AHIP FINAL EXAM 2026-2027 LATEST VERSION QUESTIONS
AND VERIFIED CORRECT ANSWERS JUST RELEASED
Which of the following individuals is most likely to be eligible to enroll in a Part D Plan? -
answer>>>Jose, a grandfather who was granted asylum and has worked in the United
States for many years.
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? - answer>>>If a Part D benefit is offered through her plan she may choose to
enroll in that plan or a standalone PDP.
Mr. Schultz was still working when he first qualified for Medicare. At that time, he had
employer group coverage that was creditable. During his initial Part D eligibility period, he
decided not to enroll because he was satisfied with his drug coverage. It is now a year
later and Mr. Schultz has lost his employer group coverage within the last two weeks.
How would you advise him? - answer>>>Mr. Schultz should enroll in a Part D plan before
he has a 63-day break in coverage in order to avoid a premium penalty.
Mr. Hutchinson has drug coverage through his former employer's retiree plan. He is
concerned about the Part D premium penalty if he does not enroll in a Medicare
prescription drug plan, but does not want to purchase extra coverage that he will not
need. What should you tell him? - answer>>>If the drug coverage he has is not expected
to pay, on average, at least as much as Medicare's standard Part D coverage expects to
pay, then he will need to enroll in Medicare Part D during his initial eligibility period to
avoid the late enrollment penalty.
Mr. Jacob understands that there is a standard Medicare Part D prescription drug benefit,
but when he looks at information on various plans available in his area, he sees a wide
range in what they charge for deductibles, premiums, and cost sharing. How can you
explain this to him? - answer>>>Medicare Part D drug plans may have different benefit
structures, but on average, they must all be at least as good as the standard model
established by the government.
,-
Mrs. Roberts has Original Medicare and would like to enroll in a Private Fee-for-Service
(PFFS) plan. All types of PFFS plans are available in her area. Which options could Mrs.
Roberts consider before selecting a PFFS plan? - answer>>>A Medicare Advantage
Prescription Drug (MA-PD) PFFS plan that combines medical benefits and Part D
prescription drug coverage, a PFFS plan offering only medical benefits, or a PFFS plan in
combination with a stand-alone prescription drug plan.
Mrs. Berkowitz wants to enroll in a Medicare Advantage plan that does not include drug
coverage and also enroll in a stand-alone Medicare prescription drug plan. Under what
circumstances can she do this? - answer>>>If the Medicare Advantage plan is a Private
Fee-for-Service (PFFS) plan that does not offer drug coverage or a Medical Savings
Account plan, Mrs. Berkowitz can do this.
Mrs. McIntire is enrolled in her state's Medicaid plan and has just become eligible for
Medicare as well. What can she expect will happen to her drug coverage? -
answer>>>Unless she chooses a Medicare Part D prescription drug plan on her own, she
will be automatically enrolled in one available in her area.
Mrs. Cantwell is enrolled in a prescription drug plan. She has heard about something
called True-Out-Pocket costs or "TrOOP" and asks you if any of the following count toward
reaching the catastrophic coverage phase. What do you say? - answer>>>Her annual PDP
deductible, A drug manufacturer's discount for brand name drugs after her initial
coverage period
Mr. Carlini has heard that Medicare prescription drug plans are only offered through
private companies under a program known as Medicare Advantage (MA), not by the
government. He likes Original Medicare and does not want to sign up for an MA product,
but he also wants prescription drug coverage. What should you tell him? - answer>>>Mr.
Carlini can stay with Original Medicare and also enroll in a Medicare prescription drug
plan through a private company that has contracted with the government to provide only
such drug coverage to eligible Medicare beneficiaries.
, Mrs. Imelda Diaz is a Medicare beneficiary enrolled in a MA-PD plan you represent. Her
neighbor recently suffered from a painful case of shingles. Mrs. Diaz hopes to avoid such
an illness through vaccination. She asks you whether the cost of shingles vaccination will
be covered under the plan you represent. What should you say? - answer>>>Yes, there is
no cost sharing for the shingles vaccine even in the deductible phase of her prescription
drug plan because it is an adult vaccine recommended by the Advisory Committee on
Immunization Practices (AICP).
Which of the following statements about Medicare Part D are correct? - answer>>>Part D
plans must enroll any eligible beneficiary who applies regardless of health status except in
limited circumstances. Private fee-for-service (PFFS) plans are not required to use a
pharmacy network but may choose to have one.Beneficiaries enrolled in a MA-Medical
Savings Account (MSA) plan may only obtain Part D benefits through a standalone PDP.
Mrs. Fiore is a retired federal worker with coverage under a Federal Employee Health
Benefits (FEHB) plan that includes creditable drug coverage. She is ready to turn 65 and
become Medicare eligible for the first time. What issues might she consider about
whether to enroll in a Medicare prescription drug plan? - answer>>>She could compare
the coverage to see if the Medicare Part D plan offers better benefits and coverage than
the FEHB plan for the specific medications she needs and whether any additional benefits
are worth the Part D premium costs on top of her FEHB contribution.
Mr. Shapiro gets by on a very small amount of fixed income. He has heard there may be
extra help paying for Part D prescription drugs for Medicare beneficiaries with limited
income. He wants to know whether he might qualify. What should you tell him? -
answer>>>The extra help is available to beneficiaries whose income and assets do not
exceed annual limits specified by the government.
