AHIP
FINAL EXAM
AHIP 2027 Final Exam set 3 –
Medicare Certification – Actual
Questions & Answers (AHIP)
Guarantee Pass
50 quiz
1. Mrs. West wears glasses and dentures and has enjoyed considerable pain relief from
arthritis through acupuncture. She is concerned about whether Medicare will cover these
items and services. What should you tell her?
A. Medicare generally covers routine glasses, dentures, and acupuncture.
B. Medicare does not cover acupuncture, glasses, or dentures under any circumstances.
C. Medicare does not generally cover routine glasses or dentures, and acupuncture coverage is
limited to specific circumstances.
D. Medicare covers dentures and glasses but not acupuncture.
Correct Answer: C.
Rationale:
Original Medicare generally does not cover routine eyeglasses or dentures. Medicare Part B
does provide limited coverage for acupuncture for chronic low back pain under specified
conditions. Therefore, the broad statement that Medicare never covers acupuncture is too
absolute.
2. Mr. Bickford did not qualify for the Part D Extra Help program and wants assistance with his
prescription drug costs. What should you tell him?
A. He has no other options because Extra Help is the only prescription assistance available.
B. He could investigate pharmaceutical manufacturer assistance programs and determine
,whether his state offers a State Pharmaceutical Assistance Program (SPAP).
C. He can automatically receive Medicaid drug coverage.
D. Medicare will automatically reduce his Part D premiums.
Correct Answer: B.
Rationale:
Beneficiaries who do not qualify for Extra Help may have other sources of assistance.
Pharmaceutical manufacturers may offer patient assistance programs for qualifying individuals.
Some states also operate State Pharmaceutical Assistance Programs that can help eligible
residents with prescription drug expenses.
3. Mr. Lombardi is interested in a Medicare Advantage PPO plan that does not include drug
coverage. He wants to obtain drug coverage through a stand-alone Part D plan. What should
you tell him?
A. He can enroll in the MA-only PPO and any stand-alone Part D plan.
B. He must enroll in two separate Part D plans.
C. He could enroll in an MA plan that includes prescription drug coverage, or choose Original
Medicare with Medigap and stand-alone Part D, but he generally cannot combine the MA-only
PPO with a stand-alone Part D plan.
D. He cannot obtain Part D coverage if he chooses Original Medicare.
Correct Answer: C.
Rationale:
Most Medicare Advantage plans cannot be combined with a separate stand-alone Part D plan. If
a beneficiary wants Medicare Advantage and prescription drug coverage, an MA-PD plan is
generally the appropriate arrangement. A beneficiary who chooses Original Medicare can
instead purchase a Medigap policy and a stand-alone Part D plan.
4. Mr. Torres wants to pay his Part D premiums from his savings account through automatic
withdrawals until the account is exhausted and then have the premiums withheld from Social
Security. What should you tell him?
A. He can automatically switch between any number of payment methods each month.
B. He must always pay the entire year's premium in advance.
C. In general, he must select a single premium payment mechanism to use throughout the year.
D. Part D premiums can only be deducted from Social Security.
, Correct Answer: C.
Rationale:
Medicare prescription drug plans generally offer several premium payment methods, such as
direct billing, electronic funds transfer, or deduction from Social Security benefits. Beneficiaries
generally select one payment method rather than switching payment sources when one
account becomes exhausted. The specific payment options should be confirmed with the
individual's Part D plan.
5. Agent Jennings conducts an event advertised as an educational event. Her materials are
educational, but she gives a presentation mentioning plan-specific premiums. Is this
permissible?
A. Yes, because plan-specific premiums are educational information.
B. Yes, as long as no enrollment forms are distributed.
C. No. Discussing plan-specific premiums is considered marketing and is not appropriate at an
event advertised as educational.
D. Yes, provided she discusses only one plan.
Correct Answer: C.
Rationale:
Educational events are intended to provide objective information about Medicare without
marketing specific plans or products. Discussing plan-specific premiums moves the presentation
into marketing activity. Marketing events are subject to different requirements. Therefore,
Agent Jennings should not use an educational event to promote specific plan details.
6. Mrs. Mulcahy is entitled to Medicare Part A but is not enrolled in Part B. Can she enroll in a
Medicare prescription drug plan?
A. No. She must have both Part A and Part B.
B. Yes. A person who is entitled to Part A or enrolled in Part B can generally enroll in a Medicare
prescription drug plan.
C. No. She must first enroll in Medicare Advantage.
D. Yes, but only if she also has Medicaid.
Correct Answer: B.
