AHIP FINAL EXAM
AHIP FINAL EXAM NEWEST 2025/2026
COMPLETE ALL 250 QUESTIONS AND
CORRECT DETAILED ANSWERS
|ALREADY GRADED A+||ALREADY
GRADED A+
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?
a.He should contact his neighbors and family members and let them know that any
contributions they make toward his drug expenses will be tax deductible.
b.The only option available is to reduce his income so that he can qualify for the Part D extra
help or wait until next year to see if the annual limits change.
c.He could check with the manufacturers of his medications to see if they offer an assistance
program to help people with limited means to 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.
d.He should look into the possibility of purchasing his medications through the internet from
off-shore pharmacies.
c.
He could check with the manufacturers of his medications to see if they offer an assistance
program to help people with limited means to 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
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?
a.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.
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
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, AHIP FINAL EXAM
exhausted.
c.In general, he must select a single Part D premium payment mechanism that will be used
throughout the year.
d.In general, to pay his Part D premium, he only can have automatic withdrawals made from
a checking account, so he will need to transfer the funds prior to beginning such
withdrawals.
c.
In general, he must select a single Part D premium payment mechanism that will be used
throughout the year.
Mrs. Lopez is enrolled in a cost plan for her Medicare benefits. 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?
a.Mrs. Lopez must first seek COBRA benefits under her husband's plan before she can apply
for Part D coverage.
b.If a Part D benefit is offered through her plan she may choose to enroll in that plan or a
standalone PDP.
c.If a Part D benefit is offered through her plan she must enroll in this plan.
d.Mrs. Lopez must enroll in either a HMO or PPO Medicare Advantage plan in order to
obtain Part D coverage.
b.
If a Part D benefit is offered through her plan she may choose to enroll in that plan or a
standalone PDP.
All plans must cover at least the standard Part D coverage or its actuarial equivalent. Which
of the following statements best describes some of the costs a beneficiary would incur for
prescription drugs under the standard coverage?
a.Standard Part D coverage would require payment of only fixed per-prescription co-
payments.
b.Standard Part D coverage would require payment of fixed per-prescription co-payments
and 75% of the costs in the coverage gap.
c.Standard Part D coverage would require payment of an annual deductible, and once past
the catastrophic coverage threshold, the beneficiary pays whichever is greater of either the
co-pays for generic and brand name drugs or coinsurance of 5%.
d.Standard Part D coverage would require payment of an annual deductible, fixed per-
prescription co-payments, and once catastrophic coverage begins, the plan covers 100% of
all costs.
c.
Standard Part D coverage would require payment of an annual deductible, and once past the
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, AHIP FINAL EXAM
catastrophic coverage threshold, the beneficiary pays whichever is greater of either the co-
pays for generic and brand name drugs or coinsurance of 5%.
Mr. Jacob understands that there is a standard Medicare Part D prescription drug benefit,
but when he looks at information on various plans available in his area, he sees a wide range
in what they charge for deductibles, premiums, and cost sharing. How can you explain this
to him?
a.The government allows Part D plans to adopt any benefit structure as long as the list of
covered drugs meets their approval.
b.The Part D standard model's importance is that it is the only type of plan into which low-
income beneficiaries can enroll and still receive any extra help for which they may qualify.
c.The government bases its payments to Part D plans on the standard benefit model. For
Part D plans to receive the full government payment, they must offer the standard model,
however, they can take a risk and revise their benefit structure to attract more beneficiaries.
d.Medicare Part D drug plans may have different benefit structures, but on average, they
must all be at least as good as the standard model established by the government.
d.
Medicare Part D drug plans may have different benefit structures, but on average, they must
all be at least as good as the standard model established by the government.
Which of the following statements about Medicare Part D are correct?
I. Part D plans must enroll any eligible beneficiary who applies regardless of health status
except in limited circumstances.
II. Private fee-for-service (PFFS) plans are not required to use a pharmacy network but may
choose to have one.
III. Beneficiaries enrolled in a MA-Medical Savings Account (MSA) plan may only obtain Part
D benefits through a standalone PDP.
IV. Beneficiaries enrolled in a MA-PPO may obtain Part D benefits through a standalone PDP
or through their plan.
a.I and II only
b.I, II, III, and IV
c.I, II, and III only
d.I only
c.
I, II, and III only
ABC is a Medicare Advantage (MA) plan sponsor. It would like to use its enrollees'
information to market non-health related products such as life insurance and annuities.