Wendy Park becomes eligible for Medicare for the first time in July. With the help of
Agent James Chan, she enrolls in FeelBetter Medicare Advantage plan with an effective
date of July 1st. Which statement best describes how Agent Chan may be compensated
under CMS rules? - answer>>>FeelBetter will pay Agent Chan initial year compensation
AND VERIFIED CORRECT ANSWERS JUST RELEASED
Which of the following individuals is most likely to be eligible to enroll in a Part D Plan? -
answer>>>Jose, a grandfather who was granted asylum and has worked in the United
States for many years.
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? - answer>>>If a Part D benefit is offered through her plan she may choose to
enroll in that plan or a standalone PDP.
Mr. Schultz was still working when he first qualified for Medicare. At that time, he had
employer group coverage that was creditable. During his initial Part D eligibility period, he
decided not to enroll because he was satisfied with his drug coverage. It is now a year
later and Mr. Schultz has lost his employer group coverage within the last two weeks.
How would you advise him? - answer>>>Mr. Schultz should enroll in a Part D plan before
he has a 63-day break in coverage in order to avoid a premium penalty.
Mr. Hutchinson has drug coverage through his former employer's retiree plan. He is
concerned about the Part D premium penalty if he does not enroll in a Medicare
prescription drug plan, but does not want to purchase extra coverage that he will not
need. What should you tell him? - answer>>>If the drug coverage he has is not expected
to pay, on average, at least as much as Medicare's standard Part D coverage expects to
pay, then he will need to enroll in Medicare Part D during his initial eligibility period to
avoid the late enrollment penalty.
Mr. Jacob understands that there is a standard Medicare Part D prescription drug benefit,
but when he looks at information on various plans available in his area, he sees a wide
range in what they charge for deductibles, premiums, and cost sharing. How can you
explain this to him? - answer>>>Medicare Part D drug plans may have different benefit
structures, but on average, they must all be at least as good as the standard model
established by the government.
,-
Mrs. Roberts has Original Medicare and would like to enroll in a Private Fee-for-Service
(PFFS) plan. All types of PFFS plans are available in her area. Which options could Mrs.
Roberts consider before selecting a PFFS plan? - answer>>>A Medicare Advantage
Prescription Drug (MA-PD) PFFS plan that combines medical benefits and Part D
prescription drug coverage, a PFFS plan offering only medical benefits, or a PFFS plan in
combination with a stand-alone prescription drug plan.
Mrs. Berkowitz wants to enroll in a Medicare Advantage plan that does not include drug
coverage and also enroll in a stand-alone Medicare prescription drug plan. Under what
circumstances can she do this? - answer>>>If the Medicare Advantage plan is a Private
Fee-for-Service (PFFS) plan that does not offer drug coverage or a Medical Savings
Account plan, Mrs. Berkowitz can do this.
Mrs. McIntire is enrolled in her state's Medicaid plan and has just become eligible for
Medicare as well. What can she expect will happen to her drug coverage? -
answer>>>Unless she chooses a Medicare Part D prescription drug plan on her own, she
will be automatically enrolled in one available in her area.
Mrs. Cantwell is enrolled in a prescription drug plan. She has heard about something
called True-Out-Pocket costs or "TrOOP" and asks you if any of the following count toward
reaching the catastrophic coverage phase. What do you say? - answer>>>Her annual PDP
deductible, A drug manufacturer's discount for brand name drugs after her initial
coverage period
Mr. Carlini has heard that Medicare prescription drug plans are only offered through
private companies under a program known as Medicare Advantage (MA), not by the
government. He likes Original Medicare and does not want to sign up for an MA product,
but he also wants prescription drug coverage. What should you tell him? - answer>>>Mr.
Carlini can stay with Original Medicare and also enroll in a Medicare prescription drug
plan through a private company that has contracted with the government to provide only
such drug coverage to eligible Medicare beneficiaries.
, Mrs. Imelda Diaz is a Medicare beneficiary enrolled in a MA-PD plan you represent. Her
neighbor recently suffered from a painful case of shingles. Mrs. Diaz hopes to avoid such
an illness through vaccination. She asks you whether the cost of shingles vaccination will
be covered under the plan you represent. What should you say? - answer>>>Yes, there is
no cost sharing for the shingles vaccine even in the deductible phase of her prescription
drug plan because it is an adult vaccine recommended by the Advisory Committee on
Immunization Practices (AICP).
Which of the following statements about Medicare Part D are correct? - answer>>>Part D
plans must enroll any eligible beneficiary who applies regardless of health status except in
limited circumstances. Private fee-for-service (PFFS) plans are not required to use a
pharmacy network but may choose to have one.Beneficiaries enrolled in a MA-Medical
Savings Account (MSA) plan may only obtain Part D benefits through a standalone PDP.
Mrs. Fiore is a retired federal worker with coverage under a Federal Employee Health
Benefits (FEHB) plan that includes creditable drug coverage. She is ready to turn 65 and
become Medicare eligible for the first time. What issues might she consider about
whether to enroll in a Medicare prescription drug plan? - answer>>>She could compare
the coverage to see if the Medicare Part D plan offers better benefits and coverage than
the FEHB plan for the specific medications she needs and whether any additional benefits
are worth the Part D premium costs on top of her FEHB contribution.
Mr. Shapiro gets by on a very small amount of fixed income. He has heard there may be
extra help paying for Part D prescription drugs for Medicare beneficiaries with limited
income. He wants to know whether he might qualify. What should you tell him? -
answer>>>The extra help is available to beneficiaries whose income and assets do not
exceed annual limits specified by the government.
Wendy Park becomes eligible for Medicare for the first time in July. With the help of
Agent James Chan, she enrolls in FeelBetter Medicare Advantage plan with an effective
date of July 1st. Which statement best describes how Agent Chan may be compensated
under CMS rules? - answer>>>FeelBetter will pay Agent Chan initial year compensation
