AHIP/NUR Community Exam
: Questions and Answers, certified latest update
2026/2027 GRADED A+
• Mr. Roberts is concerned that if he signs up for a
Medicare Advantage plan, the health plan may, at some
time in the future, reduce his benefits below what is
available in Original Medicare. What should you tell him
about his concern?
• Medicare health plans must cover all benefits available
under Medicare Part A and Part B. Many also cover Part D
prescription drugs
• Mrs. Carol enrolled in the ABC Medicare Advantage (MA)
plan several years ago. Her doctor recently confirmed a
diagnosis of end-stage renal disease (ESRD). What
options does she have in regard to her MA plan during
the next open enrollment season?
• She may remain in her ABC MA plan or enroll in a
Special Needs Plan (SNP) for individuals suffering from
ESRD if one is available in her area
• Mrs. Prudence is a widow who will attain age 65 and
enroll in Medicare in just a few weeks. She concerned
about having prescription drug coverage. Which of the
, following statements provides the best advice?
• Prescription drug coverage can be obtained by
enrolling in a Medicare Advantage plan that includes
Part D coverage
• Mr. Kumar is considering a Medicare Advantage HMO
and has questions about his ability to access
providers. What should you tell him?
• In most Medicare Advantage HMOs, Mr. Kumar must
obtain his services only from providers who have a
contractual relationship with the plan (except in an
emergency)
, • Mr. Romero is 64, retiring soon, and considering
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j enrollment in his employer-sponsored retiree group
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j health plan that includes drug coverage with nominal
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j copays. He heard about a neighbor’s MA-PD plan that you
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j represent and because he takes numerous prescription
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j drugs,he is considering signing up for it. What should you
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j tell him?
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• Beneficiaries should check with their employer or union j j j j j j j
j group benefits administrator beforechanging plans to
j j j j j j
j avoid losing coverage they want to keep
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• Mrs. Walters is enrolled in her state’s Medicaid program in
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j addition to Medicare. What shouldshe be aware of when
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j considering enrollment in a Medicare Health Plan? j j j j j j
• Medicaid will coordinate benefits only with Medicaid
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j participating providers. j
• Mrs. Andrews asked how a Private Fee-for-Service (PFFS)
j j j j j j j
j plan might affect her access to services since she
j j j j j j j j
j receives some assistance for her health care costs from
j j j j j j j j
AHIP/NUR Community Exam
: Questions and Answers, certified latest update
2022/2023 GRADED A+
, j the State. Whatshould you tell her?
j j j j j j
• Medicaid may provide additional benefits, but j j j j j
j Medicaid will coordinate benefits only withMedicaid
j j j j j j
j participating providers. j
• Mr. Rivera has QMB-Plus eligibility and is thus covered by
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j both Medicare and Medicaid. He decides to enroll in a
j j j j j j j j j
j Medicare Advantage (MA) plan. Later in the year, Mr. Rivera
j j j j j j j j j
j needs dentures, a service only covered under Medicaid.
j j j j j j j
j What action would you recommend he take inorder to have
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j this cost covered?
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• He should go to a Medicaid provider or obtain the
j j j j j j j j j
j services through a Medicaid manage careplan if he is
j j j j j j j j j
j enrolled in one j j
• Ms. Moore plans to retire when she turns 65 in a few
j j j j j j j j j j j
j months. She is in excellent health and willhave
j j j j j j j j
j considerable income when she retires. She is concerned j j j j j j j
j that her income will make it impossible for her to qualify for
j j j j j j j j j j j
j Medicare. What could you tell her to address her concern?
j j j j j j j j j
• Medicare is a program for people age 65 or older and those
j j j j j j j j j j j
AHIP/NUR Community Exam
: Questions and Answers, certified latest update
2022/2023 GRADED A+
: Questions and Answers, certified latest update
2026/2027 GRADED A+
• Mr. Roberts is concerned that if he signs up for a
Medicare Advantage plan, the health plan may, at some
time in the future, reduce his benefits below what is
available in Original Medicare. What should you tell him
about his concern?
