AHIP Module 2 NEWEST 2025-2026
VERSION EXAM With Comprehensive
Questions and Well Elaborated Correct
Answers GRADED A+
Mr. Kelly wants to know whether he is eligible to sign up for a private fee-for-service (PFFS) plan. What
questions would you need to ask to determine his eligibility? - correct ans:You would need to ask Mr.
Kelly if he is entitled to Part A, enrolled in Part B, and if he lives in the PFFS plan's service area.
Mr. Barker enjoys a comfortable retirement income. He recently had surgery and expected that he
would have certain services and items covered by the plan with minimal out-of-pocket costs because his
MA-PD coverage has been very good. However, when he received the bill, he was surprised to see large
charges in excess of his maximum out-of-pocket limit that included some services and items he thought
would be fully covered. He called you to ask what he could do? What could you tell him? - correct
ans:You can offer to review the plans appeal process to help him ask the plan to review the coverage
decision.
Mrs. Chi is age 75 and enjoys a comfortable but not extremely high-income level. She wishes to enroll in
a MA MSA plan that she heard about from her neighbor. She also wants to have prescription drug
coverage since her doctor recently prescribed several expensive medications. Currently, she is enrolled
in Original Medicare and a standalone Part D plan. How would you advise Mrs. Chi? - correct ans:Mrs.
Chi may enroll in a MA MSA plan and remain in her current standalone Part D prescription drug plan.
Mr. Romero is 64, retiring soon, and considering enrollment in his employer-sponsored retiree group
health plan that includes drug coverage with nominal copays. He heard about a neighbor's MA-PD plan
that you represent and because he takes numerous prescription drugs, he is considering signing up for
it. What should you tell him? - correct ans:He should compare the benefits in his employer-sponsored
retiree group health plan with the benefits in his neighbor's MA-PD plan to determine which one will
provide sufficient coverage for his prescription needs.
VERSION EXAM With Comprehensive
Questions and Well Elaborated Correct
Answers GRADED A+
Mr. Kelly wants to know whether he is eligible to sign up for a private fee-for-service (PFFS) plan. What
questions would you need to ask to determine his eligibility? - correct ans:You would need to ask Mr.
Kelly if he is entitled to Part A, enrolled in Part B, and if he lives in the PFFS plan's service area.
Mr. Barker enjoys a comfortable retirement income. He recently had surgery and expected that he
would have certain services and items covered by the plan with minimal out-of-pocket costs because his
MA-PD coverage has been very good. However, when he received the bill, he was surprised to see large
charges in excess of his maximum out-of-pocket limit that included some services and items he thought
would be fully covered. He called you to ask what he could do? What could you tell him? - correct
ans:You can offer to review the plans appeal process to help him ask the plan to review the coverage
decision.
Mrs. Chi is age 75 and enjoys a comfortable but not extremely high-income level. She wishes to enroll in
a MA MSA plan that she heard about from her neighbor. She also wants to have prescription drug
coverage since her doctor recently prescribed several expensive medications. Currently, she is enrolled
in Original Medicare and a standalone Part D plan. How would you advise Mrs. Chi? - correct ans:Mrs.
Chi may enroll in a MA MSA plan and remain in her current standalone Part D prescription drug plan.
Mr. Romero is 64, retiring soon, and considering enrollment in his employer-sponsored retiree group
health plan that includes drug coverage with nominal copays. He heard about a neighbor's MA-PD plan
that you represent and because he takes numerous prescription drugs, he is considering signing up for
it. What should you tell him? - correct ans:He should compare the benefits in his employer-sponsored
retiree group health plan with the benefits in his neighbor's MA-PD plan to determine which one will
provide sufficient coverage for his prescription needs.
