2026 AHIP Flashcards for Final Test
2026Study
AHIP Flashcards for Final Test
online at https://quizlet.com/_hidikz
1. Mr. Wendt suffers from diabetes which has gotten pro- If there is a special needs
gressively worseduring the last year. He is currently plan (SNP) in Mr. Wendt's
enrolled in Original Medicare (PartsA and B) and a area that specializes in
Part D prescription drug plan and did not enroll in caring for individuals with
aMedicare Advantage (MA) plan during the last annual diabetes, he may enroll in
open enrollmentperiod (AEP) which has just closed. Mr. the SNP at any time under
Wendt has heard certain MAplans might provide him a special election period
with more specialized coverage for hisdiabetes and (SEP).
wants to know if he must wait until the next annual
open. enrollment period (AEP) before enrolling in such
a plan. What should
you tell him?
2. During a sales presentation to Ms. Daley for a Medicare The Medicare Advantage
Advantage plan received a 5-star rat-
plan that has a 5-star rating in customer service and ing in customer service
care coordination and received an overall plan perfor- and
mance rating of a 4-star, which of care coordination with an
the following would be the best statement to say to overall performance rating
her? of 4 stars.
3. Mrs. Hernandez is one of your clients. She has read Part D enrollees can opt
that there is a new program that may help her manage into the Medicare Pre-
prescription drug costs. What do you tell her about the scription Payment Plan at
Medicare Prescription Payment Plan? the beginning of the plan
year or any point during
the year
4. Mr. Wingate is a newly enrolled Medicare Part D bene- None of the costs of
ficiary and one Mr. Wingate's other med-
of your clients. In addition to drugs on his plan's for- ications would currently
mulary, he takes count toward TrOOP but
1/7
, 2026 AHIP Flashcards for Final Test
2026Study
AHIP Flashcards for Final Test
online at https://quizlet.com/_hidikz
several other medications. These include a prescrip- he may wish to ask his plan
tion drug not on his plan's formulary, over-the-counter for an exception to cover
medications for colds and allergies,vitamins, and the prescription, not on its
drugs from an Internet-based Canadian pharmacy formulary.
to promote hair growth and reduce joint swelling.
His neighbor recentlytold him about a concept called
TrOOP and he asks you if any of his other medications
could count toward TrOOP should he ever reach the
Part D catastrophic limit. What should you say.
5. Mr. Liu turns 65 on June 19. He has never previously He can enroll in a MA-PD
qualified for as long as he enrolls in
Medicare so his first Medicare eligibility date will be Part B and is entitled to
June 1. Mr. Liu's Part A.
ICEP and Part D IEP begin on March 1 and end on
September 30. He
wants prescription drug coverage with his Part A and
Part B benefits.
What advice can you provide him?
6. Mr. Hildalgo complains to you that because he takes The Medicare Prescrip-
multiple tion Payment Plan helps
expensive drugs, he has trouble paying his cost shar- spread out beneficiary
ing for his costsharing payments but
prescription drugs, particularly at the beginning of the does not decrease the to-
year during the deductible phase. He is happy with his tal amount owed.
plan and does not want to
change. However, he said he had heard about a new
program called
the Medicare Prescription Payment Plan and asked
whether it might
help. What do you tell him?
2/7
2026Study
AHIP Flashcards for Final Test
online at https://quizlet.com/_hidikz
1. Mr. Wendt suffers from diabetes which has gotten pro- If there is a special needs
gressively worseduring the last year. He is currently plan (SNP) in Mr. Wendt's
enrolled in Original Medicare (PartsA and B) and a area that specializes in
Part D prescription drug plan and did not enroll in caring for individuals with
aMedicare Advantage (MA) plan during the last annual diabetes, he may enroll in
open enrollmentperiod (AEP) which has just closed. Mr. the SNP at any time under
Wendt has heard certain MAplans might provide him a special election period
with more specialized coverage for hisdiabetes and (SEP).
wants to know if he must wait until the next annual
open. enrollment period (AEP) before enrolling in such
a plan. What should
you tell him?
2. During a sales presentation to Ms. Daley for a Medicare The Medicare Advantage
Advantage plan received a 5-star rat-
plan that has a 5-star rating in customer service and ing in customer service
care coordination and received an overall plan perfor- and
mance rating of a 4-star, which of care coordination with an
the following would be the best statement to say to overall performance rating
her? of 4 stars.
3. Mrs. Hernandez is one of your clients. She has read Part D enrollees can opt
that there is a new program that may help her manage into the Medicare Pre-
prescription drug costs. What do you tell her about the scription Payment Plan at
Medicare Prescription Payment Plan? the beginning of the plan
year or any point during
the year
4. Mr. Wingate is a newly enrolled Medicare Part D bene- None of the costs of
ficiary and one Mr. Wingate's other med-
of your clients. In addition to drugs on his plan's for- ications would currently
mulary, he takes count toward TrOOP but
1/7
, 2026 AHIP Flashcards for Final Test
2026Study
AHIP Flashcards for Final Test
online at https://quizlet.com/_hidikz
several other medications. These include a prescrip- he may wish to ask his plan
tion drug not on his plan's formulary, over-the-counter for an exception to cover
medications for colds and allergies,vitamins, and the prescription, not on its
drugs from an Internet-based Canadian pharmacy formulary.
to promote hair growth and reduce joint swelling.
His neighbor recentlytold him about a concept called
TrOOP and he asks you if any of his other medications
could count toward TrOOP should he ever reach the
Part D catastrophic limit. What should you say.
5. Mr. Liu turns 65 on June 19. He has never previously He can enroll in a MA-PD
qualified for as long as he enrolls in
Medicare so his first Medicare eligibility date will be Part B and is entitled to
June 1. Mr. Liu's Part A.
ICEP and Part D IEP begin on March 1 and end on
September 30. He
wants prescription drug coverage with his Part A and
Part B benefits.
What advice can you provide him?
6. Mr. Hildalgo complains to you that because he takes The Medicare Prescrip-
multiple tion Payment Plan helps
expensive drugs, he has trouble paying his cost shar- spread out beneficiary
ing for his costsharing payments but
prescription drugs, particularly at the beginning of the does not decrease the to-
year during the deductible phase. He is happy with his tal amount owed.
plan and does not want to
change. However, he said he had heard about a new
program called
the Medicare Prescription Payment Plan and asked
whether it might
help. What do you tell him?
2/7
