AHIP Final Certification Exam | UPDATED ACTUAL Exam
Questions and CORRECT Answers | Real Exam Questions &
Correct Answers | Updated Guide
Question 1.
Mr. Edwards, a marketing representative of the ACME Insurance Company, scheduled a
marketing event and expects about 40 people to attend. He has hired a magician at a
cost of $200 to entertain attendees. Can he do this in a way that complies with guidance
from the Medicare agency?
Correct Answer: a. He can do this because the estimated number of attendees
is based on the venue size and response rate and the value of the gift does
not exceed $15.
Question 2.
Mrs. Ramos is considering a Medicare Advantage PPO and has questions about which
providers she can go to for her health care. What should you tell her?
Correct Answer: b. Mrs. Ramos can obtain care from any provider who
participates in Original Medicare, but generally will have a higher cost-sharing
amount if she sees a provider who/that is not a part of the PPO network.
Question 3.
Julia Harris is turning 66 in July, at which time she will retire. She has contacted your
office and requested a meeting so that she can learn about Medicare and the products
you represent. How should you respond?
Correct Answer: c. Tell Julia that you will meet with her to explain Medicare
and should she be interested you can accept and submit an enrollment
request, since this is an initial enrollment qualifying her for a special
enrollment period.
• Mr. Rivera has Qualified Medicare Beneficiary (QMB) eligibility and is thus
covered by both Medicare and Medicaid. He decides to enroll in a Medicare
Advantage (MA) PPO plan. Later he sees an out-of-network doctor to receive a
Medicare covered service. How much The doctor may only collect from Mr.
Rivera the cost sharing allowable under the state's Medicaid program.may the
doctor collect from Mr. Rivera? - ✓✓The doctor may only collect from Mr.
Rivera the cost sharing allowable under the state's Medicaid program.
Question 4.
During a sales presentation in Ms. Sullivan's home, she tells you that she has heard
about a type of Medicare health plan known as Private Fee-for-Service (PFFS). She wants
to know if this would be available to her. What should you tell her about PFFS plans?
Correct Answer:
,Question 5.
Choose one answer.
Correct Answer:
Question 6.
-✓✓a. A PFFS plan is a type of Medicare Supplement plan and she may enroll in one if it
is available in her area.
Question 7.
-✓✓b. A PFFS plan is exactly the same as Original Medicare, only offered by a private
entity and she may enroll in one if it is available in her area.
Question 8.
-✓✓c. PFFS plans are designed to cover only prescription drugs and if that is the type of
coverage she wants, she may enroll in one if it is available in her area.
•
Correct Answer: d. A PFFS plan is one of the various types of Medicare
Advantage plans offered by private entities and she may enroll in one if it is
available in her area.
Question 9.
Question8
Correct Answer:
Question 10.
Marks: 1
Correct Answer:
Question 11.
During an appointment scheduled to discuss a Medicare Advantage Prescription Drug
plan (MA-PD), Mr. Peters asked his agent to describe a stand-alone prescription drug
plan (Part D plan) that his neighbor told him about. What should his agent do?
Correct Answer:
Question 12.
Choose one answer.
Correct Answer:
,Question 13.
-✓✓a. Since Mr. Peters requested a description of the Part D plan, his agent must leave
the Part D plan brochure, but not an enrollment form, and would have to schedule
another appointment after at least 48 hours have passed to discuss the Part D plan with
Mr. Peters.
Question 14.
-✓✓b. Since Mr. Peters requested a description of the Part D plan, his agent must have
Mr. Peters sign a new scope of appointment form that includes Part D, and then the
agent may discuss the Part D plan so Mr. Peters can compare plans and make an
informed enrollment choice during the appointment.
•
Correct Answer: c. Since Mr. Peters requested a description of the Part D plan,
his agent must inform Mr. Peters that he can only sign up for the MA-PD plan
and cannot receive a brochure or any other information about the Part D plan
now because he did not agree in advance to discuss that plan
Question 15.
-✓✓d. Since Mr. Peters requested a description of the Part D plan, his agent must
discuss both the Part D and the MA-PD plans and return after at least 48 hours to
complete the Part D plan enrollment form with Mr. Peters.
Question 16.
Question9
Correct Answer:
Question 17.
Marks: 1
Correct Answer:
Question 18.
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:
Question 19.
Choose one answer.
Correct Answer:
, Question 20.
-✓✓a. In general, he must select a single Part D premium payment mechanism that will
be used throughout the year.
•
Correct Answer: b. As long as he fills out the paperwork to begin withholding
from his Social Security check at least 63 days before such withholding should
begin, he can change his method of Part D premium payment and withholding
will begin the month after his savings account is exhausted.
Question 21.
-✓✓c. During 2017, many people experienced significant problems with deductions from
their Social Security check for their Part D premium. As a result, this method of payment
is no longer an option for Part D premium payments
Question 22.
-✓✓d. In general, to pay his Part D premium, he only can have automatic withdrawals
made from a checking account, so he will need to transfer the funds prior to beginning
such withdrawals.
Question 23.
Question10
Correct Answer:
Question 24.
Marks: 1
Correct Answer:
Question 25.
Since 2004 Ms. Eisenberg has had a Medigap plan that provides some drug coverage.
She has recently received a letter from her Medigap carrier informing her that her drug
coverage is not "creditable." She wants to know what this means. What should you tell
her?
Correct Answer:
Question 26.
Choose one answer.
Correct Answer: • -✓✓a. The letter is to inform her that her Medigap drug
coverage must be supplemented by purchasing coverage under a Part D plan.
