AHIP Practice Exam [ACTUAL EXAM] LATEST VERSION
[QUESTIONS AND ANSWERS] WITH PRACTICE EXAM
DETAILED AND VERIFIED FOR GUARANTEED PASS- LATEST
UPDATE 2025 GRADED A
Mrs. Pena is 66 years old, has coverage under an employer plan and will retire next
year. She heard she must enroll in Part B at the beginning of the year to ensure no gap
in coverage. What can you tell her? - CORRECT ANSWER She may enroll at any
time while she is covered under her employer plan, but she will have a special eight-
month enrollment period that differs from the standard general enrollment period, during
which she may enroll in Medicare Part B
Mr. Bickford did not quite qualify for the extra help low-income subsidy under the
Medicare Part D Prescription Drug program and he is wondering if there is any other
option he has for obtaining help with his considerable drug costs. What should you tell
him? - CORRECT ANSWER He could check with the manufacturers of his
medications to see if they offer an assistance program to help people with limited
means obtain the medications they need. Alternatively, he could check to see whether
his state has a pharmacy assistance program to help him with his expenses.
Alice is a marketing representative employed by a health plan. Betty is a captive agent
of a health plan who markets to multiple plans and sponsors. Carl is a captive agent
who markets to only one plan/sponsor. Denise is an independent agent who markets to
different types of groups. Edward is an independent agent who markets only to
employer and union groups. CMS marketing representative compensation rules
generally apply to: - CORRECT ANSWER Betty and Denise, but not Alice (the
employee) or Carl or Edward (to whom exceptions apply).
Mrs. Valentino is currently enrolled in a Medicare Cost plan. This plan is no longer
meeting her needs, but it is now mid-year and past the annual election period (AEP).
What would you say to Mrs. Valentino regarding her options? - CORRECT ANSWER
Mrs. Valentino can submit a written request to Medicare to be disenrolled from the Cost
plan and enroll in Original Medicare.
When Myra first became eligible for Medicare, she enrolled in Original Medicare (Parts
A and B). She is now 67 and will turn 68 on July 1. She would now like to enroll in a
Medicare Advantage (MA) plan and approaches you about her options. What advice
would you give her? - CORRECT ANSWER She should remain in Original Medicare
until the annual election period running from October 15 to December 7, during which
she can select an MA plan.
Mrs. Tanner is enrolled in a Medicare Advantage HMO that offers a point of service
options. This allows Mrs. Tanner to do which of the following? - CORRECT ANSWER
, Mrs. Tanner can go to non-plan doctors for certain services without receiving prior
approval
Agent Harriet Walker has recently begun marketing Medicare Advantage and related
products aimed at meeting the needs of senior citizens. Client Mildred Jones has
expressed interest in a Medicare Advantage plan. It is now the beginning of September.
If you were in Agent Walker's position, what would you do? - CORRECT ANSWER
Inquire whether the client qualifies for a special enrollment period, and if not, solicit an
enrollment application once the annual open enrollment election period begins on
October 15th.
Mrs. Chen will be 65 soon, has been a citizen for twelve years, has been employed full
time, and paid taxes during that entire period. She is concerned that she will not qualify
for coverage under part A because she was not born in the United States. What should
you tell her? - CORRECT ANSWER Most individuals who are citizens and over age
65 are covered under Part A by virtue of having paid Medicare taxes while working,
though some may be covered as a result of paying monthly premiums.
Mr. Katz reached the Part D coverage gap in August last year. His prescriptions have
not been changed, he is keeping the same Part D plan and the benefits, cost-sharing,
and coverage of his drugs are all the same as last year. He asked what to expect for
this year about his out-of-pocket costs. What could you tell him? - CORRECT
ANSWER Because he reached the coverage gap last year, he will probably reah it
again this year close to the same time.
ABC is a Medicare Advantage (MA) plan sponsor. It would like to use its enrollees'
protected health information to market non-health related products such as life
insurance and annuities. To do so it must obtain authorization from the enrollees. Which
statement best describes the authorization process? - CORRECT ANSWER
Authorization may be obtained by directing a beneficiary to a website to provide consent
Mrs. Henderson believes that she will qualify for Medicare coverage when she turns 65,
without paying any premiums, because she has been working for 40 years and paying
Medicare taxes. What should you tell her? - CORRECT ANSWER In order to obtain
Part B coverage, she must pay a standard monthly premium, though it is higher for
individuals with higher incomes.
Mr. Buck has several family members who died from different cancers. He wants to
know if Medicare covers cancer screening. What should you tell him? - CORRECT
ANSWER Medicare covers periodic performance of a range of screening tests that
are meant to provide early detection of disease. Mr. Buck will need to check specific
tests before obtaining them to see if they will be covered.
