2025 AHIP FINAL EXAM : 100+ FREQUENTLY
TESTED QUESTION & 100% VERIFIED
ANSWERS/ GRADED A+ / GUARANTEED PASS!!
1. 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.
2. Agent Harriet Walker has recently begun marketing Medicare Advantage
and related products aimed at meeting the needs of senior citizens. Client
Mildred Jones has expressed interest in a Medicare Advantage plan. It is
now the beginning of September. If you were in Agent Walker's position,
what would you do?
- answer-Inquire whether the client qualifies for a special enrollment period,
and if not, solicit an enrollment application once the annual open enrollment
election period begins on October 15th.
3. 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?
- answer-Yes. When an event has been advertised as "educational,"
discussing plan-specific premiums is impermissible.
4. Alice is enrolled in a MA-PD plan. She makes a permanent move across the
country and wonders what her options are for continuing MA-PD coverage.
What would you say to her in regard to a special enrollment period (SEP)?
- answer-She is likely to qualify for a SEP. She can choose an effective date
of up to three months after the month in which the enrollment form is
received by the new plan, but the effective date may not be earlier than the
date of her permanent move.
,5. Anita Magri will turn age 65 in August 2023. Anita intends to enroll in
Original Medicare Part A and Part B. She would also like to enroll in a
Medicare Supplement (Medigap) plan. Anita's older neighbor Mel has told
her about the Medigap Plan F in which he is enrolled. It not only provides
foreign travel emergency benefits but also covers his Medicare Part B
deductible. Anita comes to you for advice. What should you tell her?
- answer-You are sorry to disappoint Anita, but a Medigap F plan is no
longer available to those who turn age 65 after January 1, 2020. Anita might
instead consider other Medigap plans that offer foreign travel benefits but do
not cover the Part B deductible.
6. By contacting plans available in your area, you have learned that the plan
you represent has a significantly lower monthly premium than the others.
Furthermore, you see that the plan you represent has a unique benefits
package. What should you do to make sure your clients know about these
pieces of information?
- answer-You may make comparisons between plans if you can support them
with studies or statistical data and such comparisons are factually based and
referenced.
7. Dr. Elizabeth Brennan does not contract with the ABC PFFS plan but
accepts the plan's terms and conditions for payment. Mary Rodgers sees Dr.
Brennan for treatment. How much may Dr. Brennan charge?
- answer-Dr. Brennan can charge Mary Rogers no more than the cost sharing
specified in the PFFS plan's terms and condition of payment which may
include balance billing up to 15%of the Medicare rate.
8. 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?
- answer-The Medicare Advantage plan received a 5-star rating in customer
service and care coordination with an overall performance rating of 4 stars.
9. Hank's Fish Store, Inc. is a small company with just 15 employees located in
Florida. Hank, the store owner, has provided excellent health benefits to the
store's workforce. William, one of the store's long-time employees, will soon
be reaching age 65 and eligible for Medicare. William is in good health. He
intends to remain an active full-time employee, working several years after
becoming eligible for Medicare. What type(s) of retiree health benefit will
, Hank's Fish Store be able to offer William?
- answer-Hank's can continue to offer William the same employee health
benefit plan, or, if William enrolls in Medicare Part B, it can enroll him in a
Medicare Advantage plan that is offered to the public.
10.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.
11.Mr. Alonso receives some help paying for his two generic prescription drugs
from his employer's retiree coverage, but he wants to compare it to a Part D
prescription drug plan. He asks you what costs he would generally expect to
encounter when enrolling into a standard Medicare Part D prescription drug
plan. What should you tell him?
- answer-He generally would pay a monthly premium, annual deductible,
and per-prescription cost-sharing.
12.Mr. and Mrs. Nunez attended one of your sales presentations. They've asked
you to come to their home to clear up a few questions. During the
presentation, Mrs. Nunez feels tired and tells you that her husband can finish
things up. She goes to bed. At the end of your discussion, Mr. Nunez says
that he wants to enroll both himself and his wife. What should you do?
- answer-As long as she can do so, only Mrs. Nunez can sign her enrollment
form. Mrs. Nunez will have to wake up to sign her form or do so at another
time.
13.Mr. and Mrs. Vaughn both take a specialized multivitamin prescription each
day. Mr. Vaughn takes a prescription to help to regrow his hair. They are
anxious to have their Medicare prescription drug plan cover these drug
needs. What should you tell them?
- answer-Medicare prescription drug plans are not permitted to cover the
prescription medications the Vaughns are interested in under Part D
coverage, however, plans may cover them as supplemental benefits and the
Vaughns could look into that possibility.
