AHIP PRACTICE EXAM WITH
COMPLETE SOLUTIONS
Mr. sCarlini shas sheard sthat sMedicare sprescription sdrug splans sare sonly soffered
sthrough sprivate scompanies sunder sa sprogram sknown sas sMedicare sAdvantage
s(MA), snot sby sthe sgovernment. sHe slikes sOriginal sMedicare sand sdoes snot swant sto
ssign sup sfor san sMA sproduct, sbut she salso swants sprescription sdrug scoverage.
sWhat sshould syou stell shim? s- scorrect sanswers s-Mr. sCarlini scan sstay swith sOriginal
sMedicare sand salso senroll sin sa sMedicare sprescription sdrug splan sthrough sa sprivate
scompany sthat shas scontracted swith sthe sgovernment sto sprovide sonly ssuch sdrug
scoverage sto seligible sMedicare sbeneficiaries.
During sa ssales spresentation sto sMs sDaley sfor sa sMedicare sAdvantage splan sthat
shas sa s5-star srating sin scustomer sservice sand scare scoordination, sand sreceived san
soverall splan sperformance sof sa s4-star, swhich sof sthe sfollowing swould sbe sthe
scorrect sstatement sto ssay sto sher? s- scorrect sanswers s-The sMedicare sAdvantage
splan sreceived sa s5-star srating sin scustomer sservice sand scare scoordination swith san
soverall sperformance srating sof s4-stars
, Mrs. sPena sis s66 syears sold, shas scoverage sunder san semployer splan sand swill
sretire snext syear. sShe sheard sshe smust senroll sin sPart sB sat sthe sbeginning sof sthe
syear sto sensure sno sgap sin scoverage. sWhat scan syou stell sher? s- scorrect sanswers
s-She smay senroll sat sany stime swhile sshe sis scovered sunder sher semployer splan,
sbut sshe swill shave sa sspecial seight-month senrollment speriod sthat sdiffers sfrom sthe
sstandard sgeneral senrollment speriod, sduring swhich sshe smay senroll sin sMedicare
sPart sB
Mr. sBickford sdid snot squite squalify sfor sthe sextra shelp slow-income ssubsidy sunder
sthe sMedicare sPart sD sPrescription sDrug sprogram sand she sis swondering sif sthere sis
sany sother soption she shas sfor sobtaining shelp swith shis sconsiderable sdrug scosts.
sWhat sshould syou stell shim? s- scorrect sanswers s-He scould scheck swith sthe
smanufacturers sof shis smedications sto ssee sif sthey soffer san sassistance sprogram sto
shelp speople swith slimited smeans sobtain sthe smedications sthey sneed. sAlternatively,
she scould scheck sto ssee swhether shis sstate shas sa spharmacy sassistance sprogram
sto shelp shim swith shis sexpenses.
Alice sis sa smarketing srepresentative semployed sby sa shealth splan. sBetty sis sa
scaptive sagent sof sa shealth splan swho smarkets sto smultiple splans sand ssponsors.
sCarl sis sa scaptive sagent swho smarkets sto sonly sone splan/sponsor. sDenise sis san
sindependent sagent swho smarkets sto sdifferent stypes sof sgroups. sEdward sis san
sindependent sagent swho smarkets sonly sto semployer sand sunion sgroups. sCMS
smarketing srepresentative scompensation srules sgenerally sapply sto: s- scorrect
sanswers s-Betty sand sDenise, sbut snot sAlice s(the semployee) sor sCarl sor sEdward s(to
swhom sexceptions sapply).
Mrs. sValentino sis scurrently senrolled sin sa sMedicare sCost splan. sThis splan sis sno
slonger smeeting sher sneeds, sbut sit sis snow smid-year sand spast sthe sannual selection
speriod s(AEP). sWhat swould syou ssay sto sMrs. sValentino sregarding sher soptions? s-
scorrect sanswers s-Mrs. sValentino scan ssubmit sa swritten srequest sto sMedicare sto sbe
sdisenrolled sfrom sthe sCost splan sand senroll sin sOriginal sMedicare.
When sMyra sfirst sbecame seligible sfor sMedicare, sshe senrolled sin sOriginal sMedicare
s(Parts sA sand sB). sShe sis snow s67 sand swill sturn s68 son sJuly s1. sShe swould snow
slike sto senroll sin sa sMedicare sAdvantage s(MA) splan sand sapproaches syou sabout
sher soptions. sWhat sadvice swould syou sgive sher? s- scorrect sanswers s-She sshould
sremain sin sOriginal sMedicare suntil sthe sannual selection speriod srunning sfrom
sOctober s15 sto sDecember s7, sduring swhich sshe scan sselect san sMA splan.
