AHIP 2025 FINAL EXAMS WITH
COMPLETE SOLUTIONS
Agent Chan is conducting a sales presentation on senior issues where he hopes to
enroll some attendees in the Medicare Advantage (MA) plans he represents. What
action(s) may Agent Chan take during the event? - ANSWER-Discuss plan specific
information such as premiums and benefits.
Mr. Liu turns 65 on June 19. He has never previously qualified for Medicare so his first
Medicare eligibility date will be June 1. Mr. Liu's ICEP and Part D IEP begin on March 1
and end on September 30. He wants prescription drug coverage with his Part A and
Part B benefits. What advice can you provide him? - ANSWER-
Dr. Elizabeth Brennan does not contract with the ABC PFFS plan but accepts the plan's
terms and conditions for payment. Mary Rodgers sees Dr. Brennan for treatment. How
much may Dr. Brennan charge? - ANSWER-
Mr. Barker enjoys a comfortable retirement income. He recently had surgery and
expected that he would have certain services and items covered by the plan with
minimal out-of-pocket costs because his MA-PD coverage has been very good.
However, when he received the bill, he was surprised to see large charges in excess of
his maximum out-of-pocket limit that included some services and items he thought
would be fully covered. He called you to ask what he could do? What could you tell
him? - ANSWER-You can offer to review the plans appeal process to help him ask the
plan to review the coverage decision.
Mr. Carlini has heard that Medicare prescription drug plans are only offered through
private companies under a program known as Medicare Advantage (MA), not by the
government. He likes Original Medicare and does not want to sign up for an MA
product, but he also wants prescription drug coverage. What should you tell him? -
ANSWER-Mr. Carlini can stay with Original Medicare and also enroll in a Medicare
prescription drug plan through a private company that has contracted with the
government to provide only such drug coverage to eligible Medicare beneficiaries.
You will be holding a sales event soon, at which you would like to offer door prizes to
attendees. Under guidelines from the Medicare agency, what types of gifts or prizes
would not be allowed in this situation? - ANSWER-Gift cards or gift certificates of $15 or
less that can be readily converted to cash.
Mr. Kelly wants to know whether he is eligible to sign up for a Private fee-for-service
(PFFS) plan. What questions would you need to ask to determine his eligibility? -
ANSWER-You would need to ask Mr. Kelly if he is enrolled in Part A and Part B and if
he lives in the PFFS plan's service area.
, Mr. Landry is approaching his 65th birthday. He has signed up for Medicare Part A, but
he did not enroll in Part B because he has employer-sponsored coverage and intends to
keep working for several more years. But he is considering enrolling in Part D
prescription drug coverage because he believes it is superior to his employer plan. How
would you advise him? - ANSWER-Mr. Landry is eligible for Part D since he has Part A,
and his initial enrollment period (IEP) for Part D will continue for three months after his
65th birthday.
Mr. Rice is 68, actively working, and has coverage for medical services and medications
through his employer's group health plan. He is entitled to premium free Part A and
thinking of enrolling in Part B and switching to an MA-PD because he is paying a very
large part of his group coverage premium, and it does not provide coverage for a
number of his medications. Which of the following is NOT a consideration when making
the change? - ANSWER-
A Medicare beneficiary has walked into your office and requested that you sit down with
her and discuss her options under the Medicare Advantage program. Before engaging
in such a discussion, what should you do? - ANSWER-You must have her sign a scope
of appointment form, indicating which products she wishes to discuss. You may then
proceed with the discussion.
Mr. Rodriguez is currently enrolled in a MA plan, but his plan doesn't sufficiently cover
his prescription drug needs. He is interested in changing plans during the upcoming MA
Open Enrollment Period. What are his options during the MA OEP? - ANSWER-
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? - ANSWER-He will have to enroll in Part B.
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? - ANSWER-In general, he must select a single Part D premium
payment mechanism that will be used throughout the year.
enrolling in such a plan. What should you tell him? - ANSWER-If there is a special
needs plan (SNP) in Mr. Wendt's area that specializes in caring for individuals with
diabetes, he may enroll in the SNP at any time under a special election period (SEP)
Mr. Yoo's employer has recently dropped comprehensive creditable prescription drug
coverage that was offered to company retirees. The company told Mr. Yoo that,
because he was affected by this change, he would qualify for a special election period.
