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AHIP Questions Verified and Provided with A+ Graded Answers
Latest Updated 2026
Which of the following steps may a Part D sponsor I. Identifying at risk individuals by using criteria that includes the number
adopt for beneficiaries who are at risk of misusing of opioid prescriptions the beneficiary has and the number of
or abusing frequently abused drugs? prescribers who have written those prescriptions.
II. Locking an at-risk beneficiary into one pharmacy.
III. Locking an at-risk beneficiary into one prescriber.
Mrs. Wolf wears glasses and dentures and has Medicare does not cover acupuncture, or, in general, glasses or
enjoyed considerable pain relief from arthritis dentures.
through acupuncture. She is concerned about
whether or not Medicare will cover these items
and services. What should you tell her?
Which statement best describes PACE plans? It includes comprehensive medical and social service delivery
systems using an interdisciplinary team approach in an adult day
health center, supplemented by in-home and referral services.
Mr. Shultz was still working when he first qualified Mr. Schultz should enroll in a Part D plan before he has a 63-day break
for Medicare. At that time, he had employer group in coverage in order to avoid a premium penalty.
coverage that was creditable. During his initial
Part D eligibility period, he decided not to
enroll because he was satisfied with his drug
coverage. It is now a year later and Mr. Shultz
has lost his
employer group coverage. How would you
advise him?
For which of the following individuals would a Cost Ms. Baker who is enrolled in Medicare Part B and is willing to continue
Plan be most appropriate? paying Part B premiums plus any plan premiums.
Mrs. Berkowitz wants to enroll in a Medicare If the Medicare Advantage plan is a Private Fee-for-Service (PFFS) plan
Advantage plan that does not include drug that does not offer drug coverage or a Medical Savings Account,
coverage and also enroll in a stand-alone Mrs. Berkowitz can do this.
Medicare prescription drug plan. Under what
circumstances can she do this?
Ms. Goldstein is required by the plan she She should make every effort to safeguard the beneficiary information
represents to obtain enrollment forms that on those enrollment forms.
have carbon copies in the back. She gives one
to the beneficiary, sends another to the plan and
retains the third. What should she do with her
copies of the enrollment forms?
Mr. Lopez takes several high cost prescription Private Fee-for-Service (PFFS) plan that does not include drug
drugs. He would like to enroll in a standalone Part coverage.
D prescription drug plan that is available in his
area. In what type of Medicare Health Plan can he
enroll?
, Mr. Block is currently enrolled in a Medicare If Mr. Block enrolls in the stand-alone Medicare prescription drug plan,
Advantage plan that includes drug coverage. He he will be disenrolled from the Medicare Advantage plan.
found a stand-alone Medicare prescription drug
plan in his area that offers better coverage
than
that available through his MA-PD plan and in
addition has a low premium. It won't cost him much
more and, because he has the means to do so, he
wishes to enroll in the stand-alone prescription
drug plan in addition to his MA-PD plan. What
should you tell him?
Mrs. Chen will be 65 soon, has been a citizen for Most individuals who are citizens and over age 65 are covered under
twelve years, has been employed full time, and Part A by virtue of having paid Medicare taxes while working, though
paid taxes during that entire period. She is some may be covered as a result of paying monthly premiums.
concerned that she will not qualify for coverage
under part A because she was not born in the
United States. What should you tell her?
Mrs. Lopez is enrolled in a Medicare Advantage If a Part D benefit is offered through her plan she must enroll in this
cost plan. She has recently lost creditable plan.
coverage previously available through her
husband's employer. She is interested in enrolling
in a Medicare Part D prescription drug plan (PDP).
What should you tell her?
Mr. Schmidt would like to plan for retirement Part A, which covers hospital, skilled nursing facility, hospice and home
and has asked you what is covered under Original health services and Part B, which covers professional services such as
Fee-for-Service (FFS) Medicare? What could those provided by a doctor are covered under Original Medicare.
you tell him?
Mrs. Wellington is enrolled in Parts A and B of Mrs. Wellington is eligible for a SEP that may be used once until
Original Medicare. A friend recently told her that November 30 to enroll in the five-star plan.
there is an excellent Medicare Advantage (MA)
plan with a five-star rating serving her area. On
January 15 she comes to you for advice as to what
options, if any, she has. What should you say
regarding special enrollment periods (SEPs)?
Mr. Shapiro gets by on a very small fixed income. The extra help is available to beneficiaries whose income and assets do
He has heard there may be extra help paying for not exceed annual limits specified by the government.
Part D prescription drugs for Medicare
beneficiaries with limited income. He wants to
know whether he might qualify. What should you
tell him?
A client wants to give you an enrollment You must tell him you are not permitted to take the form. If he sends the
application on October 1 prior to the beginning of form directly to the plan, the plan will process the enrollment on the
the Annual Election Period because he is leaving day the Annual Election Period begins.
on vacation for two weeks and does not want
to forget about turning it in. What should you
tell him?
