2026 AHIP EXTRAS |
COMPREHENSIVE MEDICARE
CERTIFICATION EXAM PREP WITH
SUPPLEMENTAL PRACTICE
QUESTIONS, COMPLIANCE REVIEW
& VERIFIED ANSWERS
Agent Roderick enrolls retiree Mrs. Martinez in a medical savings account
(MSA) Medicare health plan. The MSA plan does not offer prescription drug
coverage, so Agent Roderick also enrolls Mrs. Martinez in a standalone
prescription drug plan (PDP). What CMS compensation rules apply to this
situation?
a. Regular CMS and renewal compensation rules apply to the PDP enrollment,
but compensation is limited to $100 for the MSA health plan enrollment to
recompense CMS for contributions made to the enrollee's MSA account.
b. MSA Medicare health plans are subject to special rules limiting initial year
compensation to 50 percent of the fair market value (FMV) published annually
by CMS. Regular initial year enrollment rules apply to the PDP.
c. When an MSA Medicare health plan is combined with a PDP, initial and
renewal year(s) compensation is paid only for the MSA enrollment to
,recompense CMS for contributions made to th - CORRECT ANSWER : -This
situation is considered a "dual enrollment," and CMS compensation rules are
applied to the two plans at once and independently of each other.
Ms. Chase is interested in discussing various Medicare Advantage (MA) Plans
available in her area with you. She has heard that MA plans have something
called a "maximum out-of-pocket" limit. She asks you to explain what this
means. What do you say?
a. Each year, CMS specifies an optional MOOP, which health plans can exceed
or lower.
b. Original Medicare, not MA plans, have a maximum out-of-pocket limit, for
Part A and Part B benefits.
c. MA plans have a maximum out-of-pocket limit, known as the "MOOP" for
Part A and Part B benefits. Once a plan member pays a specified amount of
cost-sharing, the health plan covers 80 percent of covered medical services.
d. MA plans have a maximum out-of-pocket limit, known as the "MOOP", for
Part A and Part B benefits. Once a plan member pays a specified amount of
cost-sharing, the health plan covers 100 percent of covered medical services. -
CORRECT ANSWER : -MA plans have a maximum out-of-pocket limit, known as
the "MOOP", for Part A and Part B benefits. Once a plan member pays a
, specified amount of cost-sharing, the health plan covers 100 percent of
covered medical services.
Agent Marvin Millner wants to reach out to his current clients for referrals.
What advice would you give to Marvin?
a. CMS guidelines limit the value of gifts provided in exchange for referrals to a
value of $50 or less.
b. Marvin should understand that under CMS guidelines he can no longer
provide gifts, even of minimal value, in exchange for referrals.
c. Marvin should consult with the health plans he represents to determine
whether those plans impose requirements around beneficiary referrals.
d. CMS guidelines limit the value of gifts provided in exchange for referrals to a
value of $100 or less. - CORRECT ANSWER : -Marvin should consult with the
health plans he represents to determine whether those plans impose
requirements around beneficiary referrals
Mr. Perry is entitled to Medicare Part A but has not yet enrolled in Part B, even
though he is 69 years old. He would like to enroll in a Medicare Part D
prescription drug plan but is concerned that he will have to sign up for Part B as
COMPREHENSIVE MEDICARE
CERTIFICATION EXAM PREP WITH
SUPPLEMENTAL PRACTICE
QUESTIONS, COMPLIANCE REVIEW
& VERIFIED ANSWERS
Agent Roderick enrolls retiree Mrs. Martinez in a medical savings account
(MSA) Medicare health plan. The MSA plan does not offer prescription drug
coverage, so Agent Roderick also enrolls Mrs. Martinez in a standalone
prescription drug plan (PDP). What CMS compensation rules apply to this
situation?
a. Regular CMS and renewal compensation rules apply to the PDP enrollment,
but compensation is limited to $100 for the MSA health plan enrollment to
recompense CMS for contributions made to the enrollee's MSA account.
b. MSA Medicare health plans are subject to special rules limiting initial year
compensation to 50 percent of the fair market value (FMV) published annually
by CMS. Regular initial year enrollment rules apply to the PDP.
c. When an MSA Medicare health plan is combined with a PDP, initial and
renewal year(s) compensation is paid only for the MSA enrollment to
,recompense CMS for contributions made to th - CORRECT ANSWER : -This
situation is considered a "dual enrollment," and CMS compensation rules are
applied to the two plans at once and independently of each other.
Ms. Chase is interested in discussing various Medicare Advantage (MA) Plans
available in her area with you. She has heard that MA plans have something
called a "maximum out-of-pocket" limit. She asks you to explain what this
means. What do you say?
a. Each year, CMS specifies an optional MOOP, which health plans can exceed
or lower.
b. Original Medicare, not MA plans, have a maximum out-of-pocket limit, for
Part A and Part B benefits.
c. MA plans have a maximum out-of-pocket limit, known as the "MOOP" for
Part A and Part B benefits. Once a plan member pays a specified amount of
cost-sharing, the health plan covers 80 percent of covered medical services.
d. MA plans have a maximum out-of-pocket limit, known as the "MOOP", for
Part A and Part B benefits. Once a plan member pays a specified amount of
cost-sharing, the health plan covers 100 percent of covered medical services. -
CORRECT ANSWER : -MA plans have a maximum out-of-pocket limit, known as
the "MOOP", for Part A and Part B benefits. Once a plan member pays a
, specified amount of cost-sharing, the health plan covers 100 percent of
covered medical services.
Agent Marvin Millner wants to reach out to his current clients for referrals.
What advice would you give to Marvin?
a. CMS guidelines limit the value of gifts provided in exchange for referrals to a
value of $50 or less.
b. Marvin should understand that under CMS guidelines he can no longer
provide gifts, even of minimal value, in exchange for referrals.
c. Marvin should consult with the health plans he represents to determine
whether those plans impose requirements around beneficiary referrals.
d. CMS guidelines limit the value of gifts provided in exchange for referrals to a
value of $100 or less. - CORRECT ANSWER : -Marvin should consult with the
health plans he represents to determine whether those plans impose
requirements around beneficiary referrals
Mr. Perry is entitled to Medicare Part A but has not yet enrolled in Part B, even
though he is 69 years old. He would like to enroll in a Medicare Part D
prescription drug plan but is concerned that he will have to sign up for Part B as
