AHIP FINAL EXAM UPDATED QUESTION AND VERIFIED
ANSWERS A+ GRADED
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. Whatshould you tell him? - 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, shegives a brief presentation that
mentions plan-specific premiums. Is this a prohibited activity at an
event that has been advertised as educational? - Yes. When an event
hasbeen 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? - Everyone who is entitled to Part A orenrolled 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 seesa wide range in what they charge
for deductibles, premiums and cost sharing. How canyou explain this
to him? - 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 addressher concern? -
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 HealthPlan, 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
statementbest describes the marketing and compliance rules that
apply to Agent Armstrong? - Agent Armstrong needs to be licensed and
appointed in every state in which beneficiaries to whom he markets
ABC MA plans are located.
,Mrs. West wears glasses and dentures and has enjoyed considerable
pain relief fromarthritis through acupuncture. She is concerned about
whether or not Medicare will cover these items and services. What
should you tell her? - Medicare does not coveracupuncture, 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? - 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 assistanceprogram 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. Lombardilikes 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? - 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. Schmidt would like to plan for retirement and has asked you what
is covered underOriginal Fee-for-Service (FFS) Medicare? What could
you tell him? - 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 individualPart 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 canyou do in
this situation? - You will not be able to represent any Medicare
Advantage orPart 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 iseligible for Medicare. What should
you tell him? - 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
ANSWERS A+ GRADED
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. Whatshould you tell him? - 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, shegives a brief presentation that
mentions plan-specific premiums. Is this a prohibited activity at an
event that has been advertised as educational? - Yes. When an event
hasbeen 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? - Everyone who is entitled to Part A orenrolled 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 seesa wide range in what they charge
for deductibles, premiums and cost sharing. How canyou explain this
to him? - 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 addressher concern? -
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 HealthPlan, 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
statementbest describes the marketing and compliance rules that
apply to Agent Armstrong? - Agent Armstrong needs to be licensed and
appointed in every state in which beneficiaries to whom he markets
ABC MA plans are located.
,Mrs. West wears glasses and dentures and has enjoyed considerable
pain relief fromarthritis through acupuncture. She is concerned about
whether or not Medicare will cover these items and services. What
should you tell her? - Medicare does not coveracupuncture, 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? - 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 assistanceprogram 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. Lombardilikes 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? - 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. Schmidt would like to plan for retirement and has asked you what
is covered underOriginal Fee-for-Service (FFS) Medicare? What could
you tell him? - 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 individualPart 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 canyou do in
this situation? - You will not be able to represent any Medicare
Advantage orPart 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 iseligible for Medicare. What should
you tell him? - 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
