AHIP FINAL EXAM TEST QUESTIONS – EXAM QUESTIONS
AND CORRECT ANSWERS (VERIFIED ANSWERS) PLUS
RATIONALE | 2027 Q&A | INSTANT DOWNLOAD PDF
Mrs. West wears glasses and dentures and has enjoyed considerable pain relief from arthritis
through acupuncture. She is concerned about whether or not Medicare will cover these items and
services. What should you tell her? - Correct Answer Medicare does not cover acupuncture, or,
in general, glasses or dentures.
Mr. Bickford did not quite qualify for the extra help low-income subsidy under the Medicare Part
D Prescription Drug program and he is wondering if there is any other option he has for
obtaining help with his considerable drug costs. What should you tell him? - Correct Answer He
could check with the manufacturers of his medications to see if they offer an assistance program
to help people with limited means obtain the medications they need. Alternatively, he could
check to see whether his state has a pharmacy assistance program to help him with his expenses.
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? - Correct
Answer He could enroll in one of the MA plans that include prescription drug coverage or a
Medigap plan and a stand-alone prescription drug plan, but he cannot enroll in the MA-only PPO
plan and a stand-alone prescription drug plan.
Mr. Torres has a small savings account. He would like to pay for his monthly Part D premiums
with an automatic monthly withdrawal from his savings account until it is exhausted, and then
have his premiums withheld from his Social Security check. What should you tell him? - Correct
Answer In general, he must select a single Part D premium payment mechanism that will be used
throughout the year.
Agent Jennings makes a presentation on Medicare advertised as an educational event. Agent
Jennings distributes materials that are solely educational in nature. However, she gives a brief
presentation that mentions plan-specific premiums. Is this a prohibited activity at an event that
has been advertised as educational? - Correct Answer Yes. When an event has been advertised as
"educational," discussing plan-specific premiums is impermissible.
Mrs. Mulcahy is concerned that she may not qualify for enrollment in a Medicare prescription
drug plan because, although she is entitled to Part A, she is not enrolled under Medicare Part B.
What should you tell her? - Correct Answer Everyone who is entitled to Part A or enrolled under
Part B is eligible to enroll in a Medicare prescription drug plan. As long as Mrs. Mulcahy is
entitled to Part A, she does not need to enroll under Part B before enrolling in a prescription drug
plan.
, Mr. Jacob understands that there is a standard Medicare Part D prescription drug benefit, but
when he looks at information on various plans available in his area, he sees a wide range in what
they charge for deductibles, premiums and cost sharing. How can you explain this to him? -
Correct Answer Medicare Part D drug plans may have different benefit structures, but on
average, they must all be at least as good as the standard model established by the government.
Ms. Moore plans to retire when she turns 65 in a few months. She is in excellent health and will
have considerable income when she retires. She is concerned that her income will make it
impossible for her to qualify for Medicare. What could you tell her to address her concern? -
Correct Answer Medicare is a program for people age 65 or older and those under age 65 with
certain disabilities, end stage renal disease or Lou Gehrig's disease, so she will be eligible for
Medicare.
Agent Armstrong is employed by XYZ Agency, which is under contract with ABC Health Plan,
a Medicare Advantage (MA) plan that offers plans in multiple states. XYZ Agency maintains a
website marketing the MA plans with which it has contracts. Agent Armstrong follows up with
individuals who request more information about ABC MA plans via the website and tries to
persuade them to enroll in ABC plans. What statement best describes the marketing and
compliance rules that apply to Agent Armstrong? - Correct Answer Agent Armstrong needs to be
licensed and appointed in every state in which beneficiaries to whom he markets ABC MA plans
are located.
Mr. Schmidt would like to plan for retirement and has asked you what is covered under Original
Fee-for-Service (FFS) Medicare? What could you tell him? - Correct Answer Part A, which
covers hospital, skilled nursing facility, hospice and home health services and Part B, which
covers professional services such as those provided by a doctor are covered under Original
Medicare.
You are seeking to represent an individual Medicare Advantage plan and an individual Part D
plan in your state. You have completed the required training for each plan, but you did not
achieve a passing score on the tests that came after the training. What can you do in this
situation? - Correct Answer You will not be able to represent any Medicare Advantage or Part D
plan until you complete the training and achieve an adequate score, although you will not have to
take a test if you exclusively market employer/union group plans and the companies do not
require testing.
Mr. Chen is enrolled in his employer's group health plan and will be retiring soon. He would like
to know his options since he has decided to drop his retiree coverage and is eligible for
Medicare. What should you tell him? - Correct Answer Mr. Chen can disenroll from his
employer-sponsored coverage to elect a Medicare Advantage or Part D plan within 2 months of
his disenrollment, but he should revaluate if he really wants to drop his employer coverage.
Mr. Davis is 52 years old and has recently been diagnosed with end-stage renal disease (ESRD)
and will soon begin dialysis. He is wondering if he can obtain coverage under Medicare. What
should you tell him? - Correct Answer He may sign-up for Medicare at any time however
coverage usually begins on the fourth month after dialysis treatments start.
