AHIP TRAINING Exam 2025/2026 Actual Complete Real Exam
Questions & Correct Well Elaborated Answers | 100% Verified
solutions / Already Verified Test | Already Graded A+ | 2025
Latest Exam!!
One of your clients, Lauren Nichols, has heard about a
Medicare concept from one of her neighbors called TrOOP. She
asks you to explain it. What do you say? - ANSWER-TrOOP
stands for true out-of-pocket costs that count toward the
Medicare Part D catastrophic limit and include not only
expenses paid by a beneficiary but also in some instances
amounts paid by or through qualified State Pharmaceutical
Assistance Programs.
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? - ANSWER-Part D enrollees can opt into the
Medicare Prescription Payment Plan at the beginning of the
plan year or any point during the year.
What types of tools can Medicare Part D prescription drug plans
use that affect
,the way their enrollees can access medications? - ANSWER-
Part D plans do
not have to cover all medications. As a result, their
formularies, or lists of
covered drugs, will vary from plan to plan. In addition, they can
use cost containment techniques such as tiered co-payments
and step therapy.
Who is most likely to benefit from the Medicare Prescription
Payment Plan? - ANSWER-Kevin, who suffered a heart attack at
the beginning of the year requiring him to take an expensive
brand name blood thinner on a daily, as well as an equally
expensive injectable cholesterol medication on a bi-weekly
basis for which he incurs high out-of-pocket costs.
Next week you will be participating in your first "educational
event" for prospective enrollees. To be sure that you do not
violate any of the applicable guidelines, in what activities
should you plan to engage? - ANSWER-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.
You will be holding a sales event soon, at which you would like
to offer door prizes to attendees. Under guidelines from the
,Medicare agency, what types of gifts or prizes would not be
allowed in this situation - ANSWER-Gift cards or gift certificates
of $15 or less that can be readily converted to cash.
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? - ANSWER-You must
have her sign a scope of appointment form, indicating which
products she wishes to discuss. You may then proceed with
the discussion.
If you are to comply with Medicare's guidance regarding
educational events, which of the following would be acceptable
activities? - ANSWER-You may distribute business cards to
individuals who request information on how to contact you for
further details on the plan(s) you represent.
When you market Medicare Advantage and Part D plans, what
may you offer as
a gift to induce enrollment in a plan? - ANSWER-You may
provide gifts or prizes
to all potential enrollees during an event that does not
exceed $15 in retail
value.
, You have set up an appointment for an in-home sales
presentation with Mrs. Fernandez, who expressed interest in
the Medicare plans you represent. In preparation for the sales
presentation, what must you do? - ANSWER-Before conducting
the presentation, obtain and document having obtained her
permission to visit, along with her interest in the specific
products you will present.
Mrs. Duarte is enrolled in Original Medicare Parts A and B. She
has recently reviewed her Medicare Summary Notice (MSN) and
disagrees with a determination that partially denied one of her
claims for services. What advice would you give her? -
ANSWER-Mrs. Duarte should file an appeal of this initial
determination within 120 days of the date she received the MSN
in the mail.
Mr. Davis is 52 years old and has recently been diagnosed with
end-stage renal disease (ESRD) and will soon begin dialysis.
He is wondering if he can obtain coverage under Medicare.
What should you tell him? - ANSWER-He may signup for
Medicare at any time however coverage usually begins on the
fourth month after dialysis treatments start.
Questions & Correct Well Elaborated Answers | 100% Verified
solutions / Already Verified Test | Already Graded A+ | 2025
Latest Exam!!
One of your clients, Lauren Nichols, has heard about a
Medicare concept from one of her neighbors called TrOOP. She
asks you to explain it. What do you say? - ANSWER-TrOOP
stands for true out-of-pocket costs that count toward the
Medicare Part D catastrophic limit and include not only
expenses paid by a beneficiary but also in some instances
amounts paid by or through qualified State Pharmaceutical
Assistance Programs.
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? - ANSWER-Part D enrollees can opt into the
Medicare Prescription Payment Plan at the beginning of the
plan year or any point during the year.
What types of tools can Medicare Part D prescription drug plans
use that affect
,the way their enrollees can access medications? - ANSWER-
Part D plans do
not have to cover all medications. As a result, their
formularies, or lists of
covered drugs, will vary from plan to plan. In addition, they can
use cost containment techniques such as tiered co-payments
and step therapy.
Who is most likely to benefit from the Medicare Prescription
Payment Plan? - ANSWER-Kevin, who suffered a heart attack at
the beginning of the year requiring him to take an expensive
brand name blood thinner on a daily, as well as an equally
expensive injectable cholesterol medication on a bi-weekly
basis for which he incurs high out-of-pocket costs.
Next week you will be participating in your first "educational
event" for prospective enrollees. To be sure that you do not
violate any of the applicable guidelines, in what activities
should you plan to engage? - ANSWER-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.
You will be holding a sales event soon, at which you would like
to offer door prizes to attendees. Under guidelines from the
,Medicare agency, what types of gifts or prizes would not be
allowed in this situation - ANSWER-Gift cards or gift certificates
of $15 or less that can be readily converted to cash.
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? - ANSWER-You must
have her sign a scope of appointment form, indicating which
products she wishes to discuss. You may then proceed with
the discussion.
If you are to comply with Medicare's guidance regarding
educational events, which of the following would be acceptable
activities? - ANSWER-You may distribute business cards to
individuals who request information on how to contact you for
further details on the plan(s) you represent.
When you market Medicare Advantage and Part D plans, what
may you offer as
a gift to induce enrollment in a plan? - ANSWER-You may
provide gifts or prizes
to all potential enrollees during an event that does not
exceed $15 in retail
value.
, You have set up an appointment for an in-home sales
presentation with Mrs. Fernandez, who expressed interest in
the Medicare plans you represent. In preparation for the sales
presentation, what must you do? - ANSWER-Before conducting
the presentation, obtain and document having obtained her
permission to visit, along with her interest in the specific
products you will present.
Mrs. Duarte is enrolled in Original Medicare Parts A and B. She
has recently reviewed her Medicare Summary Notice (MSN) and
disagrees with a determination that partially denied one of her
claims for services. What advice would you give her? -
ANSWER-Mrs. Duarte should file an appeal of this initial
determination within 120 days of the date she received the MSN
in the mail.
Mr. Davis is 52 years old and has recently been diagnosed with
end-stage renal disease (ESRD) and will soon begin dialysis.
He is wondering if he can obtain coverage under Medicare.
What should you tell him? - ANSWER-He may signup for
Medicare at any time however coverage usually begins on the
fourth month after dialysis treatments start.
