AHIP Final Review Module 2 NEWEST
2025-2026 VERSION EXAM With
Comprehensive Questions and Well
Elaborated Correct Answers GRADED
A+
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.
Mrs. Chou likes a Private Fee-for-Service (PFFS) plan available in her area that does not include drug
coverage. She wants to enroll in the plan and enroll in a stand-alone prescription drug plan. What should
you tell her? - correct ans:She could enroll in a PFFS plan and a stand-alone Medicare prescription drug
plan.
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.
Mrs. Radford asks whether there are any special eligibility requirements for Medicare Advantage. What
should you tell her? - correct ans:Mrs. Radford must be entitled to Part A and enrolled in Part B to enroll
in Medicare Advantage.
Dr. Elizabeth Brennan does not contract with the ABC PFFS plan but accepts the plan's terms and
conditions for payment. Mary Rodgers sees Dr. Brennan for treatment. How much may Dr. Brennan
charge? - correct ans:Dr. Brennan can charge Mary Rogers no more than the cost sharing specified in the
2025-2026 VERSION EXAM With
Comprehensive Questions and Well
Elaborated Correct Answers GRADED
A+
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.
Mrs. Chou likes a Private Fee-for-Service (PFFS) plan available in her area that does not include drug
coverage. She wants to enroll in the plan and enroll in a stand-alone prescription drug plan. What should
you tell her? - correct ans:She could enroll in a PFFS plan and a stand-alone Medicare prescription drug
plan.
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.
Mrs. Radford asks whether there are any special eligibility requirements for Medicare Advantage. What
should you tell her? - correct ans:Mrs. Radford must be entitled to Part A and enrolled in Part B to enroll
in Medicare Advantage.
Dr. Elizabeth Brennan does not contract with the ABC PFFS plan but accepts the plan's terms and
conditions for payment. Mary Rodgers sees Dr. Brennan for treatment. How much may Dr. Brennan
charge? - correct ans:Dr. Brennan can charge Mary Rogers no more than the cost sharing specified in the
