NEW AHIP TEST BANK g g g
(COMPLETE)gAHIPgCERTIFICATIONgEXAMSgALLgEXAMSgFROMg2019-
2024,gALLgMODULESgEXAMS,gREALgAHIPgEXAMSg1800gQUESTIONSgFULLYgSOLVE
DgVERIFIEDgEXAM|GRADEDgA+g|GUARANTEEDgPASS|SCOREgA
1. WhichgofgthegfollowinggstepsgmaygagPartgDgsponsorgadoptgforgbeneficiariesgwhogaregatgrisk
gofgmisusinggorgabusinggfrequentlygabusedgdrugs?
I. Identifyinggatgriskgindividualsgbygusinggcriteriagthatgincludesgthegnumbergofgopioidgprescriptionsgt
hegbeneficiaryghasgandgthegnumbergofgprescribersgwhoghavegwrittengthosegprescriptions.
II. Lockinggangat-riskgbeneficiarygintogonegpharmacy.
III. Lockinggangat-riskgbeneficiarygintogonegprescriber.
2. Mrs.gWolfgwearsgglassesgandgdenturesgandghasgenjoyedgconsiderablegpaingreliefgfromgarthritisgth
roughgacupuncture.gShegisgconcernedgaboutgwhethergorgnotgMedicaregwillgcovergthesegitemsgand
gservices.gWhatgshouldgyougtellgher?
Medicaregdoesgnotgcovergacupuncture,gor,ginggeneral,gglassesgorgdentures.
3. WhichgstatementgbestgdescribesgPACEgplans?
Itgincludesgcomprehensivegmedicalgandgsocialgservicegdeliverygsystemsgusingganginterdisciplinarygteamgappr
oachgingangadultgdayghealthgcenter,gsupplementedgbygin-homegandgreferralgservices.
4. Mr.gShultzgwasgstillgworkinggwhenghegfirstgqualifiedgforgMedicare.gAtgthatgtime,gheghadgemployerg
groupgcoveragegthatgwasgcreditable.gDuringghisginitialgPartgDgeligibilitygperiod,ghegdecidedgnotgtog
enrollgbecauseghegwasgsatisfiedgwithghisgdruggcoverage.gItgisgnowgagyearglatergandgMr.gShultzghasgl
ostghisgemployerggroupgcoverage.gHowgwouldgyougadviseghim?
Mr.gSchultzgshouldgenrollgingagPartgDgplangbeforegheghasgag63-
daygbreakgingcoveragegingordergtogavoidgagpremiumgpenalty.
,5. ForgwhichgofgthegfollowinggindividualsgwouldgagCostgPlangbegmostgappropriate?
Ms.gBakergwhogisgenrolledgingMedicaregPartgBgandgisgwillinggtogcontinuegpayinggPartgBgpremiumsgplusga
nygplangpremiums.
6. Mrs.gBerkowitzgwantsgtogenrollgingagMedicaregAdvantagegplangthatgdoesgnotgincludegdruggcoverag
egandgalsogenrollgingagstand-
alonegMedicaregprescriptiongdruggplan.gUndergwhatgcircumstancesgcangshegdogthis?
IfgthegMedicaregAdvantagegplangisgagPrivategFee-for-
Serviceg(PFFS)gplangthatgdoesgnotgoffergdruggcoveragegorgagMedicalgSavingsgAccount,gMrs.gBerkowitzgca
ngdogthis.
7. Ms.gGoldsteingisgrequiredgbygthegplangshegrepresentsgtogobtaingenrollmentgformsgthatghavegcarbo
ngcopiesgingthegback.gSheggivesgonegtogthegbeneficiary,gsendsganothergtogthegplangandgretainsgtheg
third.gWhatgshouldgshegdogwithghergcopiesgofgthegenrollmentgforms?
Shegshouldgmakegeverygeffortgtogsafeguardgthegbeneficiaryginformationgongthosegenrollmentgforms.
8. Mr.gLopezgtakesgseveralghighgcostgprescriptiongdrugs.gHegwouldglikegtogenrollgingagstandalonegPar
tgDgprescriptiongdruggplangthatgisgavailableginghisgarea.gIngwhatgtypegofgMedicaregHealthgPlangca
nghegenroll?
PrivategFee-for-Serviceg(PFFS)gplangthatgdoesgnotgincludegdruggcoverage.
