Social Science Business Insurance
AHIP 2026 Final Exam
Students also studied
C
Terms in this set (50)
Mr. Arias, a naturalized citizen, previously He is not eligible to enroll in a Medicare Advantage plan until
enrolled in Medicare Part B but has recently he re-enrolls in Medicare Part B.
stopped paying his Part B premium. Mr.
Arias is still covered by Part A. He would like
to enroll in a Medicare Advantage (MA)
plan and is still covered by Part A. What
should you tell him?
Mrs. Joy, age 65, is entitled to Part A but has To join a Medicare Advantage plan, she also must enroll in
not yet enrolled in Part B. She is Part B.
considering enrolling in a Medicare
Advantage plan
(Part C). What should you advise her to
do before she can enroll in a Medicare
Advantage plan?
Mr. Kumar is considering a Medicare In most Medicare Advantage HMOs, Mr. Kumar must
Advantage HMO and has questions about generally obtain his services only from providers within the
his ability to access providers. What should plan's network (except in an emergency or where care is
you tell him? unavailable within the network).
Mrs. Robles is considering a Medicare Mrs. Robles can obtain care from any provider who
Advantage PPO and has questions about participates in Original Medicare, but generally will have a
which providers she can go to for her health higher cost-sharing amount if she sees a provider who/that is
care. What should you tell her? not a part of the PPO network.
, Mrs. Lester is age 75 and enjoys a Mrs. Lester may enroll in an MA MSA plan and remain in her
comfortable but not extremely high-income current standalone Part D prescription drug plan.
level. She wishes to enroll in an 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.
Lester?
Mr. Dalton is in excellent health, lives in his SNPs limit enrollment to certain subpopulations of
own home, and has a sizeable income from beneficiaries. Given his current situation, he is unlikely to
his investments. He has a friend enrolled in a qualify and would not be able to enroll in the SNP.
Medicare Advantage Special Needs Plan
(SNP). His friend has mentioned that the
SNP charges very low cost-sharing amounts
and Mr. Dalton would like to join that plan.
What should you tell him?
Mr. Anderson wants to know whether he You would need to ask Mr. Anderson if he is entitled to Part A,
is eligible to sign up for a Private fee- enrolled in Part B, and if he lives in the PFFS plan's service
for- area.
service (PFFS) plan. What questions would
you need to ask to determine his eligibility?
Herber Noble is turning 65 next month, Herber is eligible to enroll in Medicare Advantage as long
Herber legally entered the United States as he is entitled to Part A and enrolled in Part B. Herber
over twenty years ago but is not a citizen. should go to the Social Security website to enroll in
Since his entry into the country, Herber has Medicare Part A and B if he has not done so already. Once
worked at Smallcap Incorporated and he is enrolled, he can choose a Medicare Advantage
contributed to the Medicare system. Herber plan.
suffers from diabetes. He will soon retire
and asks you if he can enroll in a Medicare
Advantage plan that you represent. How
would you respond?
Which of the following individuals is most Jose, a grandfather who was granted asylum and has worked
likely to be eligible to enroll in a Part D in the United States for many years.
Plan?
Mrs. Castro has just turned 65, is in excellent If she does not sign up for a Medicare prescription drug
health and has a relatively high income. She plan as soon as she is eligible to do so, and if she does sign up
uses no medications and sees no reason to at a later date, her premium will be permanently increased by
spend money on a Medicare prescription 1% of the national average premium for every month that she
drug plan if she does not need the was not covered.
coverage. She currently does not have
creditable coverage. What could you tell
her about the implications of such a
decision?
AHIP 2026 Final Exam
Students also studied
C
Terms in this set (50)
Mr. Arias, a naturalized citizen, previously He is not eligible to enroll in a Medicare Advantage plan until
enrolled in Medicare Part B but has recently he re-enrolls in Medicare Part B.
stopped paying his Part B premium. Mr.
Arias is still covered by Part A. He would like
to enroll in a Medicare Advantage (MA)
plan and is still covered by Part A. What
should you tell him?
Mrs. Joy, age 65, is entitled to Part A but has To join a Medicare Advantage plan, she also must enroll in
not yet enrolled in Part B. She is Part B.
considering enrolling in a Medicare
Advantage plan
(Part C). What should you advise her to
do before she can enroll in a Medicare
Advantage plan?
Mr. Kumar is considering a Medicare In most Medicare Advantage HMOs, Mr. Kumar must
Advantage HMO and has questions about generally obtain his services only from providers within the
his ability to access providers. What should plan's network (except in an emergency or where care is
you tell him? unavailable within the network).
Mrs. Robles is considering a Medicare Mrs. Robles can obtain care from any provider who
Advantage PPO and has questions about participates in Original Medicare, but generally will have a
which providers she can go to for her health higher cost-sharing amount if she sees a provider who/that is
care. What should you tell her? not a part of the PPO network.
, Mrs. Lester is age 75 and enjoys a Mrs. Lester may enroll in an MA MSA plan and remain in her
comfortable but not extremely high-income current standalone Part D prescription drug plan.
level. She wishes to enroll in an 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.
Lester?
Mr. Dalton is in excellent health, lives in his SNPs limit enrollment to certain subpopulations of
own home, and has a sizeable income from beneficiaries. Given his current situation, he is unlikely to
his investments. He has a friend enrolled in a qualify and would not be able to enroll in the SNP.
Medicare Advantage Special Needs Plan
(SNP). His friend has mentioned that the
SNP charges very low cost-sharing amounts
and Mr. Dalton would like to join that plan.
What should you tell him?
Mr. Anderson wants to know whether he You would need to ask Mr. Anderson if he is entitled to Part A,
is eligible to sign up for a Private fee- enrolled in Part B, and if he lives in the PFFS plan's service
for- area.
service (PFFS) plan. What questions would
you need to ask to determine his eligibility?
Herber Noble is turning 65 next month, Herber is eligible to enroll in Medicare Advantage as long
Herber legally entered the United States as he is entitled to Part A and enrolled in Part B. Herber
over twenty years ago but is not a citizen. should go to the Social Security website to enroll in
Since his entry into the country, Herber has Medicare Part A and B if he has not done so already. Once
worked at Smallcap Incorporated and he is enrolled, he can choose a Medicare Advantage
contributed to the Medicare system. Herber plan.
suffers from diabetes. He will soon retire
and asks you if he can enroll in a Medicare
Advantage plan that you represent. How
would you respond?
Which of the following individuals is most Jose, a grandfather who was granted asylum and has worked
likely to be eligible to enroll in a Part D in the United States for many years.
Plan?
Mrs. Castro has just turned 65, is in excellent If she does not sign up for a Medicare prescription drug
health and has a relatively high income. She plan as soon as she is eligible to do so, and if she does sign up
uses no medications and sees no reason to at a later date, her premium will be permanently increased by
spend money on a Medicare prescription 1% of the national average premium for every month that she
drug plan if she does not need the was not covered.
coverage. She currently does not have
creditable coverage. What could you tell
her about the implications of such a
decision?
