AHIP Final Exam 2025 LATEST VERSION
360 QUESTIONS AND ANSWERS WITH
STUDY GUIDE DETAILED AND VERIFIED
FOR GUARANTEED PASS, LATEST
UPDATE 2025
Mr. Edwards, a marketing representative of the ACME Insurance Company, scheduled
a marketing event and expects about 40 people to attend. He has hired a magician at a
cost of $200 to entertain attendees. Can he do this in a way that complies with guidance
from the Medicare agency? - YOUR CORRECT CORRECT ANSWER SHOULD
BE a. He can do this because the estimated number of attendees is based on the
venue size and response rate and the value of the gift does not exceed $15.
Mrs. Ramos is considering a Medicare Advantage PPO and has questions about which
providers she can go to for her health care. What should you tell her? - YOUR
CORRECT CORRECT ANSWER SHOULD BE b. Mrs. Ramos can obtain
care from any provider who participates in Original Medicare, but generally will have a
higher cost-sharing amount if she sees a provider who/that is not a part of the PPO
network.
Julia Harris is turning 66 in July, at which time she will retire. She has contacted your
office and requested a meeting so that she can learn about Medicare and the products
you represent. How should you respond? - YOUR CORRECT CORRECT
ANSWER SHOULD BE c. Tell Julia that you will meet with her to explain
Medicare and should she be interested you can accept and submit an enrollment
request, since this is an initial enrollment qualifying her for a special enrollment period.
Mr. Rivera has Qualified Medicare Beneficiary (QMB) eligibility and is thus covered by
both Medicare and Medicaid. He decides to enroll in a Medicare Advantage (MA) PPO
plan. Later he sees an out-of-network doctor to receive a Medicare covered service.
How much The doctor may only collect from Mr. Rivera the cost sharing allowable under
the state's Medicaid program.may the doctor collect from Mr. Rivera? - YOUR
CORRECT CORRECT ANSWER SHOULD BE The doctor may only collect
from Mr. Rivera the cost sharing allowable under the state's Medicaid program.
,During a sales presentation in Ms. Sullivan's home, she tells you that she has heard
about a type of Medicare health plan known as Private Fee-for-Service (PFFS). She
wants to know if this would be available to her. What should you tell her about PFFS
plans? - YOUR CORRECT CORRECT ANSWER SHOULD BE
Choose one answer. - YOUR CORRECT CORRECT ANSWER SHOULD BE
- YOUR CORRECT CORRECT ANSWER SHOULD BE a. A PFFS plan is a
type of Medicare Supplement plan and she may enroll in one if it is available in her
area.
- YOUR CORRECT CORRECT ANSWER SHOULD BE b. A PFFS plan is
exactly the same as Original Medicare, only offered by a private entity and she may
enroll in one if it is available in her area.
- YOUR CORRECT CORRECT ANSWER SHOULD BE c. PFFS plans are
designed to cover only prescription drugs and if that is the type of coverage she wants,
she may enroll in one if it is available in her area.
- YOUR CORRECT CORRECT ANSWER SHOULD BE d. A PFFS plan is
one of the various types of Medicare Advantage plans offered by private entities and
she may enroll in one if it is available in her area.
Question8 - YOUR CORRECT CORRECT ANSWER SHOULD BE
Marks: 1 - YOUR CORRECT CORRECT ANSWER SHOULD BE
During an appointment scheduled to discuss a Medicare Advantage Prescription Drug
plan (MA-PD), Mr. Peters asked his agent to describe a stand-alone prescription drug
plan (Part D plan) that his neighbor told him about. What should his agent do? - YOUR
CORRECT CORRECT ANSWER SHOULD BE
Choose one answer. - YOUR CORRECT CORRECT ANSWER SHOULD BE
- YOUR CORRECT CORRECT ANSWER SHOULD BE a. Since Mr. Peters
requested a description of the Part D plan, his agent must leave the Part D plan
brochure, but not an enrollment form, and would have to schedule another appointment
after at least 48 hours have passed to discuss the Part D plan with Mr. Peters.
- YOUR CORRECT CORRECT ANSWER SHOULD BE b. Since Mr. Peters
requested a description of the Part D plan, his agent must have Mr. Peters sign a new
scope of appointment form that includes Part D, and then the agent may discuss the
Part D plan so Mr. Peters can compare plans and make an informed enrollment choice
during the appointment.