Ms. Moore plans to retire when she turns 65 in a few months. She is in excellent health
and will have considerable income when she retires. She is concerned that her income
will make it impossible for her to qualify for Medicare. What oculd you tell her to address
[QUESTIONS AND ANSWERS] WITH PRACTICE EXAM
DETAILED AND VERIFIED FOR GUARANTEED PASS- LATEST
UPDATE 2025 GRADED A
Mrs. Pena is 66 years old, has coverage under an employer plan and will retire next
year. She heard she must enroll in Part B at the beginning of the year to ensure no gap
in coverage. What can you tell her? - CORRECT ANSWER She may enroll at any
time while she is covered under her employer plan, but she will have a special eight-
month enrollment period that differs from the standard general enrollment period, during
which she may enroll in Medicare Part B
Mr. Bickford did not quite qualify for the extra help low-income subsidy under the
Medicare Part D Prescription Drug program and he is wondering if there is any other
option he has for obtaining help with his considerable drug costs. What should you tell
him? - CORRECT ANSWER He could check with the manufacturers of his
medications to see if they offer an assistance program to help people with limited
means obtain the medications they need. Alternatively, he could check to see whether
his state has a pharmacy assistance program to help him with his expenses.
Alice is a marketing representative employed by a health plan. Betty is a captive agent
of a health plan who markets to multiple plans and sponsors. Carl is a captive agent
who markets to only one plan/sponsor. Denise is an independent agent who markets to
different types of groups. Edward is an independent agent who markets only to
employer and union groups. CMS marketing representative compensation rules
generally apply to: - CORRECT ANSWER Betty and Denise, but not Alice (the
employee) or Carl or Edward (to whom exceptions apply).
Mrs. Valentino is currently enrolled in a Medicare Cost plan. This plan is no longer
meeting her needs, but it is now mid-year and past the annual election period (AEP).
What would you say to Mrs. Valentino regarding her options? - CORRECT ANSWER
Mrs. Valentino can submit a written request to Medicare to be disenrolled from the Cost
plan and enroll in Original Medicare.
When Myra first became eligible for Medicare, she enrolled in Original Medicare (Parts
A and B). She is now 67 and will turn 68 on July 1. She would now like to enroll in a
Medicare Advantage (MA) plan and approaches you about her options. What advice
would you give her? - CORRECT ANSWER She should remain in Original Medicare
until the annual election period running from October 15 to December 7, during which
she can select an MA plan.
Mrs. Tanner is enrolled in a Medicare Advantage HMO that offers a point of service
options. This allows Mrs. Tanner to do which of the following? - CORRECT ANSWER
, Mrs. Tanner can go to non-plan doctors for certain services without receiving prior
approval
Agent Harriet Walker has recently begun marketing Medicare Advantage and related
products aimed at meeting the needs of senior citizens. Client Mildred Jones has
expressed interest in a Medicare Advantage plan. It is now the beginning of September.
If you were in Agent Walker's position, what would you do? - CORRECT ANSWER
Inquire whether the client qualifies for a special enrollment period, and if not, solicit an
enrollment application once the annual open enrollment election period begins on
October 15th.
Mrs. Chen will be 65 soon, has been a citizen for twelve years, has been employed full
time, and paid taxes during that entire period. She is concerned that she will not qualify
for coverage under part A because she was not born in the United States. What should
you tell her? - CORRECT ANSWER Most individuals who are citizens and over age
65 are covered under Part A by virtue of having paid Medicare taxes while working,
though some may be covered as a result of paying monthly premiums.
Mr. Katz reached the Part D coverage gap in August last year. His prescriptions have
not been changed, he is keeping the same Part D plan and the benefits, cost-sharing,
and coverage of his drugs are all the same as last year. He asked what to expect for
this year about his out-of-pocket costs. What could you tell him? - CORRECT
ANSWER Because he reached the coverage gap last year, he will probably reah it
again this year close to the same time.
ABC is a Medicare Advantage (MA) plan sponsor. It would like to use its enrollees'
protected health information to market non-health related products such as life
insurance and annuities. To do so it must obtain authorization from the enrollees. Which
statement best describes the authorization process? - CORRECT ANSWER
Authorization may be obtained by directing a beneficiary to a website to provide consent
Mrs. Henderson believes that she will qualify for Medicare coverage when she turns 65,
without paying any premiums, because she has been working for 40 years and paying
Medicare taxes. What should you tell her? - CORRECT ANSWER In order to obtain
Part B coverage, she must pay a standard monthly premium, though it is higher for
individuals with higher incomes.
Mr. Buck has several family members who died from different cancers. He wants to
know if Medicare covers cancer screening. What should you tell him? - CORRECT
ANSWER Medicare covers periodic performance of a range of screening tests that
are meant to provide early detection of disease. Mr. Buck will need to check specific
tests before obtaining them to see if they will be covered.
Ms. Moore plans to retire when she turns 65 in a few months. She is in excellent health
and will have considerable income when she retires. She is concerned that her income
will make it impossible for her to qualify for Medicare. What oculd you tell her to address
