2025 AHIP FINAL EXAM ACTUAL EXAM LATEST
VERSION QUESTIONS AND ACCURATE DETAILED
ANSWERS VERIFIED 100% ALREADY GRADED A+
COMPLETE DOCUMET ASSURED PASS
Agent Harriet Walker has recently begun marketing Medicare
Advantage and related products aimed at meeting the needs of senior
citizens. Client Mildred Jones has expressed interest in a Medicare
Advantage plan. It is now the beginning of September. If you were in
Agent Walker's position, what would you do?
Inquire whether the client qualifies for a special enrollment period, and
if not, solicit an enrollment application once the annual open
enrollment election period begins on October 15th.
Which of the following individuals are likely to qualify for a special
election period (SEP) for either a MA and/or 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 to a new state providing him with
new MA and Part D options.
II, III, and IV only.
,Mrs. Shields is covered by Original Medicare. She sustained a hip
fracture and is being successfully treated for that condition. However,
she and her physicians feel that after her lengthy hospital stay, she will
need a month or two of nursing and rehabilitative care. What should
you tell them about Original Medicare's coverage of care in a skilled
nursing facility?
Medicare will cover Mrs. Shield's skilled nursing services provided
during the first 20 days of her stay, after which she would have a copay
until she has been in the facility for 100 days.
Mrs. West wears glasses and dentures and has enjoyed considerable
pain relief from arthritis through massage therapy. She is concerned
about whether or not Medicare will cover these items and services.
What should you tell her?
Medicare does not cover massage therapy, or, in general, glasses or
dentures.
Hank's Fish Store, Inc. is a small company with just 15 employees
located in Florida. Hank, the store owner, has provided excellent health
benefits to the store's workforce. William, one of the store's long-time
employees, will soon be reaching age 65 and eligible for Medicare.
William is in good health. He intends to remain an active full-time
employee, working several years after becoming eligible for Medicare.
What type(s) of retiree health benefit will Hank's Fish Store be able to
offer William?
Hank's can continue to offer William the same employee health benefit
plan, or, if William enrolls in Medicare Part B, it can enroll him in a
Medicare Advantage plan that is offered to the public.
Mr. Sanchez has just turned 65 and is entitled to Part A but has not
enrolled in Part B because he has coverage through an employer plan. If
,he wants to enroll in a Medicare Advantage plan, what will he have to
do?
He will have to enroll in Part B.
Mrs. Velasquez cares for her frail elderly mother, Maria, who lives in
North Carolina. She is worried that without additional support, her
mother will need to go into a nursing home. Mrs. Velasquez asks you if
there is any Medicare plan that might allow her mother to remain in
the community rather than going into a nursing home. How should you
advise Mrs. Velasquez?
There are Programs of All-Inclusive Care for the Elderly (PACE) for frail
elderly beneficiaries certified as needing a nursing home level of care
but are able to live safely in the community at the time of enrolment.
Which of the following statement(s) is/are correct about a Medicare
Savings Account (MSA) Plans?
I. MSAs may have either a partial network, full network, or no network
of providers.
II. MSA plans cover Part A and Part B benefits but not Part D
prescription drug benefits.
III. An individual who is enrolled in an MSA plan is responsible for a
minimal deductible of $500 indexed for inflation.
IV. Non-network providers must accept the same amount that Original
Medicare would pay them as payment in full.
I, II, and IV only
Mrs. Chi is age 75 and enjoys a comfortable but not extremely high-
income level. She wishes to enroll in a MA MSA plan that she heard
about from her neighbor. She also wants to have prescription drug
coverage since her doctor recently prescribed several expensive
, medications. Currently, she is enrolled in Original Medicare and a
standalone Part D plan. How would you advise Mrs. Chi?
Mrs. Chi may enroll in a MA MSA plan and remain in her current
standalone Part D prescription drug plan.
Mrs. Lyons is in good health, uses a single prescription, and lives
independently in her own home. She is attracted by the idea of
maintaining control over a Medical Savings Account (MSA) but is not
sure if the plan associated with the account will fit her needs. What
specific piece of information about a Medicare MSA plan would it be
important for her to know, prior to enrolling in such a plan?
All MSAs cover Part A and Part B benefits, but not Part D prescription
drug benefits, which could be obtained by also enrolling in a separate
prescription drug plan.
Mrs. Park is an elderly retiree. Mrs. Park has a low fixed income. What
could you tell Mrs. Park that might be of assistance?
She should contact her state Medicaid agency to see if she qualifies for
one of several programs that can help with Medicare costs for which
she is responsible.
Mr. Alonso receives some help paying for his two generic prescription
drugs from his employer's retiree coverage, but he wants to compare it
to a Part D prescription drug plan. He asks you what costs he would
generally expect to encounter when enrolling into a standard Medicare
Part D prescription drug plan. What should you tell him?
He generally would pay a monthly premium, annual deductible, and
per-prescription cost-sharing.