, - YOUR CORRECT CORRECT ANSWER SHOULD BE c. Since Mr. Peters
requested a description of the Part D plan, his agent must inform Mr. Peters that he can
only sign up for the MA-PD plan and cannot receive a brochure or any other information
about the Part D plan now because he did not agree in advance to discuss that plan
- YOUR CORRECT CORRECT ANSWER SHOULD BE d. Since Mr. Peters
requested a description of the Part D plan, his agent must discuss both the Part D and
the MA-PD plans and return after at least 48 hours to complete the Part D plan
enrollment form with Mr. Peters.
Question9 - YOUR CORRECT CORRECT ANSWER SHOULD BE
Marks: 1 - YOUR CORRECT CORRECT ANSWER SHOULD BE
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? - YOUR CORRECT CORRECT ANSWER SHOULD BE
Choose one answer. - YOUR CORRECT CORRECT ANSWER SHOULD BE
- YOUR CORRECT CORRECT ANSWER SHOULD BE a. In general, he
must select a single Part D premium payment mechanism that will be used throughout
the year.
- YOUR CORRECT CORRECT ANSWER SHOULD BE b. As long as he
fills out the paperwork to begin withholding from his Social Security check at least 63
days before such withholding should begin, he can change his method of Part D
premium payment and withholding will begin the month after his savings account is
exhausted.
- YOUR CORRECT CORRECT ANSWER SHOULD BE c. During 2017,
many people experienced significant problems with deductions from their Social
Security check for their Part D premium. As a result, this method of payment is no
longer an option for Part D premium payments
- YOUR CORRECT CORRECT ANSWER SHOULD BE d. In general, to pay
his Part D premium, he only can have automatic withdrawals made from a checking
account, so he will need to transfer the funds prior to beginning such withdrawals.
Question10 - YOUR CORRECT CORRECT ANSWER SHOULD BE
Marks: 1 - YOUR CORRECT CORRECT ANSWER SHOULD BE
, Since 2004 Ms. Eisenberg has had a Medigap plan that provides some drug coverage.
She has recently received a letter from her Medigap carrier informing her that her drug
coverage is not "creditable." She wants to know what this means. What should you tell
her? - YOUR CORRECT CORRECT ANSWER SHOULD BE
Choose one answer. - YOUR CORRECT CORRECT ANSWER SHOULD BE
- YOUR CORRECT CORRECT ANSWER SHOULD BE a. The letter is to
inform her that her Medigap drug coverage must be supplemented by purchasing
coverage under a Part D plan. If she does not do so within 63 days, she will not be able
to obtain Part D coverage at a later date.
- YOUR CORRECT CORRECT ANSWER SHOULD BE b. The letter is to
inform her that the drug coverage offered through her Medigap plan does not offer drug
coverage that is at least comparable to that provided under the Medicare Part D
prescription drug program. If she does not have such creditable coverage during
periods when she is first eligible for the Part D program, she will face a premium penalty
if she enrolls in a Part D plan at a later date.
- YOUR CORRECT CORRECT ANSWER SHOULD BE c. The letter is to
inform her that her Medigap plan's coverage has been determined by the Federal
government to be inadequate and the plan must therefore discontinue offering such
coverage. Ms. Eisenberg will have to select a different Medigap plan if she wants drug
coverage.
- YOUR CORRECT CORRECT ANSWER SHOULD BE d. The letter is to
inform her that Medicare Part D prescription drug coverage is available, but there is no
need for her to change her drug coverage since it is just as good as Part D. She may
keep her current coverage through the Medigap plan.
Question11 - YOUR CORRECT CORRECT ANSWER SHOULD BE
Marks: 1 - YOUR CORRECT CORRECT ANSWER SHOULD BE
Richard is a licensed agent who represents Spartan Health Plan and its Medicare
Advantage (MA) plans. Richard has several clients who have recently come to him for
help who are in their initial coverage election period (ICEP) and are interested in
enrolling in one of Spartan Health Plan's MA plans. Alice will soon turn 65 and retire.
Alice has coverage through Spartan Health Plan offered by her employer. Bob had
health coverage through Spartan but dropped the coverage when he retired early to
travel overseas. Bob, who has just turned age 65, is now back in the United States.
