs from the standard general enrollment period, during which she may
enroll in Medicare Part B
Mr. Bickford did not quite qualify for the extra help low-income subsidy under the
Medicare Part D Prescription Drug program and he is wondering if there is any other
option he has for obtaining help with his considerable drug costs. What should you tell
him? - ANSWER-He could check with the manufacturers of his medications to see if
they offer an assistance program to help people with limited means obtain the
medications they need. Alternatively, he could check to see whether his state has a
pharmacy assistance program to help him with his expenses.
Alice is a marketing representative employed by a health plan. Betty is a captive agent
of a health plan who markets to multiple plans and sponsors. Carl is a captive agent
who markets to only one plan/sponsor. Denise is an independent agent who markets to
different types of groups. Edward is an independent agent who markets only to
employer and union groups. CMS marketing representative compensation rules
generally apply to: - ANSWER-Betty and Denise, but not Alice (the employee) or Carl or
Edward (to whom exceptions apply).
Ms. Moore plans to retire when she turns 65 in a few months. She is in excellent health
and will have considerable income when she retires. She is concerned that her income
, will make it impossible for her to qualify for Medicare. What oculd you tell her to address
her concern. - ANSWER-Medicare is a program for people age 65 or older and those
under age 65 with certain disabilities, end-stage renal disease, and Lou Gehrig's
disease so she will be eligible for Medicare.
Mr. Wells is trying to understand the difference between Original Medicare and
Medicare Advantage. What would be a correct description? - ANSWER-Medicare
Advantage is a way of covering all the Original Medicare benefits through private health
insurance companies.
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.
IV. Increasing deductibles and copays for at-risk beneficiaries. - ANSWER-I, II, and III
only
Mrs. Valentino is currently enrolled in a Medicare Cost plan. This plan is no longer
meeting her needs, but it is now mid-year and past the annual election period (AEP).
What would you say to Mrs. Valentino regarding her options? - ANSWER-Mrs.
Valentino can submit a written request to Medicare to be disenrolled from the Cost plan
and enroll in Original Medicare.
When Myra first became eligible for Medicare, she enrolled in Original Medicare (Parts
A and B). She is now 67 and will turn 68 on July 1. She would now like to enroll in a
Medicare Advantage (MA) plan and approaches you about her options. What advice
would you give her? - ANSWER-She should remain in Original Medicare until the
annual election period running from October 15 to December 7, during which she can
select an MA plan.
Mrs. Tanner is enrolled in a Medicare Advantage HMO that offers a point of service
options. This allows Mrs. Tanner to do which of the following? - ANSWER-Mrs. Tanner
can go to non-plan doctors for certain services without receiving prior approval
Agent Harriet Walker has recently begun marketing Medicare Advantage and related
products aimed at meeting the needs of senior citizens. Client Mildred Jones has
expressed interest in a Medicare Advantage plan. It is now the beginning of September.
If you were in Agent Walker'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.
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
AND ANSWERS 100% CORRECT
Mr. Carlini has heard that Medicare prescription drug plans are only offered through
private companies under a program known as Medicare Advantage (MA), not by the
government. He likes Original Medicare and does not want to sign up for an MA
product, but he also wants prescription drug coverage. What should you tell him? -
ANSWER-Mr. Carlini can stay with Original Medicare and also enroll in a Medicare
prescription drug plan through a private company that has contracted with the
government to provide only such drug coverage to eligible Medicare beneficiaries.
During a sales presentation to Ms Daley for a Medicare Advantage plan that has a 5-
star rating in customer service and care coordination, and received an overall plan
performance of a 4-star, which of the following would be the correct 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
Mrs. Pena is 66 years old, has coverage under an employer plan and will retire next
year. She heard she must enroll in Part B at the beginning of the year to ensure no gap
in coverage. What can you tell her? - ANSWER-She may enroll at any time while she is
covered under her employer plan, but she will have a special eight-month enrollment
period that differs from the standard general enrollment period, during which she may
enroll in Medicare Part B
Mr. Bickford did not quite qualify for the extra help low-income subsidy under the
Medicare Part D Prescription Drug program and he is wondering if there is any other
option he has for obtaining help with his considerable drug costs. What should you tell
him? - ANSWER-He could check with the manufacturers of his medications to see if
they offer an assistance program to help people with limited means obtain the
medications they need. Alternatively, he could check to see whether his state has a
pharmacy assistance program to help him with his expenses.
Alice is a marketing representative employed by a health plan. Betty is a captive agent
of a health plan who markets to multiple plans and sponsors. Carl is a captive agent
who markets to only one plan/sponsor. Denise is an independent agent who markets to
different types of groups. Edward is an independent agent who markets only to
employer and union groups. CMS marketing representative compensation rules
generally apply to: - ANSWER-Betty and Denise, but not Alice (the employee) or Carl or
Edward (to whom exceptions apply).
Ms. Moore plans to retire when she turns 65 in a few months. She is in excellent health
and will have considerable income when she retires. She is concerned that her income
, will make it impossible for her to qualify for Medicare. What oculd you tell her to address
her concern. - ANSWER-Medicare is a program for people age 65 or older and those
under age 65 with certain disabilities, end-stage renal disease, and Lou Gehrig's
disease so she will be eligible for Medicare.
Mr. Wells is trying to understand the difference between Original Medicare and
Medicare Advantage. What would be a correct description? - ANSWER-Medicare
Advantage is a way of covering all the Original Medicare benefits through private health
insurance companies.
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.
IV. Increasing deductibles and copays for at-risk beneficiaries. - ANSWER-I, II, and III
only
Mrs. Valentino is currently enrolled in a Medicare Cost plan. This plan is no longer
meeting her needs, but it is now mid-year and past the annual election period (AEP).
What would you say to Mrs. Valentino regarding her options? - ANSWER-Mrs.
Valentino can submit a written request to Medicare to be disenrolled from the Cost plan
and enroll in Original Medicare.
When Myra first became eligible for Medicare, she enrolled in Original Medicare (Parts
A and B). She is now 67 and will turn 68 on July 1. She would now like to enroll in a
Medicare Advantage (MA) plan and approaches you about her options. What advice
would you give her? - ANSWER-She should remain in Original Medicare until the
annual election period running from October 15 to December 7, during which she can
select an MA plan.
Mrs. Tanner is enrolled in a Medicare Advantage HMO that offers a point of service
options. This allows Mrs. Tanner to do which of the following? - ANSWER-Mrs. Tanner
can go to non-plan doctors for certain services without receiving prior approval
Agent Harriet Walker has recently begun marketing Medicare Advantage and related
products aimed at meeting the needs of senior citizens. Client Mildred Jones has
expressed interest in a Medicare Advantage plan. It is now the beginning of September.
If you were in Agent Walker'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.
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
