AHIP Module 2 | 2025-2026 LATEST UPDATED| 20 ACTUAL
EXAM COMPLETE QUESTIONS AND ANSWERS | 100%
RATED CORRECT | 100% VERFIED | ALREADY GRADED A+
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 entitled to Part A, enrolled in Part
B, and if he lives in the PFFS plan's service area.
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.
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? - (answer)Mrs. Chi may
enroll in a MA MSA plan and remain in her current standalone Part D prescription
drug plan.
Mr. Romero is 64, retiring soon, and considering enrollment in his employer-
sponsored retiree group health plan that includes drug coverage with nominal
copays. He heard about a neighbor's MA-PD plan that you represent and because he
takes numerous prescription drugs, he is considering signing up for it. What should
you tell him? - (answer)He should compare the benefits in his employer-sponsored
retiree group health plan with the benefits in his neighbor's MA-PD plan to
determine which one will provide sufficient coverage for his prescription needs.
Mr. Lombardi is interested in a Medicare Advantage (MA) PPO plan that you
represent. It is one of three plans operated by the same organization in Mr.
Lombardi's area. The MA PPO plan does not include drug coverage, but the other
two plans do. Mr. Lombardi likes the PPO plan that does not include drug coverage
and intends to obtain his drug coverage through a stand-alone Medicare prescription
drug plan. What should you tell him about this situation? - (answer)He could enroll
either in one of the MA plans that include prescription drug coverage or Original
EXAM COMPLETE QUESTIONS AND ANSWERS | 100%
RATED CORRECT | 100% VERFIED | ALREADY GRADED A+
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 entitled to Part A, enrolled in Part
B, and if he lives in the PFFS plan's service area.
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.
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? - (answer)Mrs. Chi may
enroll in a MA MSA plan and remain in her current standalone Part D prescription
drug plan.
Mr. Romero is 64, retiring soon, and considering enrollment in his employer-
sponsored retiree group health plan that includes drug coverage with nominal
copays. He heard about a neighbor's MA-PD plan that you represent and because he
takes numerous prescription drugs, he is considering signing up for it. What should
you tell him? - (answer)He should compare the benefits in his employer-sponsored
retiree group health plan with the benefits in his neighbor's MA-PD plan to
determine which one will provide sufficient coverage for his prescription needs.
Mr. Lombardi is interested in a Medicare Advantage (MA) PPO plan that you
represent. It is one of three plans operated by the same organization in Mr.
Lombardi's area. The MA PPO plan does not include drug coverage, but the other
two plans do. Mr. Lombardi likes the PPO plan that does not include drug coverage
and intends to obtain his drug coverage through a stand-alone Medicare prescription
drug plan. What should you tell him about this situation? - (answer)He could enroll
either in one of the MA plans that include prescription drug coverage or Original