VERSION QUESTIONS AND ACCURATE DETAILED
ANSWERS VERIFIED 100% ALREADY GRADED A+
COMPLETE DOCUMET ASSURED PASS
Agent Harriet Walker has recently begun marketing Medicare
Advantage and related products aimed at meeting the needs of senior
citizens. Client Mildred Jones has expressed interest in a Medicare
Advantage plan. It is now the beginning of September. If you were in
Agent Walker's position, what would you do?
Inquire whether the client qualifies for a special enrollment period, and
if not, solicit an enrollment application once the annual open
enrollment election period begins on October 15th.
Which of the following individuals are likely to qualify for a special
election period (SEP) for either a MA and/or 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 to a new state providing him with
new MA and Part D options.
II, III, and IV only.
,Mrs. Shields is covered by Original Medicare. She sustained a hip
fracture and is being successfully treated for that condition. However,
she and her physicians feel that after her lengthy hospital stay, she will
need a month or two of nursing and rehabilitative care. What should
you tell them about Original Medicare's coverage of care in a skilled
nursing facility?
Medicare will cover Mrs. Shield's skilled nursing services provided
during the first 20 days of her stay, after which she would have a copay
until she has been in the facility for 100 days.
Mrs. West wears glasses and dentures and has enjoyed considerable
pain relief from arthritis through massage therapy. She is concerned
about whether or not Medicare will cover these items and services.
What should you tell her?
Medicare does not cover massage therapy, or, in general, glasses or
dentures.
Hank's Fish Store, Inc. is a small company with just 15 employees
located in Florida. Hank, the store owner, has provided excellent health
benefits to the store's workforce. William, one of the store's long-time
employees, will soon be reaching age 65 and eligible for Medicare.
William is in good health. He intends to remain an active full-time
employee, working several years after becoming eligible for Medicare.
What type(s) of retiree health benefit will Hank's Fish Store be able to
offer William?
Hank's can continue to offer William the same employee health benefit
plan, or, if William enrolls in Medicare Part B, it can enroll him in a
Medicare Advantage plan that is offered to the public.
Mr. Sanchez has just turned 65 and is entitled to Part A but has not
enrolled in Part B because he has coverage through an employer plan. If
,he wants to enroll in a Medicare Advantage plan, what will he have to
do?
He will have to enroll in Part B.
Mrs. Velasquez cares for her frail elderly mother, Maria, who lives in
North Carolina. She is worried that without additional support, her
mother will need to go into a nursing home. Mrs. Velasquez asks you if
there is any Medicare plan that might allow her mother to remain in
the community rather than going into a nursing home. How should you
advise Mrs. Velasquez?
There are Programs of All-Inclusive Care for the Elderly (PACE) for frail
elderly beneficiaries certified as needing a nursing home level of care
but are able to live safely in the community at the time of enrolment.
Which of the following statement(s) is/are correct about a Medicare
Savings Account (MSA) Plans?
I. MSAs may have either a partial network, full network, or no network
of providers.
II. MSA plans cover Part A and Part B benefits but not Part D
prescription drug benefits.
III. An individual who is enrolled in an MSA plan is responsible for a
minimal deductible of $500 indexed for inflation.
IV. Non-network providers must accept the same amount that Original
Medicare would pay them as payment in full.
I, II, and IV only
Mrs. Chi is age 75 and enjoys a comfortable but not extremely high-
income level. She wishes to enroll in a MA MSA plan that she heard
about from her neighbor. She also wants to have prescription drug
coverage since her doctor recently prescribed several expensive
, medications. Currently, she is enrolled in Original Medicare and a
standalone Part D plan. How would you advise Mrs. Chi?
Mrs. Chi may enroll in a MA MSA plan and remain in her current
standalone Part D prescription drug plan.
Mrs. Lyons is in good health, uses a single prescription, and lives
independently in her own home. She is attracted by the idea of
maintaining control over a Medical Savings Account (MSA) but is not
sure if the plan associated with the account will fit her needs. What
specific piece of information about a Medicare MSA plan would it be
important for her to know, prior to enrolling in such a plan?
All MSAs cover Part A and Part B benefits, but not Part D prescription
drug benefits, which could be obtained by also enrolling in a separate
prescription drug plan.
Mrs. Park is an elderly retiree. Mrs. Park has a low fixed income. What
could you tell Mrs. Park that might be of assistance?
She should contact her state Medicaid agency to see if she qualifies for
one of several programs that can help with Medicare costs for which
she is responsible.
Mr. Alonso receives some help paying for his two generic prescription
drugs from his employer's retiree coverage, but he wants to compare it
to a Part D prescription drug plan. He asks you what costs he would
generally expect to encounter when enrolling into a standard Medicare
Part D prescription drug plan. What should you tell him?
He generally would pay a monthly premium, annual deductible, and
per-prescription cost-sharing.