9. Mr.gBlockgisgcurrentlygenrolledgingagMedicaregAdvantagegplangthatgincludesgdruggcoverage.gHegfou
ndgagstand-
alonegMedicaregprescriptiongdruggplanginghisgareagthatgoffersgbettergcoveragegthangthatgavailableg
throughghisgMA-
PDgplangandgingadditionghasgaglowgpremium.gItgwon'tgcostghimgmuchgmoregand,gbecausegheghasgt
hegmeansgtogdogso,ghegwishesgtogenrollgingthegstand-
alonegprescriptiongdruggplangingadditiongtoghisgMA-PDgplan.gWhatgshouldgyougtellghim?
IfgMr.gBlockgenrollsgingthegstand-
alonegMedicaregprescriptiongdruggplan,ghegwillgbegdisenrolledgfromgthegMedicaregAdvantagegplan.
,10. Mrs.gChengwillgbeg65gsoon,ghasgbeengagcitizengforgtwelvegyears,ghasgbeengemployedgfullgtime,ga
ndgpaidgtaxesgduringgthatgentiregperiod.gShegisgconcernedgthatgshegwillgnotgqualifygforgcoverageg
undergpartgAgbecausegshegwasgnotgborngingthegUnitedgStates.gWhatgshouldgyougtellgher?
Mostgindividualsgwhogaregcitizensgandgovergageg65garegcoveredgundergPartgAgbygvirtuegofghavinggp
aid
Medicaregtaxesgwhilegworking,gthoughgsomegmaygbegcoveredgasgagresultgofgpayinggmonthlygpremiu
ms.
11. Mrs.gLopezgisgenrolledgingagMedicaregAdvantagegcostgplan.gSheghasgrecentlyglostgcreditablegcovera
gegpreviouslygavailablegthroughgherghusband'sgemployer.gShegisginterestedgingenrollinggingagMedic
aregPartgDgprescriptiongdruggplang(PDP).gWhatgshouldgyougtellgher?
IfgagPartgDgbenefitgisgofferedgthroughghergplangshegmustgenrollgingthisgplan.
12. Mr.gSchmidtgwouldglikegtogplangforgretirementgandghasgaskedgyougwhatgisgcoveredgundergOriginalgF
ee-gfor-Serviceg(FFS)gMedicare?gWhatgcouldgyougtellghim?
PartgA,gwhichgcoversghospital,gskilledgnursinggfacility,ghospicegandghomeghealthgservicesgandgPartgB,gwhi
ch
coversgprofessionalgservicesgsuchgasgthosegprovidedgbygagdoctorgaregcoveredgundergOriginalgMedicar
e.
13. Mrs.gWellingtongisgenrolledgingPartsgAgandgBgofgOriginalgMedicare.gAgfriendgrecentlygtoldghergt
hatgtheregisgangexcellentgMedicaregAdvantageg(MA)gplangwithgagfive-
stargratinggservingghergarea.gOngJanuaryg15gshegcomesgtogyougforgadvicegasgtogwhatgoptions,gif
gany,gsheghas.gWhatgshouldgyougsaygregardinggspecialgenrollmentgperiodsg(SEPs)?
Mrs.gWellingtongisgeligiblegforgagSEPgthatgmaygbegusedgonceguntilgNovemberg30gtogenrollgingthegfive-
stargplan.
14. Mr.gShapiroggetsgbygongagverygsmallgfixedgincome.gHeghasgheardgtheregmaygbegextraghelpgpayinggfo
rgPartgDgprescriptiongdrugsgforgMedicaregbeneficiariesgwithglimitedgincome.gHegwantsgtogknowgwhe
therghegmightgqualify.gWhatgshouldgyougtellghim?
Thegextraghelpgisgavailablegtogbeneficiariesgwhosegincomegandgassetsgdognotgexceedgannualglimitsgsp
ecifiedgbygtheggovernment.
, 15. AgclientgwantsgtoggivegyougangenrollmentgapplicationgongOctoberg1gpriorgtogthegbeginninggofgthegA
nnualgElectiongPeriodgbecauseghegisgleavinggongvacationgforgtwogweeksgandgdoesgnotgwantgtogforg
etgaboutgturninggitgin.gWhatgshouldgyougtellghim?
Yougmustgtellghimgyougaregnotgpermittedgtogtakegthegform.gIfghegsendsgthegformgdirectlygtogthegplan,gt
hegplangwillgprocessgthegenrollmentgongthegdaygthegAnnualgElectiongPeriodgbegins.
