AHIP Final EXAM 2026-2027 LATEST UPDATED
VERSION QUESTIONS AND ANSWERS
Which of the following statement(s) is/are correct about a Medicare
Savings Account (MSA) Plans?
I. MSAs may have either a partial network, full network, or no network of
providers.
II. MSA plans cover Part A and Part B benefits but not Part D prescription
drug benefits.
III. An individual who is enrolled in an MSA plan is responsible for a minimal
deductible of
$500 indexed for inflation.
IV. Non−network providers must accept the same amount that Original
Medicare would pay them as payment in full. − answer>>>I, II, and IV
only
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? −
answer>>>Mrs. Chi may enroll in a MA MSA plan and remain in her
current standalone Part D prescription drug plan.
Mrs. Lyons is in good health, uses a single prescription, and lives
independently in her own home. She is attracted by the idea of
maintaining control over a Medical Savings Account (MSA) but is not sure
if the plan associated with the account will fit her needs. What specific
piece of information about a Medicare MSA plan would it be important
for her to know, prior to enrolling in such a plan? − answer>>>All MSAs
cover Part A and Part B benefits, but not Part D prescription drug
benefits, which could be obtained by also enrolling in a separate
prescription drug plan.
Mrs. Burton is a retiree with substantial income. She is enrolled in an
MA−PD plan and was disappointed with the service she received from
her primary care physician because she was told she would have to wait
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, AHIP Final EXAM 2026-2027 LATEST UPDATED
VERSION QUESTIONS AND ANSWERS
five weeks to get an appointment when she was feeling ill. She called you
to ask what she could do so she would not have to put up with such poor
access to care. What could you tell her? − answer>>>She could file a
grievance with her plan to complain about the lack of timeliness in
getting an appointment.
Mrs. Radford asks whether there are any special eligibility requirements
for Medicare Advantage. What should you tell her? − answer>>>Mrs.
Radford must be entitled to Part A and enrolled in Part B to enroll in
Medicare Advantage.
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, AHIP Final EXAM 2026-2027 LATEST UPDATED
VERSION QUESTIONS AND ANSWERS
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? − answer>>>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. 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? −
answer>>>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.
Ms. Gibson recently lost her employer group health and drug
coverage and now she wants to enroll in a PPO that does not include
drug coverage. What should you tell her about obtaining drug
coverage? − answer>>>She can enroll in the PPO, but she will not be
able to purchase a stand−alone Medicare Part D prescription drug
plan.
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? − answer>>>Dr. Brennan can charge Mary Rogers no
more than the cost sharing specified in the PFFS plan's terms and
condition of payment which may include balance billing up to 15%of the
Medicare rate.
Mrs. Kelly, age 65, is entitled to Part A but has not yet enrolled in Part B.
She is considering enrollment in a Medicare Advantage plan (Part C).
What should you advise her to do before she can enroll in a Medicare
Advantage plan? − answer>>>To join a Medicare Advantage plan, she also
must enroll in Part B.
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, AHIP Final EXAM 2026-2027 LATEST UPDATED
VERSION QUESTIONS AND ANSWERS
Mr. Wells is trying to understand the difference between Original
Medicare and Medicare Advantage. What would be the correct
description? − answer>>>Medicare Advantage is a way of covering all
the Original Medicare benefits through private health insurance
companies.
Mr. Lombardi is interested in a Medicare Advantage (MA) PPO plan that
you represent. It is one of three plans operated by the same organization
in Mr. Lombardi's area. The MA PPO plan does not include drug coverage,
but the other two plans do. Mr. Lombardi likes the PPO plan that does
not include drug coverage and intends to obtain his drug coverage
through a stand−alone Medicare prescription drug plan. What should you
tell him about this situation? − answer>>>He could enroll either in one of
the MA plans that include prescription drug coverage or Original
Medicare with a
Document shared on https://www.docsity.com/en/docs/ahip-final-exam-2026-2027-latest-updated-version-questions-and-answerspdf/16325448/
VERSION QUESTIONS AND ANSWERS
Which of the following statement(s) is/are correct about a Medicare
Savings Account (MSA) Plans?