• Medicare health plans must cover all benefits available
under Medicare Part A and Part B. Many also cover Part D
prescription drugs
• Mrs. Carol enrolled in the ABC Medicare Advantage (MA)
plan several years ago. Her doctor recently confirmed a
diagnosis of end-stage renal disease (ESRD). What
options does she have in regard to her MA plan during
the next open enrollment season?
• She may remain in her ABC MA plan or enroll in a
Special Needs Plan (SNP) for individuals suffering from
ESRD if one is available in her area
• Mrs. Prudence is a widow who will attain age 65 and
enroll in Medicare in just a few weeks. She concerned
about having prescription drug coverage. Which of the
, following statements provides the best advice?
• Prescription drug coverage can be obtained by
enrolling in a Medicare Advantage plan that includes
Part D coverage
• Mr. Kumar is considering a Medicare Advantage HMO
and has questions about his ability to access
providers. What should you tell him?
• In most Medicare Advantage HMOs, Mr. Kumar must
obtain his services only from providers who have a
contractual relationship with the plan (except in an
emergency)
, • Mr. Romero is 64, retiring soon, and considering
j j j j j j j
j enrollment in his employer-sponsored retiree group
j j j j j
j health plan that includes drug coverage with nominal
j j j j j j j
j copays. He heard about a neighbor’s MA-PD plan that you
j j j j j j j j j
j represent and because he takes numerous prescription
j j j j j j
j drugs,he is considering signing up for it. What should you
j j j j j j j j j j
j tell him?
j
• Beneficiaries should check with their employer or union j j j j j j j
j group benefits administrator beforechanging plans to
j j j j j j
j avoid losing coverage they want to keep
j j j j j j
• Mrs. Walters is enrolled in her state’s Medicaid program in
j j j j j j j j j
j addition to Medicare. What shouldshe be aware of when
j j j j j j j j j
j considering enrollment in a Medicare Health Plan? j j j j j j
• Medicaid will coordinate benefits only with Medicaid
j j j j j j
j participating providers. j
• Mrs. Andrews asked how a Private Fee-for-Service (PFFS)
j j j j j j j
j plan might affect her access to services since she
j j j j j j j j
j receives some assistance for her health care costs from
j j j j j j j j
AHIP/NUR Community Exam
: Questions and Answers, certified latest update
2022/2023 GRADED A+
, j the State. Whatshould you tell her?
j j j j j j
• Medicaid may provide additional benefits, but j j j j j
j Medicaid will coordinate benefits only withMedicaid
j j j j j j
j participating providers. j
• Mr. Rivera has QMB-Plus eligibility and is thus covered by
j j j j j j j j j
j both Medicare and Medicaid. He decides to enroll in a
j j j j j j j j j
j Medicare Advantage (MA) plan. Later in the year, Mr. Rivera
j j j j j j j j j
j needs dentures, a service only covered under Medicaid.
j j j j j j j
j What action would you recommend he take inorder to have
j j j j j j j j j j
j this cost covered?
j j
• He should go to a Medicaid provider or obtain the
j j j j j j j j j
j services through a Medicaid manage careplan if he is
j j j j j j j j j
j enrolled in one j j
• Ms. Moore plans to retire when she turns 65 in a few
j j j j j j j j j j j
j months. She is in excellent health and willhave
j j j j j j j j
j considerable income when she retires. She is concerned j j j j j j j
j that her income will make it impossible for her to qualify for
j j j j j j j j j j j
j Medicare. What could you tell her to address her concern?
j j j j j j j j j
• Medicare is a program for people age 65 or older and those
j j j j j j j j j j j
AHIP/NUR Community Exam
: Questions and Answers, certified latest update
2022/2023 GRADED A+