Mr. Yoo contacted you to find out more about what this means. What can you tell him -
ANSWER-
COMPLETE SOLUTIONS
Agent Chan is conducting a sales presentation on senior issues where he hopes to
enroll some attendees in the Medicare Advantage (MA) plans he represents. What
action(s) may Agent Chan take during the event? - ANSWER-Discuss plan specific
information such as premiums and benefits.
Mr. Liu turns 65 on June 19. He has never previously qualified for Medicare so his first
Medicare eligibility date will be June 1. Mr. Liu's ICEP and Part D IEP begin on March 1
and end on September 30. He wants prescription drug coverage with his Part A and
Part B benefits. What advice can you provide him? - ANSWER-
Dr. Elizabeth Brennan does not contract with the ABC PFFS plan but accepts the plan's
terms and conditions for payment. Mary Rodgers sees Dr. Brennan for treatment. How
much may Dr. Brennan charge? - ANSWER-
Mr. Barker enjoys a comfortable retirement income. He recently had surgery and
expected that he would have certain services and items covered by the plan with
minimal out-of-pocket costs because his MA-PD coverage has been very good.
However, when he received the bill, he was surprised to see large charges in excess of
his maximum out-of-pocket limit that included some services and items he thought
would be fully covered. He called you to ask what he could do? What could you tell
him? - ANSWER-You can offer to review the plans appeal process to help him ask the
plan to review the coverage decision.
Mr. Carlini has heard that Medicare prescription drug plans are only offered through
private companies under a program known as Medicare Advantage (MA), not by the
government. He likes Original Medicare and does not want to sign up for an MA
product, but he also wants prescription drug coverage. What should you tell him? -
ANSWER-Mr. Carlini can stay with Original Medicare and also enroll in a Medicare
prescription drug plan through a private company that has contracted with the
government to provide only such drug coverage to eligible Medicare beneficiaries.
You will be holding a sales event soon, at which you would like to offer door prizes to
attendees. Under guidelines from the Medicare agency, what types of gifts or prizes
would not be allowed in this situation? - ANSWER-Gift cards or gift certificates of $15 or
less that can be readily converted to cash.
Mr. Kelly wants to know whether he is eligible to sign up for a Private fee-for-service
(PFFS) plan. What questions would you need to ask to determine his eligibility? -
ANSWER-You would need to ask Mr. Kelly if he is enrolled in Part A and Part B and if
he lives in the PFFS plan's service area.
, Mr. Landry is approaching his 65th birthday. He has signed up for Medicare Part A, but
he did not enroll in Part B because he has employer-sponsored coverage and intends to
keep working for several more years. But he is considering enrolling in Part D
prescription drug coverage because he believes it is superior to his employer plan. How
would you advise him? - ANSWER-Mr. Landry is eligible for Part D since he has Part A,
and his initial enrollment period (IEP) for Part D will continue for three months after his
65th birthday.
Mr. Rice is 68, actively working, and has coverage for medical services and medications
through his employer's group health plan. He is entitled to premium free Part A and
thinking of enrolling in Part B and switching to an MA-PD because he is paying a very
large part of his group coverage premium, and it does not provide coverage for a
number of his medications. Which of the following is NOT a consideration when making
the change? - ANSWER-
A Medicare beneficiary has walked into your office and requested that you sit down with
her and discuss her options under the Medicare Advantage program. Before engaging
in such a discussion, what should you do? - ANSWER-You must have her sign a scope
of appointment form, indicating which products she wishes to discuss. You may then
proceed with the discussion.
Mr. Rodriguez is currently enrolled in a MA plan, but his plan doesn't sufficiently cover
his prescription drug needs. He is interested in changing plans during the upcoming MA
Open Enrollment Period. What are his options during the MA OEP? - ANSWER-
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? - ANSWER-He will have to enroll in Part B.
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? - ANSWER-In general, he must select a single Part D premium
payment mechanism that will be used throughout the year.
enrolling in such a plan. What should you tell him? - ANSWER-If there is a special
needs plan (SNP) in Mr. Wendt's area that specializes in caring for individuals with
diabetes, he may enroll in the SNP at any time under a special election period (SEP)
Mr. Yoo's employer has recently dropped comprehensive creditable prescription drug
coverage that was offered to company retirees. The company told Mr. Yoo that,
because he was affected by this change, he would qualify for a special election period.
Mr. Yoo contacted you to find out more about what this means. What can you tell him -
ANSWER-