AND CORRECT ANSWERS (VERIFIED ANSWERS) PLUS
RATIONALE | 2027 Q&A | INSTANT DOWNLOAD PDF
Mrs. West wears glasses and dentures and has enjoyed considerable pain relief from arthritis
through acupuncture. She is concerned about whether or not Medicare will cover these items and
services. What should you tell her? - Correct Answer Medicare does not cover acupuncture, or,
in general, glasses or dentures.
Mr. Bickford did not quite qualify for the extra help low-income subsidy under the Medicare Part
D Prescription Drug program and he is wondering if there is any other option he has for
obtaining help with his considerable drug costs. What should you tell him? - Correct Answer He
could check with the manufacturers of his medications to see if they offer an assistance program
to help people with limited means obtain the medications they need. Alternatively, he could
check to see whether his state has a pharmacy assistance program to help him with his expenses.
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? - Correct
Answer He could enroll in one of the MA plans that include prescription drug coverage or a
Medigap plan and a stand-alone prescription drug plan, but he cannot enroll in the MA-only PPO
plan and a stand-alone prescription drug plan.
Mr. Torres has a small savings account. He would like to pay for his monthly Part D premiums
with an automatic monthly withdrawal from his savings account until it is exhausted, and then
have his premiums withheld from his Social Security check. What should you tell him? - Correct
Answer In general, he must select a single Part D premium payment mechanism that will be used
throughout the year.
Agent Jennings makes a presentation on Medicare advertised as an educational event. Agent
Jennings distributes materials that are solely educational in nature. However, she gives a brief
presentation that mentions plan-specific premiums. Is this a prohibited activity at an event that
has been advertised as educational? - Correct Answer Yes. When an event has been advertised as
"educational," discussing plan-specific premiums is impermissible.
Mrs. Mulcahy is concerned that she may not qualify for enrollment in a Medicare prescription
drug plan because, although she is entitled to Part A, she is not enrolled under Medicare Part B.
What should you tell her? - Correct Answer Everyone who is entitled to Part A or enrolled under
Part B is eligible to enroll in a Medicare prescription drug plan. As long as Mrs. Mulcahy is
entitled to Part A, she does not need to enroll under Part B before enrolling in a prescription drug
plan.
, Mr. Jacob understands that there is a standard Medicare Part D prescription drug benefit, but
when he looks at information on various plans available in his area, he sees a wide range in what
they charge for deductibles, premiums and cost sharing. How can you explain this to him? -
Correct Answer Medicare Part D drug plans may have different benefit structures, but on
average, they must all be at least as good as the standard model established by the government.
Ms. Moore plans to retire when she turns 65 in a few months. She is in excellent health and will
have considerable income when she retires. She is concerned that her income will make it
impossible for her to qualify for Medicare. What could you tell her to address her concern? -
Correct Answer Medicare is a program for people age 65 or older and those under age 65 with
certain disabilities, end stage renal disease or Lou Gehrig's disease, so she will be eligible for
Medicare.
Agent Armstrong is employed by XYZ Agency, which is under contract with ABC Health Plan,
a Medicare Advantage (MA) plan that offers plans in multiple states. XYZ Agency maintains a
website marketing the MA plans with which it has contracts. Agent Armstrong follows up with
individuals who request more information about ABC MA plans via the website and tries to
persuade them to enroll in ABC plans. What statement best describes the marketing and
compliance rules that apply to Agent Armstrong? - Correct Answer Agent Armstrong needs to be
licensed and appointed in every state in which beneficiaries to whom he markets ABC MA plans
are located.
Mr. Schmidt would like to plan for retirement and has asked you what is covered under Original
Fee-for-Service (FFS) Medicare? What could you tell him? - Correct Answer Part A, which
covers hospital, skilled nursing facility, hospice and home health services and Part B, which
covers professional services such as those provided by a doctor are covered under Original
Medicare.
You are seeking to represent an individual Medicare Advantage plan and an individual Part D
plan in your state. You have completed the required training for each plan, but you did not
achieve a passing score on the tests that came after the training. What can you do in this
situation? - Correct Answer You will not be able to represent any Medicare Advantage or Part D
plan until you complete the training and achieve an adequate score, although you will not have to
take a test if you exclusively market employer/union group plans and the companies do not
require testing.
Mr. Chen is enrolled in his employer's group health plan and will be retiring soon. He would like
to know his options since he has decided to drop his retiree coverage and is eligible for
Medicare. What should you tell him? - Correct Answer Mr. Chen can disenroll from his
employer-sponsored coverage to elect a Medicare Advantage or Part D plan within 2 months of
his disenrollment, but he should revaluate if he really wants to drop his employer coverage.
Mr. Davis is 52 years old and has recently been diagnosed with end-stage renal disease (ESRD)
and will soon begin dialysis. He is wondering if he can obtain coverage under Medicare. What
should you tell him? - Correct Answer He may sign-up for Medicare at any time however
coverage usually begins on the fourth month after dialysis treatments start.
