AHIP FINAL EXAM NEWEST EXAM QUESTIONS AND
CORRECT DETAILED ANSWERS A NEW UPDATED
VERSION LATEST 2024-2025(VERIFIED
ANSWERS)|ALREADY GRADED A+
Mr. Nguyen understands that Medicare prescription drug plans can use a
formulary or list of covered drugs. He is suspicious about how plans establish
these formularies. What should you tell him? - ANSWER-Formularies must be
developed with input from pharmacists,doctors, and other experts.
Mr. Moreno invited his neighbor, Agent Tom Smith, to discuss Medicare Advantage
(MA) and Part D plans that Agent Smith sells at the regular Tuesday brunch the
neighbors have for senior citizens. What should Agent Tom Smith tell Mr. Moreno
about the kinds of food that can be provided to potential enrollees who attend
the sales presentation? - ANSWER-A meal cannot be provided, but light snacks
would be permitted.
Ms. Levi is considering enrollment in a Medicare Advantage HMO plan offered in
her area. Ms. Levi often travels to visit relatives and is concerned that she may
need emergency care outside of her plan's service area. What should you tell her
about coverage of emergency care? - ANSWER-Plans are required to cover out-of
network emergency care.
Which of the following individuals are likely to qualify for a special enrollment
period (SEP) for both MA and Part D due to a change of residence?
, I. Edward (enrolled in MA and Part D) moves to a new home within the same
neighborhood in his existing plan's service area.
II. Fiona (enrolled in MA and Part D) moves cross-country to an area outside
her existing plan's service area.
III. Gilbert moves into a plan service area where there is now a Part D plan
available to him from a service area where no Part D plan was available.
IV. Henry makes a permanent move providing him with new MA and Part D
options. - ANSWER-II, III, and IV only
Mr. Lynn, an agent for Acme Insurance, Inc. thinks that, since state laws are
preempted with regard to the marketing of Medicare health plans, he doesn't
have much to worry about. What might you, as his colleague, advise him
concerning the type of scrutiny he will be under? - ANSWER-Organizations
sponsoring Medicare health plans are responsible for the behavior of their
contracted representatives and will be conducting monitoring activities to ensure
compliance with all applicable Federal law and guidance and plan policies.
Furthermore, state agent licensure laws are not preempted and he must abide by
their requirements.
Mrs. Wellington is enrolled in Parts A and B of Original Medicare. A friend recently
told her that 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)? - ANSWER-Mrs. Wellington is eligible for a SEP that may be used once until
November 30 to enroll in the fivestar plan.
Mrs. Berkowitz wants to enroll in a Medicare Advantage plan that does not include
drug coverage and also enroll in a stand-alone Medicare prescription drug plan.
Under what circumstances can she do this? - ANSWER-If the Medicare Advantage
CORRECT DETAILED ANSWERS A NEW UPDATED
VERSION LATEST 2024-2025(VERIFIED
ANSWERS)|ALREADY GRADED A+
Mr. Nguyen understands that Medicare prescription drug plans can use a
formulary or list of covered drugs. He is suspicious about how plans establish
these formularies. What should you tell him? - ANSWER-Formularies must be
developed with input from pharmacists,doctors, and other experts.
Mr. Moreno invited his neighbor, Agent Tom Smith, to discuss Medicare Advantage
(MA) and Part D plans that Agent Smith sells at the regular Tuesday brunch the
neighbors have for senior citizens. What should Agent Tom Smith tell Mr. Moreno
about the kinds of food that can be provided to potential enrollees who attend
the sales presentation? - ANSWER-A meal cannot be provided, but light snacks
would be permitted.
Ms. Levi is considering enrollment in a Medicare Advantage HMO plan offered in
her area. Ms. Levi often travels to visit relatives and is concerned that she may
need emergency care outside of her plan's service area. What should you tell her
about coverage of emergency care? - ANSWER-Plans are required to cover out-of
network emergency care.
Which of the following individuals are likely to qualify for a special enrollment
period (SEP) for both MA and Part D due to a change of residence?
, I. Edward (enrolled in MA and Part D) moves to a new home within the same
neighborhood in his existing plan's service area.
II. Fiona (enrolled in MA and Part D) moves cross-country to an area outside
her existing plan's service area.
III. Gilbert moves into a plan service area where there is now a Part D plan
available to him from a service area where no Part D plan was available.
IV. Henry makes a permanent move providing him with new MA and Part D
options. - ANSWER-II, III, and IV only
Mr. Lynn, an agent for Acme Insurance, Inc. thinks that, since state laws are
preempted with regard to the marketing of Medicare health plans, he doesn't
have much to worry about. What might you, as his colleague, advise him
concerning the type of scrutiny he will be under? - ANSWER-Organizations
sponsoring Medicare health plans are responsible for the behavior of their
contracted representatives and will be conducting monitoring activities to ensure
compliance with all applicable Federal law and guidance and plan policies.
Furthermore, state agent licensure laws are not preempted and he must abide by
their requirements.
Mrs. Wellington is enrolled in Parts A and B of Original Medicare. A friend recently
told her that 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)? - ANSWER-Mrs. Wellington is eligible for a SEP that may be used once until
November 30 to enroll in the fivestar plan.
Mrs. Berkowitz wants to enroll in a Medicare Advantage plan that does not include
drug coverage and also enroll in a stand-alone Medicare prescription drug plan.
Under what circumstances can she do this? - ANSWER-If the Medicare Advantage
