AHIP Medicare Certification EXAMS WITH CORRECT
SOLUTIONS /PASS GUIDE
1. Avery recently lost her employer's 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? - -ANS☑☑-She can enroll in the PPO, but she
will not be able to purchase a stand-alone Medicare Part D prescription drug plan.
2. Conrad is 64, retiring soon, and considering enrollment in his employer-sponsored
MA 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? - -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.
3. During a sales presentation to Ms. Barbosa for a Medicare Advantage plan that has a
5-star rating in customer service and care coordination, and received an overall plan
performance rating of a 4-star, which of the following would be the best statement
to say to her? - -ANS☑☑-The Medicare Advantage Plan received a 5-star rating in
customer service and care coordination with an overall performance rating of 4
stars.
4. A Medicare beneficiary has walked into your office and requested that you sit down
with her and discuss her options under the Medicare Advantage program. Before
engaging in such a discussion, what should you do? - -ANS☑☑-You must have her
sign a scope of appointment form, indicating which products she wishes to discuss.
You may then proceed with the discussion.
5. Agent Julia Horne has recently begun marketing Medicare Advantage and related
products aimed at meeting the needs of senior citizens. Client Mary Bean has
expressed interest in a Medicare Advantage plan. It is now the beginning of
September. If you were in Agent Horne's position, what would you do? - -ANS☑☑-
, Inquire whether the client qualifies for a special enrollment period, and if not, solicit
an enrollment application once the annual open enrollment election period begins
on October 15th.
6. Hank's Fish Store, Inc. is a small company with just 15 employees located in Florida.
Hank, the store owner, has provided excellent health benefits to the store's
workforce. Nash, one of the store's long-time employees, will soon be reaching age
65 and eligible for Medicare. Nash is in good health. He intends to remain an active
full-time employee, working several years after becoming eligible for Medicare.
What type(s) of retiree health benefit will Hank's Fish Store be able to offer Nash? - -
ANS☑☑-Hank's can continue to offer Nash the same employee health benefit plan,
or, if Nash enrolls in Medicare Part B, it can enroll him in a Medicare Advantage plan
that is offered to the public.
7. If you are to comply with Medicare's guidance regarding educational events, which
of the following would be acceptable activities? - -ANS☑☑-You may distribute
business cards to individuals who request information on how to contact you for
further details on the plan(s) you represent.
8. Jason is experiencing paranoid delusions and his physician feels that he should be
hospitalized. What should you tell Jason (or his representative) about the - -
ANS☑☑-Medicare will cover a total of 190 days of inpatient psychiatric care
during Jason's entire lifetime.
9. Jenny Lind is a Medicare beneficiary who switched from Original Medicare to a MA
MSA (medical savings account) plan. During the past year, Jenny has become
dissatisfied with the MA MSA plan and now wants to disenroll and enroll in an MA
PPO plan during the Annual Election Period. How can Jenny disenroll from the MA
MSA plan? - -ANS☑☑-Jenny must write to the MA MSA plan indicating her
disenrollment.
10. Joan and Loretta are both enrolled in Medicare. Joan pays a premium for Part A
coverage. Loretta does not. Which of the following statements best explains this
difference? - -ANS☑☑-Joan worked only a short time and did not accumulate
SOLUTIONS /PASS GUIDE
1. Avery recently lost her employer's 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? - -ANS☑☑-She can enroll in the PPO, but she
will not be able to purchase a stand-alone Medicare Part D prescription drug plan.
2. Conrad is 64, retiring soon, and considering enrollment in his employer-sponsored
MA 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? - -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.
3. During a sales presentation to Ms. Barbosa for a Medicare Advantage plan that has a
5-star rating in customer service and care coordination, and received an overall plan
performance rating of a 4-star, which of the following would be the best statement
to say to her? - -ANS☑☑-The Medicare Advantage Plan received a 5-star rating in
customer service and care coordination with an overall performance rating of 4
stars.
4. A Medicare beneficiary has walked into your office and requested that you sit down
with her and discuss her options under the Medicare Advantage program. Before
engaging in such a discussion, what should you do? - -ANS☑☑-You must have her
sign a scope of appointment form, indicating which products she wishes to discuss.
You may then proceed with the discussion.
5. Agent Julia Horne has recently begun marketing Medicare Advantage and related
products aimed at meeting the needs of senior citizens. Client Mary Bean has
expressed interest in a Medicare Advantage plan. It is now the beginning of
September. If you were in Agent Horne's position, what would you do? - -ANS☑☑-
, Inquire whether the client qualifies for a special enrollment period, and if not, solicit
an enrollment application once the annual open enrollment election period begins
on October 15th.
6. Hank's Fish Store, Inc. is a small company with just 15 employees located in Florida.
Hank, the store owner, has provided excellent health benefits to the store's
workforce. Nash, one of the store's long-time employees, will soon be reaching age
65 and eligible for Medicare. Nash is in good health. He intends to remain an active
full-time employee, working several years after becoming eligible for Medicare.
What type(s) of retiree health benefit will Hank's Fish Store be able to offer Nash? - -
ANS☑☑-Hank's can continue to offer Nash the same employee health benefit plan,
or, if Nash enrolls in Medicare Part B, it can enroll him in a Medicare Advantage plan
that is offered to the public.
7. If you are to comply with Medicare's guidance regarding educational events, which
of the following would be acceptable activities? - -ANS☑☑-You may distribute
business cards to individuals who request information on how to contact you for
further details on the plan(s) you represent.
8. Jason is experiencing paranoid delusions and his physician feels that he should be
hospitalized. What should you tell Jason (or his representative) about the - -
ANS☑☑-Medicare will cover a total of 190 days of inpatient psychiatric care
during Jason's entire lifetime.
9. Jenny Lind is a Medicare beneficiary who switched from Original Medicare to a MA
MSA (medical savings account) plan. During the past year, Jenny has become
dissatisfied with the MA MSA plan and now wants to disenroll and enroll in an MA
PPO plan during the Annual Election Period. How can Jenny disenroll from the MA
MSA plan? - -ANS☑☑-Jenny must write to the MA MSA plan indicating her
disenrollment.
10. Joan and Loretta are both enrolled in Medicare. Joan pays a premium for Part A
coverage. Loretta does not. Which of the following statements best explains this
difference? - -ANS☑☑-Joan worked only a short time and did not accumulate