Charlotte, who will turn 65 next month, has coverage through Athena Health plan - a
360 QUESTIONS AND ANSWERS WITH
STUDY GUIDE DETAILED AND VERIFIED
FOR GUARANTEED PASS, LATEST
UPDATE 2025
Mr. Edwards, a marketing representative of the ACME Insurance Company, scheduled
a marketing event and expects about 40 people to attend. He has hired a magician at a
cost of $200 to entertain attendees. Can he do this in a way that complies with guidance
from the Medicare agency? - YOUR CORRECT CORRECT ANSWER SHOULD
BE a. He can do this because the estimated number of attendees is based on the
venue size and response rate and the value of the gift does not exceed $15.
Mrs. Ramos is considering a Medicare Advantage PPO and has questions about which
providers she can go to for her health care. What should you tell her? - YOUR
CORRECT CORRECT ANSWER SHOULD BE b. Mrs. Ramos can obtain
care from any provider who participates in Original Medicare, but generally will have a
higher cost-sharing amount if she sees a provider who/that is not a part of the PPO
network.
Julia Harris is turning 66 in July, at which time she will retire. She has contacted your
office and requested a meeting so that she can learn about Medicare and the products
you represent. How should you respond? - YOUR CORRECT CORRECT
ANSWER SHOULD BE c. Tell Julia that you will meet with her to explain
Medicare and should she be interested you can accept and submit an enrollment
request, since this is an initial enrollment qualifying her for a special enrollment period.
Mr. Rivera has Qualified Medicare Beneficiary (QMB) eligibility and is thus covered by
both Medicare and Medicaid. He decides to enroll in a Medicare Advantage (MA) PPO
plan. Later he sees an out-of-network doctor to receive a Medicare covered service.
How much The doctor may only collect from Mr. Rivera the cost sharing allowable under
the state's Medicaid program.may the doctor collect from Mr. Rivera? - YOUR
CORRECT CORRECT ANSWER SHOULD BE The doctor may only collect
from Mr. Rivera the cost sharing allowable under the state's Medicaid program.
,During a sales presentation in Ms. Sullivan's home, she tells you that she has heard
about a type of Medicare health plan known as Private Fee-for-Service (PFFS). She
wants to know if this would be available to her. What should you tell her about PFFS
plans? - YOUR CORRECT CORRECT ANSWER SHOULD BE
Choose one answer. - YOUR CORRECT CORRECT ANSWER SHOULD BE
- YOUR CORRECT CORRECT ANSWER SHOULD BE a. A PFFS plan is a
type of Medicare Supplement plan and she may enroll in one if it is available in her
area.
- YOUR CORRECT CORRECT ANSWER SHOULD BE b. A PFFS plan is
exactly the same as Original Medicare, only offered by a private entity and she may
enroll in one if it is available in her area.
- YOUR CORRECT CORRECT ANSWER SHOULD BE c. PFFS plans are
designed to cover only prescription drugs and if that is the type of coverage she wants,
she may enroll in one if it is available in her area.
- YOUR CORRECT CORRECT ANSWER SHOULD BE d. A PFFS plan is
one of the various types of Medicare Advantage plans offered by private entities and
she may enroll in one if it is available in her area.
Question8 - YOUR CORRECT CORRECT ANSWER SHOULD BE
Marks: 1 - YOUR CORRECT CORRECT ANSWER SHOULD BE
During an appointment scheduled to discuss a Medicare Advantage Prescription Drug
plan (MA-PD), Mr. Peters asked his agent to describe a stand-alone prescription drug
plan (Part D plan) that his neighbor told him about. What should his agent do? - YOUR
CORRECT CORRECT ANSWER SHOULD BE
Choose one answer. - YOUR CORRECT CORRECT ANSWER SHOULD BE
- YOUR CORRECT CORRECT ANSWER SHOULD BE a. Since Mr. Peters
requested a description of the Part D plan, his agent must leave the Part D plan
brochure, but not an enrollment form, and would have to schedule another appointment
after at least 48 hours have passed to discuss the Part D plan with Mr. Peters.
- YOUR CORRECT CORRECT ANSWER SHOULD BE b. Since Mr. Peters
requested a description of the Part D plan, his agent must have Mr. Peters sign a new
scope of appointment form that includes Part D, and then the agent may discuss the
Part D plan so Mr. Peters can compare plans and make an informed enrollment choice
during the appointment.