Rationale:
Eligibility for a stand-alone Medicare Part D plan generally requires entitlement to Part A or
FINAL EXAM
AHIP 2027 Final Exam set 3 –
Medicare Certification – Actual
Questions & Answers (AHIP)
Guarantee Pass
50 quiz
1. Mrs. West wears glasses and dentures and has enjoyed considerable pain relief from
arthritis through acupuncture. She is concerned about whether Medicare will cover these
items and services. What should you tell her?
A. Medicare generally covers routine glasses, dentures, and acupuncture.
B. Medicare does not cover acupuncture, glasses, or dentures under any circumstances.
C. Medicare does not generally cover routine glasses or dentures, and acupuncture coverage is
limited to specific circumstances.
D. Medicare covers dentures and glasses but not acupuncture.
Correct Answer: C.
Rationale:
Original Medicare generally does not cover routine eyeglasses or dentures. Medicare Part B
does provide limited coverage for acupuncture for chronic low back pain under specified
conditions. Therefore, the broad statement that Medicare never covers acupuncture is too
absolute.
2. Mr. Bickford did not qualify for the Part D Extra Help program and wants assistance with his
prescription drug costs. What should you tell him?
A. He has no other options because Extra Help is the only prescription assistance available.
B. He could investigate pharmaceutical manufacturer assistance programs and determine
,whether his state offers a State Pharmaceutical Assistance Program (SPAP).
C. He can automatically receive Medicaid drug coverage.
D. Medicare will automatically reduce his Part D premiums.
Correct Answer: B.
Rationale:
Beneficiaries who do not qualify for Extra Help may have other sources of assistance.
Pharmaceutical manufacturers may offer patient assistance programs for qualifying individuals.
Some states also operate State Pharmaceutical Assistance Programs that can help eligible
residents with prescription drug expenses.
3. Mr. Lombardi is interested in a Medicare Advantage PPO plan that does not include drug
coverage. He wants to obtain drug coverage through a stand-alone Part D plan. What should
you tell him?
A. He can enroll in the MA-only PPO and any stand-alone Part D plan.
B. He must enroll in two separate Part D plans.
C. He could enroll in an MA plan that includes prescription drug coverage, or choose Original
Medicare with Medigap and stand-alone Part D, but he generally cannot combine the MA-only
PPO with a stand-alone Part D plan.
D. He cannot obtain Part D coverage if he chooses Original Medicare.
Correct Answer: C.
Rationale:
Most Medicare Advantage plans cannot be combined with a separate stand-alone Part D plan. If
a beneficiary wants Medicare Advantage and prescription drug coverage, an MA-PD plan is
generally the appropriate arrangement. A beneficiary who chooses Original Medicare can
instead purchase a Medigap policy and a stand-alone Part D plan.
4. Mr. Torres wants to pay his Part D premiums from his savings account through automatic
withdrawals until the account is exhausted and then have the premiums withheld from Social
Security. What should you tell him?
A. He can automatically switch between any number of payment methods each month.
B. He must always pay the entire year's premium in advance.
C. In general, he must select a single premium payment mechanism to use throughout the year.
D. Part D premiums can only be deducted from Social Security.
, Correct Answer: C.
Rationale:
Medicare prescription drug plans generally offer several premium payment methods, such as
direct billing, electronic funds transfer, or deduction from Social Security benefits. Beneficiaries
generally select one payment method rather than switching payment sources when one
account becomes exhausted. The specific payment options should be confirmed with the
individual's Part D plan.
5. Agent Jennings conducts an event advertised as an educational event. Her materials are
educational, but she gives a presentation mentioning plan-specific premiums. Is this
permissible?
A. Yes, because plan-specific premiums are educational information.
B. Yes, as long as no enrollment forms are distributed.
C. No. Discussing plan-specific premiums is considered marketing and is not appropriate at an
event advertised as educational.
D. Yes, provided she discusses only one plan.
Correct Answer: C.
Rationale:
Educational events are intended to provide objective information about Medicare without
marketing specific plans or products. Discussing plan-specific premiums moves the presentation
into marketing activity. Marketing events are subject to different requirements. Therefore,
Agent Jennings should not use an educational event to promote specific plan details.
6. Mrs. Mulcahy is entitled to Medicare Part A but is not enrolled in Part B. Can she enroll in a
Medicare prescription drug plan?
A. No. She must have both Part A and Part B.
B. Yes. A person who is entitled to Part A or enrolled in Part B can generally enroll in a Medicare
prescription drug plan.
C. No. She must first enroll in Medicare Advantage.
D. Yes, but only if she also has Medicaid.
Correct Answer: B.
Rationale:
Eligibility for a stand-alone Medicare Part D plan generally requires entitlement to Part A or