AHIP Questions Verified and Provided with A+ Graded Answers
Latest Updated 2026
Which of the following steps may a Part D sponsor I. Identifying at risk individuals by using criteria that includes the number
adopt for beneficiaries who are at risk of misusing of opioid prescriptions the beneficiary has and the number of
or abusing frequently abused drugs? prescribers who have written those prescriptions.
II. Locking an at-risk beneficiary into one pharmacy.
III. Locking an at-risk beneficiary into one prescriber.
Mrs. Wolf wears glasses and dentures and has Medicare does not cover acupuncture, or, in general, glasses or
enjoyed considerable pain relief from arthritis dentures.
through acupuncture. She is concerned about
whether or not Medicare will cover these items
and services. What should you tell her?
Which statement best describes PACE plans? It includes comprehensive medical and social service delivery
systems using an interdisciplinary team approach in an adult day
health center, supplemented by in-home and referral services.
Mr. Shultz was still working when he first qualified Mr. Schultz should enroll in a Part D plan before he has a 63-day break
for Medicare. At that time, he had employer group in coverage in order to avoid a premium penalty.
coverage that was creditable. During his initial
Part D eligibility period, he decided not to
enroll because he was satisfied with his drug
coverage. It is now a year later and Mr. Shultz
has lost his
employer group coverage. How would you
advise him?
For which of the following individuals would a Cost Ms. Baker who is enrolled in Medicare Part B and is willing to continue
Plan be most appropriate? paying Part B premiums plus any plan premiums.
Mrs. Berkowitz wants to enroll in a Medicare If the Medicare Advantage plan is a Private Fee-for-Service (PFFS) plan
Advantage plan that does not include drug that does not offer drug coverage or a Medical Savings Account,
coverage and also enroll in a stand-alone Mrs. Berkowitz can do this.
Medicare prescription drug plan. Under what
circumstances can she do this?
Ms. Goldstein is required by the plan she She should make every effort to safeguard the beneficiary information
represents to obtain enrollment forms that on those enrollment forms.
have carbon copies in the back. She gives one
to the beneficiary, sends another to the plan and
retains the third. What should she do with her
copies of the enrollment forms?
Mr. Lopez takes several high cost prescription Private Fee-for-Service (PFFS) plan that does not include drug
drugs. He would like to enroll in a standalone Part coverage.
D prescription drug plan that is available in his
area. In what type of Medicare Health Plan can he
enroll?
, Mr. Block is currently enrolled in a Medicare If Mr. Block enrolls in the stand-alone Medicare prescription drug plan,
Advantage plan that includes drug coverage. He he will be disenrolled from the Medicare Advantage plan.
found a stand-alone Medicare prescription drug
plan in his area that offers better coverage
than
that available through his MA-PD plan and in
addition has a low premium. It won't cost him much
more and, because he has the means to do so, he
wishes to enroll in the stand-alone prescription
drug plan in addition to his MA-PD plan. What
should you tell him?
Mrs. Chen will be 65 soon, has been a citizen for Most individuals who are citizens and over age 65 are covered under
twelve years, has been employed full time, and Part A by virtue of having paid Medicare taxes while working, though
paid taxes during that entire period. She is some may be covered as a result of paying monthly premiums.
concerned that she will not qualify for coverage
under part A because she was not born in the
United States. What should you tell her?
Mrs. Lopez is enrolled in a Medicare Advantage If a Part D benefit is offered through her plan she must enroll in this
cost plan. She has recently lost creditable plan.
coverage previously available through her
husband's employer. She is interested in enrolling
in a Medicare Part D prescription drug plan (PDP).
What should you tell her?
Mr. Schmidt would like to plan for retirement Part A, which covers hospital, skilled nursing facility, hospice and home
and has asked you what is covered under Original health services and Part B, which covers professional services such as
Fee-for-Service (FFS) Medicare? What could those provided by a doctor are covered under Original Medicare.
you tell him?
Mrs. Wellington is enrolled in Parts A and B of Mrs. Wellington is eligible for a SEP that may be used once until
Original Medicare. A friend recently told her that November 30 to enroll in the five-star plan.
there is an excellent Medicare Advantage (MA)
plan with a five-star rating serving her area. On
January 15 she comes to you for advice as to what
options, if any, she has. What should you say
regarding special enrollment periods (SEPs)?
Mr. Shapiro gets by on a very small fixed income. The extra help is available to beneficiaries whose income and assets do
He has heard there may be extra help paying for not exceed annual limits specified by the government.
Part D prescription drugs for Medicare
beneficiaries with limited income. He wants to
know whether he might qualify. What should you
tell him?
A client wants to give you an enrollment You must tell him you are not permitted to take the form. If he sends the
application on October 1 prior to the beginning of form directly to the plan, the plan will process the enrollment on the
the Annual Election Period because he is leaving day the Annual Election Period begins.
on vacation for two weeks and does not want
to forget about turning it in. What should you
tell him?