Mrs. sTanner sis senrolled sin sa sMedicare sAdvantage sHMO sthat soffers sa spoint sof
sservice soptions. sThis sallows sMrs. sTanner sto sdo swhich sof sthe sfollowing? s- scorrect
sanswers s-Mrs. sTanner scan sgo sto snon-plan sdoctors sfor scertain sservices swithout
sreceiving sprior sapproval
COMPLETE SOLUTIONS
Mr. sCarlini shas sheard sthat sMedicare sprescription sdrug splans sare sonly soffered
sthrough sprivate scompanies sunder sa sprogram sknown sas sMedicare sAdvantage
s(MA), snot sby sthe sgovernment. sHe slikes sOriginal sMedicare sand sdoes snot swant sto
ssign sup sfor san sMA sproduct, sbut she salso swants sprescription sdrug scoverage.
sWhat sshould syou stell shim? s- scorrect sanswers s-Mr. sCarlini scan sstay swith sOriginal
sMedicare sand salso senroll sin sa sMedicare sprescription sdrug splan sthrough sa sprivate
scompany sthat shas scontracted swith sthe sgovernment sto sprovide sonly ssuch sdrug
scoverage sto seligible sMedicare sbeneficiaries.
During sa ssales spresentation sto sMs sDaley sfor sa sMedicare sAdvantage splan sthat
shas sa s5-star srating sin scustomer sservice sand scare scoordination, sand sreceived san
soverall splan sperformance sof sa s4-star, swhich sof sthe sfollowing swould sbe sthe
scorrect sstatement sto ssay sto sher? s- scorrect sanswers s-The sMedicare sAdvantage
splan sreceived sa s5-star srating sin scustomer sservice sand scare scoordination swith san
soverall sperformance srating sof s4-stars
, Mrs. sPena sis s66 syears sold, shas scoverage sunder san semployer splan sand swill
sretire snext syear. sShe sheard sshe smust senroll sin sPart sB sat sthe sbeginning sof sthe
syear sto sensure sno sgap sin scoverage. sWhat scan syou stell sher? s- scorrect sanswers
s-She smay senroll sat sany stime swhile sshe sis scovered sunder sher semployer splan,
sbut sshe swill shave sa sspecial seight-month senrollment speriod sthat sdiffers sfrom sthe
sstandard sgeneral senrollment speriod, sduring swhich sshe smay senroll sin sMedicare
sPart sB
Mr. sBickford sdid snot squite squalify sfor sthe sextra shelp slow-income ssubsidy sunder
sthe sMedicare sPart sD sPrescription sDrug sprogram sand she sis swondering sif sthere sis
sany sother soption she shas sfor sobtaining shelp swith shis sconsiderable sdrug scosts.
sWhat sshould syou stell shim? s- scorrect sanswers s-He scould scheck swith sthe
smanufacturers sof shis smedications sto ssee sif sthey soffer san sassistance sprogram sto
shelp speople swith slimited smeans sobtain sthe smedications sthey sneed. sAlternatively,
she scould scheck sto ssee swhether shis sstate shas sa spharmacy sassistance sprogram
sto shelp shim swith shis sexpenses.
Alice sis sa smarketing srepresentative semployed sby sa shealth splan. sBetty sis sa
scaptive sagent sof sa shealth splan swho smarkets sto smultiple splans sand ssponsors.
sCarl sis sa scaptive sagent swho smarkets sto sonly sone splan/sponsor. sDenise sis san
sindependent sagent swho smarkets sto sdifferent stypes sof sgroups. sEdward sis san
sindependent sagent swho smarkets sonly sto semployer sand sunion sgroups. sCMS
smarketing srepresentative scompensation srules sgenerally sapply sto: s- scorrect
sanswers s-Betty sand sDenise, sbut snot sAlice s(the semployee) sor sCarl sor sEdward s(to
swhom sexceptions sapply).
Mrs. sValentino sis scurrently senrolled sin sa sMedicare sCost splan. sThis splan sis sno
slonger smeeting sher sneeds, sbut sit sis snow smid-year sand spast sthe sannual selection
speriod s(AEP). sWhat swould syou ssay sto sMrs. sValentino sregarding sher soptions? s-
scorrect sanswers s-Mrs. sValentino scan ssubmit sa swritten srequest sto sMedicare sto sbe
sdisenrolled sfrom sthe sCost splan sand senroll sin sOriginal sMedicare.
When sMyra sfirst sbecame seligible sfor sMedicare, sshe senrolled sin sOriginal sMedicare
s(Parts sA sand sB). sShe sis snow s67 sand swill sturn s68 son sJuly s1. sShe swould snow
slike sto senroll sin sa sMedicare sAdvantage s(MA) splan sand sapproaches syou sabout
sher soptions. sWhat sadvice swould syou sgive sher? s- scorrect sanswers s-She sshould
sremain sin sOriginal sMedicare suntil sthe sannual selection speriod srunning sfrom
sOctober s15 sto sDecember s7, sduring swhich sshe scan sselect san sMA splan.
Mrs. sTanner sis senrolled sin sa sMedicare sAdvantage sHMO sthat soffers sa spoint sof
sservice soptions. sThis sallows sMrs. sTanner sto sdo swhich sof sthe sfollowing? s- scorrect
sanswers s-Mrs. sTanner scan sgo sto snon-plan sdoctors sfor scertain sservices swithout
sreceiving sprior sapproval