If she does not do so within 63 days, she will not be able to obtain Part D
Questions and CORRECT Answers | Real Exam Questions &
Correct Answers | Updated Guide
Question 1.
Mr. Edwards, a marketing representative of the ACME Insurance Company, scheduled a
marketing event and expects about 40 people to attend. He has hired a magician at a
cost of $200 to entertain attendees. Can he do this in a way that complies with guidance
from the Medicare agency?
Correct Answer: a. He can do this because the estimated number of attendees
is based on the venue size and response rate and the value of the gift does
not exceed $15.
Question 2.
Mrs. Ramos is considering a Medicare Advantage PPO and has questions about which
providers she can go to for her health care. What should you tell her?
Correct Answer: b. Mrs. Ramos can obtain care from any provider who
participates in Original Medicare, but generally will have a higher cost-sharing
amount if she sees a provider who/that is not a part of the PPO network.
Question 3.
Julia Harris is turning 66 in July, at which time she will retire. She has contacted your
office and requested a meeting so that she can learn about Medicare and the products
you represent. How should you respond?
Correct Answer: c. Tell Julia that you will meet with her to explain Medicare
and should she be interested you can accept and submit an enrollment
request, since this is an initial enrollment qualifying her for a special
enrollment period.
• Mr. Rivera has Qualified Medicare Beneficiary (QMB) eligibility and is thus
covered by both Medicare and Medicaid. He decides to enroll in a Medicare
Advantage (MA) PPO plan. Later he sees an out-of-network doctor to receive a
Medicare covered service. How much The doctor may only collect from Mr.
Rivera the cost sharing allowable under the state's Medicaid program.may the
doctor collect from Mr. Rivera? - ✓✓The doctor may only collect from Mr.
Rivera the cost sharing allowable under the state's Medicaid program.
Question 4.
During a sales presentation in Ms. Sullivan's home, she tells you that she has heard
about a type of Medicare health plan known as Private Fee-for-Service (PFFS). She wants
to know if this would be available to her. What should you tell her about PFFS plans?
Correct Answer:
,Question 5.
Choose one answer.
Correct Answer:
Question 6.
-✓✓a. A PFFS plan is a type of Medicare Supplement plan and she may enroll in one if it
is available in her area.
Question 7.
-✓✓b. A PFFS plan is exactly the same as Original Medicare, only offered by a private
entity and she may enroll in one if it is available in her area.
Question 8.
-✓✓c. PFFS plans are designed to cover only prescription drugs and if that is the type of
coverage she wants, she may enroll in one if it is available in her area.
•
Correct Answer: d. A PFFS plan is one of the various types of Medicare
Advantage plans offered by private entities and she may enroll in one if it is
available in her area.
Question 9.
Question8
Correct Answer:
Question 10.
Marks: 1
Correct Answer:
Question 11.
During an appointment scheduled to discuss a Medicare Advantage Prescription Drug
plan (MA-PD), Mr. Peters asked his agent to describe a stand-alone prescription drug
plan (Part D plan) that his neighbor told him about. What should his agent do?
Correct Answer:
Question 12.
Choose one answer.
Correct Answer:
,Question 13.
-✓✓a. Since Mr. Peters requested a description of the Part D plan, his agent must leave
the Part D plan brochure, but not an enrollment form, and would have to schedule
another appointment after at least 48 hours have passed to discuss the Part D plan with
Mr. Peters.
Question 14.
-✓✓b. Since Mr. Peters requested a description of the Part D plan, his agent must have
Mr. Peters sign a new scope of appointment form that includes Part D, and then the
agent may discuss the Part D plan so Mr. Peters can compare plans and make an
informed enrollment choice during the appointment.
•
Correct Answer: c. Since Mr. Peters requested a description of the Part D plan,
his agent must inform Mr. Peters that he can only sign up for the MA-PD plan
and cannot receive a brochure or any other information about the Part D plan
now because he did not agree in advance to discuss that plan
Question 15.
-✓✓d. Since Mr. Peters requested a description of the Part D plan, his agent must
discuss both the Part D and the MA-PD plans and return after at least 48 hours to
complete the Part D plan enrollment form with Mr. Peters.
Question 16.
Question9
Correct Answer:
Question 17.
Marks: 1
Correct Answer:
Question 18.
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:
Question 19.
Choose one answer.
Correct Answer:
, Question 20.
-✓✓a. In general, he must select a single Part D premium payment mechanism that will
be used throughout the year.
•
Correct Answer: b. As long as he fills out the paperwork to begin withholding
from his Social Security check at least 63 days before such withholding should
begin, he can change his method of Part D premium payment and withholding
will begin the month after his savings account is exhausted.
Question 21.
-✓✓c. During 2017, many people experienced significant problems with deductions from
their Social Security check for their Part D premium. As a result, this method of payment
is no longer an option for Part D premium payments
Question 22.
-✓✓d. In general, to pay his Part D premium, he only can have automatic withdrawals
made from a checking account, so he will need to transfer the funds prior to beginning
such withdrawals.
Question 23.
Question10
Correct Answer:
Question 24.
Marks: 1
Correct Answer:
Question 25.
Since 2004 Ms. Eisenberg has had a Medigap plan that provides some drug coverage.
She has recently received a letter from her Medigap carrier informing her that her drug
coverage is not "creditable." She wants to know what this means. What should you tell
her?
Correct Answer:
Question 26.
Choose one answer.
Correct Answer: • -✓✓a. The letter is to inform her that her Medigap drug
coverage must be supplemented by purchasing coverage under a Part D plan.
If she does not do so within 63 days, she will not be able to obtain Part D
