TESTBANK
AHIP Certification Study Pack | 100%
Verified Q&A with Correct Answers &
Explanations | Latest Update
Question: Agent John Miller is meeting with Jerry Smith, a new
prospect. Jerry is currently enrolled in Medicare Parts A and B
and has a Medigap plan with no drug benefits. What should
John advise?
Correct Answer: Jerry should consider adding a standalone
,Part D prescription drug coverage policy to his present
coverage.
Question: Ms. Moore will retire at age 65 and worries that her
income will make her ineligible for Medicare. What should you
tell her?
Correct Answer: Medicare is available to people age 65 and
older (and some under 65 with disabilities, ESRD, or ALS)
regardless of income.
Question: Mr. Capadona wants to buy both a Medicare
Advantage (MA) plan and a Medigap plan. How should you
respond?
Correct Answer: It is illegal to sell Medigap to someone in
an MA plan, and Medigap only works with Original Medicare.
Question: Mrs. Park is an elderly retiree with a low fixed
income. What should you advise?
Correct Answer: Contact her state Medicaid agency to see if
she qualifies for programs that help with Medicare costs.
1.
,A 68-year-old woman is newly eligible for Medicare and wants
to enroll in coverage that includes both medical and
prescription drug benefits. Which of the following options
meets her needs?
A. Original Medicare only
B. Medicare Part A with Medigap Plan A
C. Medicare Advantage (MA-PD) Plan
D. Medicaid
Answer: C. Medicare Advantage (MA-PD) Plan
Rationale: MA-PD plans bundle Medicare Part A, Part B, and
Part D, offering medical and prescription coverage. Original
Medicare does not include drug coverage.
2.
An agent is discussing Medicare Part D with a client. The client
asks when they will reach the coverage gap (donut hole).
What triggers entry into the coverage gap?
A. When their out-of-pocket costs reach $7,400
B. When total drug costs (plan + beneficiary) reach a set limit
C. At the start of the calendar year
D. After meeting the plan deductible only
Answer: B. When total drug costs (plan + beneficiary)
reach a set limit
, Rationale: The coverage gap begins when total drug spending
(not just out-of-pocket) exceeds a specific threshold determined
by CMS each year.
3.
Which of the following individuals is eligible for a Special
Enrollment Period (SEP)?
A. Someone turning 65 in six months
B. A beneficiary who moves outside their plan’s service area
C. A person who forgets to enroll during IEP
D. Anyone who wants to switch plans mid-year
Answer: B. A beneficiary who moves outside their plan’s
service area
Rationale: Moving out of a plan’s service area qualifies for a
SEP. General desires to switch do not qualify unless it's during
AEP.
4.
Which of the following is a compliant method for an agent to
market Medicare Advantage plans?
A. Door-to-door solicitation without appointment
B. Cold-calling leads from purchased list
AHIP Certification Study Pack | 100%
Verified Q&A with Correct Answers &
Explanations | Latest Update
Question: Agent John Miller is meeting with Jerry Smith, a new
prospect. Jerry is currently enrolled in Medicare Parts A and B
and has a Medigap plan with no drug benefits. What should
John advise?
Correct Answer: Jerry should consider adding a standalone
,Part D prescription drug coverage policy to his present
coverage.
Question: Ms. Moore will retire at age 65 and worries that her
income will make her ineligible for Medicare. What should you
tell her?
Correct Answer: Medicare is available to people age 65 and
older (and some under 65 with disabilities, ESRD, or ALS)
regardless of income.
Question: Mr. Capadona wants to buy both a Medicare
Advantage (MA) plan and a Medigap plan. How should you
respond?
Correct Answer: It is illegal to sell Medigap to someone in
an MA plan, and Medigap only works with Original Medicare.
Question: Mrs. Park is an elderly retiree with a low fixed
income. What should you advise?
Correct Answer: Contact her state Medicaid agency to see if
she qualifies for programs that help with Medicare costs.
1.
,A 68-year-old woman is newly eligible for Medicare and wants
to enroll in coverage that includes both medical and
prescription drug benefits. Which of the following options
meets her needs?
A. Original Medicare only
B. Medicare Part A with Medigap Plan A
C. Medicare Advantage (MA-PD) Plan
D. Medicaid
Answer: C. Medicare Advantage (MA-PD) Plan
Rationale: MA-PD plans bundle Medicare Part A, Part B, and
Part D, offering medical and prescription coverage. Original
Medicare does not include drug coverage.
2.
An agent is discussing Medicare Part D with a client. The client
asks when they will reach the coverage gap (donut hole).
What triggers entry into the coverage gap?
A. When their out-of-pocket costs reach $7,400
B. When total drug costs (plan + beneficiary) reach a set limit
C. At the start of the calendar year
D. After meeting the plan deductible only
Answer: B. When total drug costs (plan + beneficiary)
reach a set limit
, Rationale: The coverage gap begins when total drug spending
(not just out-of-pocket) exceeds a specific threshold determined
by CMS each year.
3.
Which of the following individuals is eligible for a Special
Enrollment Period (SEP)?
A. Someone turning 65 in six months
B. A beneficiary who moves outside their plan’s service area
C. A person who forgets to enroll during IEP
D. Anyone who wants to switch plans mid-year
Answer: B. A beneficiary who moves outside their plan’s
service area
Rationale: Moving out of a plan’s service area qualifies for a
SEP. General desires to switch do not qualify unless it's during
AEP.
4.
Which of the following is a compliant method for an agent to
market Medicare Advantage plans?
A. Door-to-door solicitation without appointment
B. Cold-calling leads from purchased list