Which statement best describes ABC's obligation to its enrollees regarding marketing such
products?
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, AHIP FINAL EXAM
a.The request for authorization may include a brief synopsis of non-health related content.
b.Once a plan sends out a written request for consent, a beneficiary can authorize consent
by simply failing to reply within 21 days.
c.It is not necessary for ABC to obtain an authorization to simply explain pending state or
federal legislation since there is no anticipation of selling a non-health related product in
these circumstances.
d.It must obtain a HIPAA compliant authorization from an enrollee that indicates the plan or
plan sponsor may use their information for marketing purposes.
d.
It must obtain a HIPAA compliant authorization from an enrollee that indicates the plan or
plan sponsor may use their information for marketing purposes.
Agent Armstrong is employed by XYZ Agency, which is under contract with ABC Health Plan,
a Medicare Advantage (MA) plan that offers plans in multiple states. XYZ Agency maintains a
website marketing the MA plans with which it has contracts. Agent Armstrong follows up
with individuals who request more information about ABC MA plans via the website and
tries to persuade them to enroll in ABC plans. What statement best describes the marketing
and compliance rules that apply to Agent Armstrong?
a.Agent Armstrong needs to be licensed and appointed in every state in which beneficiaries
to whom he markets ABC MA plans are located.
b.Agent Armstrong needs to be licensed and appointed only in the state where XYZ Agency
is headquartered.
c.Agent Armstrong needs to be licensed and appointed only in his state of residence.
d.Agent Armstrong needs to be licensed and appointed only in the state where ABC Health
Plan is headquartered.
a.
Agent Armstrong needs to be licensed and appointed in every state in which beneficiaries to
whom he markets ABC MA plans are located.
Your friend's mother just moved to an assisted living facility and he asked if you could
present a program for the residents about the MA-PD plans you market. What could you tell
him?
a. You appreciate the opportunity and your friend would just need to complete scope of
appointment forms on behalf of all the residents who would like to attend.
b. You appreciate the opportunity and would be happy to schedule an appointment with
anyone at their request.
c.You appreciate the opportunity and would ask the facility to provide enrollment
applications for the MA-PD plans you represent.
d.You appreciate the opportunity and will ask the facility to provide a plan brochure and
A+ TEST BANK 4
AHIP FINAL EXAM NEWEST 2025/2026
COMPLETE ALL 250 QUESTIONS AND
CORRECT DETAILED ANSWERS
|ALREADY GRADED A+||ALREADY
GRADED A+
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?
a.He should contact his neighbors and family members and let them know that any
contributions they make toward his drug expenses will be tax deductible.
b.The only option available is to reduce his income so that he can qualify for the Part D extra
help or wait until next year to see if the annual limits change.
c.He could check with the manufacturers of his medications to see if they offer an assistance
program to help people with limited means to 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.
d.He should look into the possibility of purchasing his medications through the internet from
off-shore pharmacies.
c.
He could check with the manufacturers of his medications to see if they offer an assistance
program to help people with limited means to 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
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?
a.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.
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
A+ TEST BANK 1
, AHIP FINAL EXAM
exhausted.
c.In general, he must select a single Part D premium payment mechanism that will be used
throughout the year.
d.In general, to pay his Part D premium, he only can have automatic withdrawals made from
a checking account, so he will need to transfer the funds prior to beginning such
withdrawals.
c.
In general, he must select a single Part D premium payment mechanism that will be used
throughout the year.
Mrs. Lopez is enrolled in a cost plan for her Medicare benefits. 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?
a.Mrs. Lopez must first seek COBRA benefits under her husband's plan before she can apply
for Part D coverage.
b.If a Part D benefit is offered through her plan she may choose to enroll in that plan or a
standalone PDP.
c.If a Part D benefit is offered through her plan she must enroll in this plan.
d.Mrs. Lopez must enroll in either a HMO or PPO Medicare Advantage plan in order to
obtain Part D coverage.
b.
If a Part D benefit is offered through her plan she may choose to enroll in that plan or a
standalone PDP.
All plans must cover at least the standard Part D coverage or its actuarial equivalent. Which
of the following statements best describes some of the costs a beneficiary would incur for
prescription drugs under the standard coverage?
a.Standard Part D coverage would require payment of only fixed per-prescription co-
payments.
b.Standard Part D coverage would require payment of fixed per-prescription co-payments
and 75% of the costs in the coverage gap.
c.Standard Part D coverage would require payment of an annual deductible, and once past
the catastrophic coverage threshold, the beneficiary pays whichever is greater of either the
co-pays for generic and brand name drugs or coinsurance of 5%.
d.Standard Part D coverage would require payment of an annual deductible, fixed per-
prescription co-payments, and once catastrophic coverage begins, the plan covers 100% of
all costs.
c.