16. AgentgRoderickgenrollsgretireegMrs.gMartinezgingagmedicalgsavingsgaccountg(MSA)gMedicareghealt
hgplan.gThegMSAgplangdoesgnotgoffergprescriptiongdruggcoverage,gsogAgentgRoderickgalsogenrollsg
Mrs.gMartinezgingagstandalonegprescriptiongdruggplang(PDP).gWhatgCMSgcompensationgrulesgappl
ygtogthisgsituation?
Thisgsituationgisgconsideredgag"dualgenrollment,"gandgCMSgcompensationgrulesgaregappliedgtogthegtwog
plansgatgoncegandgindependentlygofgeachgother.
17. YougaregmeetinggwithgMrs.gHallgingherghome.gOnghergscopegofgappointmentgformgshegaskedgtogdisc
ussgMedicaregAdvantagegplans.gDuringgthegmeeting,gshegasksgtogdiscussgagstand-
alonegprescriptiongdruggplan.gShegisgleavinggthegnextgdaygtogvisitghergfamilygforgagweekginganotherg
state,gsogitgisgimportantgtoghergtogmakegagdecisiongbeforegshegleaves.gWhatgmustghappengbeforegt
hatgadditionalgdiscussiongcangtakegplace?
SincegMrs.gHallgspecificallygaskedgthatgyougdiscussgthegstand-
alone Part
shegsignsgagD plan,
new yougof
gscope may do so, as long
gappointment asgfirst,gindicatinggthatgshegwantsgtogdiscussgthegPartgDgpl
gform
an.
18. YoughavegcomegtogMrs.gMidler'sghomegforgagsalesgpresentation.gAtgthegbeginninggofgthegpresentati
on,gMrs.gMidlergtellsgyougthatgsheghasgagcopygofghergmedicalgrecordgavailablegbecausegshegthinksgt
hisgwillghelpgyougunderstandghergneeds.gShegsuggestsgthatgyougwillgknowgwhichgquestionsgtogaskgh
ergaboutgherghealthgstatusgingordergtogbestgassistghergingselectinggagplan.gWhatgshouldgyougdo?
YougcangonlygaskgMrs.gMidlergquestionsgaboutgconditionsgthatgaffectgeligibility,gspecifically,gwhethergs
he
hasgendgstagegrenalgdiseasegorgonegofgthegconditionsgthatgwouldgqualifyghergforgagspecialgneedsgpl
an.
(COMPLETE)gAHIPgCERTIFICATIONgEXAMSgALLgEXAMSgFROMg2019-
2024,gALLgMODULESgEXAMS,gREALgAHIPgEXAMSg1800gQUESTIONSgFULLYgSOLVE
DgVERIFIEDgEXAM|GRADEDgA+g|GUARANTEEDgPASS|SCOREgA
1. WhichgofgthegfollowinggstepsgmaygagPartgDgsponsorgadoptgforgbeneficiariesgwhogaregatgrisk
gofgmisusinggorgabusinggfrequentlygabusedgdrugs?
I. Identifyinggatgriskgindividualsgbygusinggcriteriagthatgincludesgthegnumbergofgopioidgprescriptionsgt
hegbeneficiaryghasgandgthegnumbergofgprescribersgwhoghavegwrittengthosegprescriptions.
II. Lockinggangat-riskgbeneficiarygintogonegpharmacy.
III. Lockinggangat-riskgbeneficiarygintogonegprescriber.
2. Mrs.gWolfgwearsgglassesgandgdenturesgandghasgenjoyedgconsiderablegpaingreliefgfromgarthritisgth
roughgacupuncture.gShegisgconcernedgaboutgwhethergorgnotgMedicaregwillgcovergthesegitemsgand
gservices.gWhatgshouldgyougtellgher?
Medicaregdoesgnotgcovergacupuncture,gor,ginggeneral,gglassesgorgdentures.
3. WhichgstatementgbestgdescribesgPACEgplans?
Itgincludesgcomprehensivegmedicalgandgsocialgservicegdeliverygsystemsgusingganginterdisciplinarygteamgappr
oachgingangadultgdayghealthgcenter,gsupplementedgbygin-homegandgreferralgservices.
4. Mr.gShultzgwasgstillgworkinggwhenghegfirstgqualifiedgforgMedicare.gAtgthatgtime,gheghadgemployerg
groupgcoveragegthatgwasgcreditable.gDuringghisginitialgPartgDgeligibilitygperiod,ghegdecidedgnotgtog
enrollgbecauseghegwasgsatisfiedgwithghisgdruggcoverage.gItgisgnowgagyearglatergandgMr.gShultzghasgl
ostghisgemployerggroupgcoverage.gHowgwouldgyougadviseghim?