I. MSAs may have either a partial network, full network, or no network of
providers.
II. MSA plans cover Part A and Part B benefits but not Part D prescription
drug benefits.
III. An individual who is enrolled in an MSA plan is responsible for a minimal
deductible of
$500 indexed for inflation.
IV. Non−network providers must accept the same amount that Original
Medicare would pay them as payment in full. − answer>>>I, II, and IV
only
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? −
answer>>>Mrs. Chi may enroll in a MA MSA plan and remain in her
current standalone Part D prescription drug plan.
Mrs. Lyons is in good health, uses a single prescription, and lives
independently in her own home. She is attracted by the idea of
maintaining control over a Medical Savings Account (MSA) but is not sure
if the plan associated with the account will fit her needs. What specific
piece of information about a Medicare MSA plan would it be important
for her to know, prior to enrolling in such a plan? − answer>>>All MSAs
cover Part A and Part B benefits, but not Part D prescription drug
benefits, which could be obtained by also enrolling in a separate
prescription drug plan.
Mrs. Burton is a retiree with substantial income. She is enrolled in an
MA−PD plan and was disappointed with the service she received from
her primary care physician because she was told she would have to wait
Document shared on https://www.docsity.com/en/docs/ahip-final-exam-2026-2027-latest-updated-version-questions-and-answerspdf/16325448/
, AHIP Final EXAM 2026-2027 LATEST UPDATED
VERSION QUESTIONS AND ANSWERS
five weeks to get an appointment when she was feeling ill. She called you
to ask what she could do so she would not have to put up with such poor
access to care. What could you tell her? − answer>>>She could file a
grievance with her plan to complain about the lack of timeliness in
getting an appointment.
Mrs. Radford asks whether there are any special eligibility requirements
for Medicare Advantage. What should you tell her? − answer>>>Mrs.
Radford must be entitled to Part A and enrolled in Part B to enroll in
Medicare Advantage.
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, AHIP Final EXAM 2026-2027 LATEST UPDATED
VERSION QUESTIONS AND ANSWERS
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? − answer>>>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. 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? −
answer>>>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.
Ms. Gibson recently lost her employer group health and drug
coverage and now she wants to enroll in a PPO that does not include
drug coverage. What should you tell her about obtaining drug
coverage? − answer>>>She can enroll in the PPO, but she will not be
able to purchase a stand−alone Medicare Part D prescription drug
plan.
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? − answer>>>Dr. Brennan can charge Mary Rogers no
more than the cost sharing specified in the PFFS plan's terms and
condition of payment which may include balance billing up to 15%of the
Medicare rate.
Mrs. Kelly, age 65, is entitled to Part A but has not yet enrolled in Part B.
She is considering enrollment in a Medicare Advantage plan (Part C).
What should you advise her to do before she can enroll in a Medicare
Advantage plan? − answer>>>To join a Medicare Advantage plan, she also
must enroll in Part B.
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, AHIP Final EXAM 2026-2027 LATEST UPDATED
VERSION QUESTIONS AND ANSWERS
Mr. Wells is trying to understand the difference between Original
Medicare and Medicare Advantage. What would be the correct
description? − answer>>>Medicare Advantage is a way of covering all
the Original Medicare benefits through private health insurance
companies.
Mr. Lombardi is interested in a Medicare Advantage (MA) PPO plan that
you represent. It is one of three plans operated by the same organization
in Mr. Lombardi's area. The MA PPO plan does not include drug coverage,
but the other two plans do. Mr. Lombardi likes the PPO plan that does
not include drug coverage and intends to obtain his drug coverage
through a stand−alone Medicare prescription drug plan. What should you
tell him about this situation? − answer>>>He could enroll either in one of
the MA plans that include prescription drug coverage or Original
Medicare with a
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