Standard Part D coverage would require payment of an annual deductible, and once past the
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, AHIP FINAL EXAM
catastrophic coverage threshold, the beneficiary pays whichever is greater of either the co-
pays for generic and brand name drugs or coinsurance of 5%.
Mr. Jacob understands that there is a standard Medicare Part D prescription drug benefit,
but when he looks at information on various plans available in his area, he sees a wide range
in what they charge for deductibles, premiums, and cost sharing. How can you explain this
to him?
a.The government allows Part D plans to adopt any benefit structure as long as the list of
covered drugs meets their approval.
b.The Part D standard model's importance is that it is the only type of plan into which low-
income beneficiaries can enroll and still receive any extra help for which they may qualify.
c.The government bases its payments to Part D plans on the standard benefit model. For
Part D plans to receive the full government payment, they must offer the standard model,
however, they can take a risk and revise their benefit structure to attract more beneficiaries.
d.Medicare Part D drug plans may have different benefit structures, but on average, they
must all be at least as good as the standard model established by the government.
d.
Medicare Part D drug plans may have different benefit structures, but on average, they must
all be at least as good as the standard model established by the government.
Which of the following statements about Medicare Part D are correct?
I. Part D plans must enroll any eligible beneficiary who applies regardless of health status
except in limited circumstances.
II. Private fee-for-service (PFFS) plans are not required to use a pharmacy network but may
choose to have one.
III. Beneficiaries enrolled in a MA-Medical Savings Account (MSA) plan may only obtain Part
D benefits through a standalone PDP.
IV. Beneficiaries enrolled in a MA-PPO may obtain Part D benefits through a standalone PDP
or through their plan.
a.I and II only
b.I, II, III, and IV
c.I, II, and III only
d.I only
c.
I, II, and III only
ABC is a Medicare Advantage (MA) plan sponsor. It would like to use its enrollees'
information to market non-health related products such as life insurance and annuities.
Which statement best describes ABC's obligation to its enrollees regarding marketing such
products?
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, AHIP FINAL EXAM
a.The request for authorization may include a brief synopsis of non-health related content.
b.Once a plan sends out a written request for consent, a beneficiary can authorize consent
by simply failing to reply within 21 days.
c.It is not necessary for ABC to obtain an authorization to simply explain pending state or
federal legislation since there is no anticipation of selling a non-health related product in
these circumstances.
d.It must obtain a HIPAA compliant authorization from an enrollee that indicates the plan or
plan sponsor may use their information for marketing purposes.
d.
It must obtain a HIPAA compliant authorization from an enrollee that indicates the plan or
plan sponsor may use their information for marketing purposes.
Agent Armstrong is employed by XYZ Agency, which is under contract with ABC Health Plan,
a Medicare Advantage (MA) plan that offers plans in multiple states. XYZ Agency maintains a
website marketing the MA plans with which it has contracts. Agent Armstrong follows up
with individuals who request more information about ABC MA plans via the website and
tries to persuade them to enroll in ABC plans. What statement best describes the marketing
and compliance rules that apply to Agent Armstrong?
a.Agent Armstrong needs to be licensed and appointed in every state in which beneficiaries
to whom he markets ABC MA plans are located.
b.Agent Armstrong needs to be licensed and appointed only in the state where XYZ Agency
is headquartered.
c.Agent Armstrong needs to be licensed and appointed only in his state of residence.
d.Agent Armstrong needs to be licensed and appointed only in the state where ABC Health
Plan is headquartered.
a.
Agent Armstrong needs to be licensed and appointed in every state in which beneficiaries to
whom he markets ABC MA plans are located.
Your friend's mother just moved to an assisted living facility and he asked if you could
present a program for the residents about the MA-PD plans you market. What could you tell
him?
a. You appreciate the opportunity and your friend would just need to complete scope of
appointment forms on behalf of all the residents who would like to attend.
b. You appreciate the opportunity and would be happy to schedule an appointment with
anyone at their request.
c.You appreciate the opportunity and would ask the facility to provide enrollment
applications for the MA-PD plans you represent.
d.You appreciate the opportunity and will ask the facility to provide a plan brochure and
A+ TEST BANK 4
