AHIP Final Exam 2025/2026 ACTUAL COMPLETE REAL EXAM
QUESTIONS AND VERIFIED SOLUTIONS | CORRECT
ELABORATED &DETAILED ANSWERS!! ALREADY
GRADED A+ / 2025 BRAND NEW EXAM!!
Mr. Zachow has a right to request a formulary exception to
obtain coverage for his Part D drug. He or his physician could
obtain the standardized request form on the plan's website, fill
it out, and submit it to his plan. - ANSWER-Mr. Zachow has a
condition for which three drugs are available. He has tried two
but had an allergic reaction to them. Only the third drug works
for him and it is not on his Part D plan's formulary. What could
you tell him to do?
If a Part D benefit is offered through her plan she may choose
to enroll in that plan or a standalone PDP. - ANSWER-Mrs.
Lopez is enrolled in a cost plan for her Medicare benefits. She
has recently lost creditable coverage previously available
through her husband's employer. She is interested in enrolling
in a Medicare Part D prescription drug plan (PDP). What should
you tell her?
,Part D enrollees can opt into the Medicare Prescription
Payment Plan at the beginning of the plan year or any point
during the year. - ANSWER-Mrs. Hernandez is one of your
clients. She has read that there is a new program that may help
her manage prescription drug costs. What do you tell her about
the Medicare Prescription Payment Plan?
She may fill prescriptions for covered drugs at non-network
pharmacies, but
likely at a higher cost than paid at an in-network pharmacy. -
ANSWER-Ms.
Edwards is enrolled in a Medicare Advantage plan that
includes prescription
drug plan (PDP) coverage. She is traveling and wishes to
fill two of the
prescriptions that she has lost. How would you
advise her?
The Medicare Advantage plan received a 5-star rating in
customer service and care coordination with an overall
performance rating of 4 stars. – ANSWER-During a sales
presentation to Ms. Daley for a Medicare Advantage plan that
has a 5-star rating in customer service and care coordination,
and received an overall plan performance rating of a 4-star,
which of the following would be the best statement to say to
her?
,You must have her sign a scope of appointment form,
indicating which products she wishes to discuss. You may then
proceed with the discussion. – ANSWER-A Medicare
beneficiary has walked into your office and requested that you
sit down with her and discuss her options under the Medicare
Advantage program. Before engaging in such a discussion,
what should you do?
You can present only health care related lines of business but
must obtain the beneficiary's permission to do so before the
presentation occurs and document that you have obtained that
permission. - ANSWER-While making an appointment to
discuss Medicare Advantage (MA) and Part D plans with a
potential enrollee, you are asked to describe other types of
insurance products that your client might wish to purchase.
What additional types of insurance can you present during the
MA and Part D marketing appointments?
This could be considered discriminatory activity and a
prohibited practice. - ANSWER-One of your colleagues argues
that it is better to focus your time and energy exclusively on
neighborhoods with single-family homes. He further argues
that their older owners are more likely to have higher incomes
and purchase the Medicare Advantage products you represent
, compared to those living in apartment complexes. How should
you respond?
Yes. When an event has been advertised as "educational,"
discussing planspecific premiums is impermissible. -
ANSWER-Agent Jennings makes a presentation on Medicare
advertised as an educational event. Agent Jennings distributes
materials that are solely educational. However, she gives a brief
presentation that mentions plan-specific premiums. Is this a
prohibited activity at an event that has been advertised as
educational?
Medicare Advantage (MA) and Prescription Drug (PDP) plans. -
ANSWER-Mr.
Prentice has many clients who are Medicare beneficiaries. He
should review the
Centers for Medicare & Medicaid Services (CMS)
Communication and
Marketing Guidelines to ensure he is compliant with which
type of products.
You should plan to ensure that the educational event is
informative and must not conduct a sales presentation or
distribute or accept enrollment forms at the event. - ANSWER-
Next week you will be participating in your first "educational
QUESTIONS AND VERIFIED SOLUTIONS | CORRECT
ELABORATED &DETAILED ANSWERS!! ALREADY
GRADED A+ / 2025 BRAND NEW EXAM!!
Mr. Zachow has a right to request a formulary exception to
obtain coverage for his Part D drug. He or his physician could
obtain the standardized request form on the plan's website, fill
it out, and submit it to his plan. - ANSWER-Mr. Zachow has a
condition for which three drugs are available. He has tried two
but had an allergic reaction to them. Only the third drug works
for him and it is not on his Part D plan's formulary. What could
you tell him to do?
If a Part D benefit is offered through her plan she may choose
to enroll in that plan or a standalone PDP. - ANSWER-Mrs.
Lopez is enrolled in a cost plan for her Medicare benefits. She
has recently lost creditable coverage previously available
through her husband's employer. She is interested in enrolling
in a Medicare Part D prescription drug plan (PDP). What should
you tell her?
,Part D enrollees can opt into the Medicare Prescription
Payment Plan at the beginning of the plan year or any point
during the year. - ANSWER-Mrs. Hernandez is one of your
clients. She has read that there is a new program that may help
her manage prescription drug costs. What do you tell her about
the Medicare Prescription Payment Plan?
She may fill prescriptions for covered drugs at non-network
pharmacies, but
likely at a higher cost than paid at an in-network pharmacy. -
ANSWER-Ms.
Edwards is enrolled in a Medicare Advantage plan that
includes prescription
drug plan (PDP) coverage. She is traveling and wishes to
fill two of the
prescriptions that she has lost. How would you
advise her?
The Medicare Advantage plan received a 5-star rating in
customer service and care coordination with an overall
performance rating of 4 stars. – ANSWER-During a sales
presentation to Ms. Daley for a Medicare Advantage plan that
has a 5-star rating in customer service and care coordination,
and received an overall plan performance rating of a 4-star,
which of the following would be the best statement to say to
her?
,You must have her sign a scope of appointment form,
indicating which products she wishes to discuss. You may then
proceed with the discussion. – ANSWER-A Medicare
beneficiary has walked into your office and requested that you
sit down with her and discuss her options under the Medicare
Advantage program. Before engaging in such a discussion,
what should you do?
You can present only health care related lines of business but
must obtain the beneficiary's permission to do so before the
presentation occurs and document that you have obtained that
permission. - ANSWER-While making an appointment to
discuss Medicare Advantage (MA) and Part D plans with a
potential enrollee, you are asked to describe other types of
insurance products that your client might wish to purchase.
What additional types of insurance can you present during the
MA and Part D marketing appointments?
This could be considered discriminatory activity and a
prohibited practice. - ANSWER-One of your colleagues argues
that it is better to focus your time and energy exclusively on
neighborhoods with single-family homes. He further argues
that their older owners are more likely to have higher incomes
and purchase the Medicare Advantage products you represent
, compared to those living in apartment complexes. How should
you respond?
Yes. When an event has been advertised as "educational,"
discussing planspecific premiums is impermissible. -
ANSWER-Agent Jennings makes a presentation on Medicare
advertised as an educational event. Agent Jennings distributes
materials that are solely educational. However, she gives a brief
presentation that mentions plan-specific premiums. Is this a
prohibited activity at an event that has been advertised as
educational?
Medicare Advantage (MA) and Prescription Drug (PDP) plans. -
ANSWER-Mr.
Prentice has many clients who are Medicare beneficiaries. He
should review the
Centers for Medicare & Medicaid Services (CMS)
Communication and
Marketing Guidelines to ensure he is compliant with which
type of products.
You should plan to ensure that the educational event is
informative and must not conduct a sales presentation or
distribute or accept enrollment forms at the event. - ANSWER-
Next week you will be participating in your first "educational