, - YOUR CORRECT CORRECT ANSWER SHOULD BE c. Since Mr. Peters
requested a description of the Part D plan, his agent must inform Mr. Peters that he can
only sign up for the MA-PD plan and cannot receive a brochure or any other information
about the Part D plan now because he did not agree in advance to discuss that plan
- YOUR CORRECT CORRECT ANSWER SHOULD BE d. Since Mr. Peters
requested a description of the Part D plan, his agent must discuss both the Part D and
the MA-PD plans and return after at least 48 hours to complete the Part D plan
enrollment form with Mr. Peters.
Question9 - YOUR CORRECT CORRECT ANSWER SHOULD BE
Marks: 1 - YOUR CORRECT CORRECT ANSWER SHOULD BE
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? - YOUR CORRECT CORRECT ANSWER SHOULD BE
Choose one answer. - YOUR CORRECT CORRECT ANSWER SHOULD BE
- YOUR CORRECT CORRECT ANSWER SHOULD BE a. In general, he
must select a single Part D premium payment mechanism that will be used throughout
the year.
- YOUR CORRECT CORRECT ANSWER SHOULD BE b. As long as he
fills out the paperwork to begin withholding from his Social Security check at least 63
days before such withholding should begin, he can change his method of Part D
premium payment and withholding will begin the month after his savings account is
exhausted.
- YOUR CORRECT CORRECT ANSWER SHOULD BE c. During 2017,
many people experienced significant problems with deductions from their Social
Security check for their Part D premium. As a result, this method of payment is no
longer an option for Part D premium payments
- YOUR CORRECT CORRECT ANSWER SHOULD BE d. In general, to pay
his Part D premium, he only can have automatic withdrawals made from a checking
account, so he will need to transfer the funds prior to beginning such withdrawals.
Question10 - YOUR CORRECT CORRECT ANSWER SHOULD BE
Marks: 1 - YOUR CORRECT CORRECT ANSWER SHOULD BE
, Since 2004 Ms. Eisenberg has had a Medigap plan that provides some drug coverage.
She has recently received a letter from her Medigap carrier informing her that her drug
coverage is not "creditable." She wants to know what this means. What should you tell
her? - YOUR CORRECT CORRECT ANSWER SHOULD BE
Choose one answer. - YOUR CORRECT CORRECT ANSWER SHOULD BE
- YOUR CORRECT CORRECT ANSWER SHOULD BE a. The letter is to
inform her that her Medigap drug coverage must be supplemented by purchasing
coverage under a Part D plan. If she does not do so within 63 days, she will not be able
to obtain Part D coverage at a later date.
- YOUR CORRECT CORRECT ANSWER SHOULD BE b. The letter is to
inform her that the drug coverage offered through her Medigap plan does not offer drug
coverage that is at least comparable to that provided under the Medicare Part D
prescription drug program. If she does not have such creditable coverage during
periods when she is first eligible for the Part D program, she will face a premium penalty
if she enrolls in a Part D plan at a later date.
- YOUR CORRECT CORRECT ANSWER SHOULD BE c. The letter is to
inform her that her Medigap plan's coverage has been determined by the Federal
government to be inadequate and the plan must therefore discontinue offering such
coverage. Ms. Eisenberg will have to select a different Medigap plan if she wants drug
coverage.
- YOUR CORRECT CORRECT ANSWER SHOULD BE d. The letter is to
inform her that Medicare Part D prescription drug coverage is available, but there is no
need for her to change her drug coverage since it is just as good as Part D. She may
keep her current coverage through the Medigap plan.
Question11 - YOUR CORRECT CORRECT ANSWER SHOULD BE
Marks: 1 - YOUR CORRECT CORRECT ANSWER SHOULD BE
Richard is a licensed agent who represents Spartan Health Plan and its Medicare
Advantage (MA) plans. Richard has several clients who have recently come to him for
help who are in their initial coverage election period (ICEP) and are interested in
enrolling in one of Spartan Health Plan's MA plans. Alice will soon turn 65 and retire.
Alice has coverage through Spartan Health Plan offered by her employer. Bob had
health coverage through Spartan but dropped the coverage when he retired early to
travel overseas. Bob, who has just turned age 65, is now back in the United States.
Charlotte, who will turn 65 next month, has coverage through Athena Health plan - a