Mr.gSchultzgshouldgenrollgingagPartgDgplangbeforegheghasgag63-
daygbreakgingcoveragegingordergtogavoidgagpremiumgpenalty.
,5. ForgwhichgofgthegfollowinggindividualsgwouldgagCostgPlangbegmostgappropriate?
Ms.gBakergwhogisgenrolledgingMedicaregPartgBgandgisgwillinggtogcontinuegpayinggPartgBgpremiumsgplusga
nygplangpremiums.
6. Mrs.gBerkowitzgwantsgtogenrollgingagMedicaregAdvantagegplangthatgdoesgnotgincludegdruggcoverag
egandgalsogenrollgingagstand-
alonegMedicaregprescriptiongdruggplan.gUndergwhatgcircumstancesgcangshegdogthis?
IfgthegMedicaregAdvantagegplangisgagPrivategFee-for-
Serviceg(PFFS)gplangthatgdoesgnotgoffergdruggcoveragegorgagMedicalgSavingsgAccount,gMrs.gBerkowitzgca
ngdogthis.
7. Ms.gGoldsteingisgrequiredgbygthegplangshegrepresentsgtogobtaingenrollmentgformsgthatghavegcarbo
ngcopiesgingthegback.gSheggivesgonegtogthegbeneficiary,gsendsganothergtogthegplangandgretainsgtheg
third.gWhatgshouldgshegdogwithghergcopiesgofgthegenrollmentgforms?
Shegshouldgmakegeverygeffortgtogsafeguardgthegbeneficiaryginformationgongthosegenrollmentgforms.
8. Mr.gLopezgtakesgseveralghighgcostgprescriptiongdrugs.gHegwouldglikegtogenrollgingagstandalonegPar
tgDgprescriptiongdruggplangthatgisgavailableginghisgarea.gIngwhatgtypegofgMedicaregHealthgPlangca
nghegenroll?
PrivategFee-for-Serviceg(PFFS)gplangthatgdoesgnotgincludegdruggcoverage.
9. Mr.gBlockgisgcurrentlygenrolledgingagMedicaregAdvantagegplangthatgincludesgdruggcoverage.gHegfou
ndgagstand-
alonegMedicaregprescriptiongdruggplanginghisgareagthatgoffersgbettergcoveragegthangthatgavailableg
throughghisgMA-
PDgplangandgingadditionghasgaglowgpremium.gItgwon'tgcostghimgmuchgmoregand,gbecausegheghasgt
hegmeansgtogdogso,ghegwishesgtogenrollgingthegstand-
alonegprescriptiongdruggplangingadditiongtoghisgMA-PDgplan.gWhatgshouldgyougtellghim?
IfgMr.gBlockgenrollsgingthegstand-
alonegMedicaregprescriptiongdruggplan,ghegwillgbegdisenrolledgfromgthegMedicaregAdvantagegplan.
,10. Mrs.gChengwillgbeg65gsoon,ghasgbeengagcitizengforgtwelvegyears,ghasgbeengemployedgfullgtime,ga
ndgpaidgtaxesgduringgthatgentiregperiod.gShegisgconcernedgthatgshegwillgnotgqualifygforgcoverageg
undergpartgAgbecausegshegwasgnotgborngingthegUnitedgStates.gWhatgshouldgyougtellgher?
Mostgindividualsgwhogaregcitizensgandgovergageg65garegcoveredgundergPartgAgbygvirtuegofghavinggp
aid
Medicaregtaxesgwhilegworking,gthoughgsomegmaygbegcoveredgasgagresultgofgpayinggmonthlygpremiu
ms.
11. Mrs.gLopezgisgenrolledgingagMedicaregAdvantagegcostgplan.gSheghasgrecentlyglostgcreditablegcovera
gegpreviouslygavailablegthroughgherghusband'sgemployer.gShegisginterestedgingenrollinggingagMedic
aregPartgDgprescriptiongdruggplang(PDP).gWhatgshouldgyougtellgher?
IfgagPartgDgbenefitgisgofferedgthroughghergplangshegmustgenrollgingthisgplan.
12. Mr.gSchmidtgwouldglikegtogplangforgretirementgandghasgaskedgyougwhatgisgcoveredgundergOriginalgF
ee-gfor-Serviceg(FFS)gMedicare?gWhatgcouldgyougtellghim?
PartgA,gwhichgcoversghospital,gskilledgnursinggfacility,ghospicegandghomeghealthgservicesgandgPartgB,gwhi
ch
coversgprofessionalgservicesgsuchgasgthosegprovidedgbygagdoctorgaregcoveredgundergOriginalgMedicar
e.
13. Mrs.gWellingtongisgenrolledgingPartsgAgandgBgofgOriginalgMedicare.gAgfriendgrecentlygtoldghergt
hatgtheregisgangexcellentgMedicaregAdvantageg(MA)gplangwithgagfive-
stargratinggservingghergarea.gOngJanuaryg15gshegcomesgtogyougforgadvicegasgtogwhatgoptions,gif
gany,gsheghas.gWhatgshouldgyougsaygregardinggspecialgenrollmentgperiodsg(SEPs)?
Mrs.gWellingtongisgeligiblegforgagSEPgthatgmaygbegusedgonceguntilgNovemberg30gtogenrollgingthegfive-
stargplan.
14. Mr.gShapiroggetsgbygongagverygsmallgfixedgincome.gHeghasgheardgtheregmaygbegextraghelpgpayinggfo
rgPartgDgprescriptiongdrugsgforgMedicaregbeneficiariesgwithglimitedgincome.gHegwantsgtogknowgwhe
therghegmightgqualify.gWhatgshouldgyougtellghim?
Thegextraghelpgisgavailablegtogbeneficiariesgwhosegincomegandgassetsgdognotgexceedgannualglimitsgsp
ecifiedgbygtheggovernment.
, 15. AgclientgwantsgtoggivegyougangenrollmentgapplicationgongOctoberg1gpriorgtogthegbeginninggofgthegA
nnualgElectiongPeriodgbecauseghegisgleavinggongvacationgforgtwogweeksgandgdoesgnotgwantgtogforg
etgaboutgturninggitgin.gWhatgshouldgyougtellghim?
Yougmustgtellghimgyougaregnotgpermittedgtogtakegthegform.gIfghegsendsgthegformgdirectlygtogthegplan,gt
hegplangwillgprocessgthegenrollmentgongthegdaygthegAnnualgElectiongPeriodgbegins.
16. AgentgRoderickgenrollsgretireegMrs.gMartinezgingagmedicalgsavingsgaccountg(MSA)gMedicareghealt
hgplan.gThegMSAgplangdoesgnotgoffergprescriptiongdruggcoverage,gsogAgentgRoderickgalsogenrollsg
Mrs.gMartinezgingagstandalonegprescriptiongdruggplang(PDP).gWhatgCMSgcompensationgrulesgappl
ygtogthisgsituation?
Thisgsituationgisgconsideredgag"dualgenrollment,"gandgCMSgcompensationgrulesgaregappliedgtogthegtwog
plansgatgoncegandgindependentlygofgeachgother.
17. YougaregmeetinggwithgMrs.gHallgingherghome.gOnghergscopegofgappointmentgformgshegaskedgtogdisc
ussgMedicaregAdvantagegplans.gDuringgthegmeeting,gshegasksgtogdiscussgagstand-
alonegprescriptiongdruggplan.gShegisgleavinggthegnextgdaygtogvisitghergfamilygforgagweekginganotherg
state,gsogitgisgimportantgtoghergtogmakegagdecisiongbeforegshegleaves.gWhatgmustghappengbeforegt
hatgadditionalgdiscussiongcangtakegplace?
SincegMrs.gHallgspecificallygaskedgthatgyougdiscussgthegstand-
alone Part
shegsignsgagD plan,
new yougof
gscope may do so, as long
gappointment asgfirst,gindicatinggthatgshegwantsgtogdiscussgthegPartgDgpl
gform
an.
18. YoughavegcomegtogMrs.gMidler'sghomegforgagsalesgpresentation.gAtgthegbeginninggofgthegpresentati
on,gMrs.gMidlergtellsgyougthatgsheghasgagcopygofghergmedicalgrecordgavailablegbecausegshegthinksgt
hisgwillghelpgyougunderstandghergneeds.gShegsuggestsgthatgyougwillgknowgwhichgquestionsgtogaskgh
ergaboutgherghealthgstatusgingordergtogbestgassistghergingselectinggagplan.gWhatgshouldgyougdo?
YougcangonlygaskgMrs.gMidlergquestionsgaboutgconditionsgthatgaffectgeligibility,gspecifically,gwhethergs
he
hasgendgstagegrenalgdiseasegorgonegofgthegconditionsgthatgwouldgqualifyghergforgagspecialgneedsgpl
an.