14.Mr. Anderson is a very organized individual and has filled out and brought
to you an enrollment form on October 10 for a new plan available on
January 1 next year. He is currently enrolled in Original Medicare. What
TESTED QUESTION & 100% VERIFIED
ANSWERS/ GRADED A+ / GUARANTEED PASS!!
1. 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.
2. Agent Harriet Walker has recently begun marketing Medicare Advantage
and related products aimed at meeting the needs of senior citizens. Client
Mildred Jones has expressed interest in a Medicare Advantage plan. It is
now the beginning of September. If you were in Agent Walker's position,
what would you do?
- answer-Inquire whether the client qualifies for a special enrollment period,
and if not, solicit an enrollment application once the annual open enrollment
election period begins on October 15th.
3. 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?
- answer-Yes. When an event has been advertised as "educational,"
discussing plan-specific premiums is impermissible.
4. Alice is enrolled in a MA-PD plan. She makes a permanent move across the
country and wonders what her options are for continuing MA-PD coverage.
What would you say to her in regard to a special enrollment period (SEP)?
- answer-She is likely to qualify for a SEP. She can choose an effective date
of up to three months after the month in which the enrollment form is
received by the new plan, but the effective date may not be earlier than the
date of her permanent move.
,5. Anita Magri will turn age 65 in August 2023. Anita intends to enroll in
Original Medicare Part A and Part B. She would also like to enroll in a
Medicare Supplement (Medigap) plan. Anita's older neighbor Mel has told
her about the Medigap Plan F in which he is enrolled. It not only provides
foreign travel emergency benefits but also covers his Medicare Part B
deductible. Anita comes to you for advice. What should you tell her?
- answer-You are sorry to disappoint Anita, but a Medigap F plan is no
longer available to those who turn age 65 after January 1, 2020. Anita might
instead consider other Medigap plans that offer foreign travel benefits but do
not cover the Part B deductible.
6. By contacting plans available in your area, you have learned that the plan
you represent has a significantly lower monthly premium than the others.
Furthermore, you see that the plan you represent has a unique benefits
package. What should you do to make sure your clients know about these
pieces of information?
- answer-You may make comparisons between plans if you can support them
with studies or statistical data and such comparisons are factually based and
referenced.
7. Dr. Elizabeth Brennan does not contract with the ABC PFFS plan but
accepts the plan's terms and conditions for payment. Mary Rodgers sees Dr.
Brennan for treatment. How much may Dr. Brennan charge?
- answer-Dr. Brennan can charge Mary Rogers no more than the cost sharing
specified in the PFFS plan's terms and condition of payment which may
include balance billing up to 15%of the Medicare rate.
8. 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?
- answer-The Medicare Advantage plan received a 5-star rating in customer
service and care coordination with an overall performance rating of 4 stars.
9. Hank's Fish Store, Inc. is a small company with just 15 employees located in
Florida. Hank, the store owner, has provided excellent health benefits to the
store's workforce. William, one of the store's long-time employees, will soon
be reaching age 65 and eligible for Medicare. William is in good health. He
intends to remain an active full-time employee, working several years after
becoming eligible for Medicare. What type(s) of retiree health benefit will
, Hank's Fish Store be able to offer William?
- answer-Hank's can continue to offer William the same employee health
benefit plan, or, if William enrolls in Medicare Part B, it can enroll him in a
Medicare Advantage plan that is offered to the public.
10.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.
11.Mr. Alonso receives some help paying for his two generic prescription drugs
from his employer's retiree coverage, but he wants to compare it to a Part D
prescription drug plan. He asks you what costs he would generally expect to
encounter when enrolling into a standard Medicare Part D prescription drug
plan. What should you tell him?
- answer-He generally would pay a monthly premium, annual deductible,
and per-prescription cost-sharing.
12.Mr. and Mrs. Nunez attended one of your sales presentations. They've asked
you to come to their home to clear up a few questions. During the
presentation, Mrs. Nunez feels tired and tells you that her husband can finish
things up. She goes to bed. At the end of your discussion, Mr. Nunez says
that he wants to enroll both himself and his wife. What should you do?
- answer-As long as she can do so, only Mrs. Nunez can sign her enrollment
form. Mrs. Nunez will have to wake up to sign her form or do so at another
time.
13.Mr. and Mrs. Vaughn both take a specialized multivitamin prescription each
day. Mr. Vaughn takes a prescription to help to regrow his hair. They are
anxious to have their Medicare prescription drug plan cover these drug
needs. What should you tell them?
- answer-Medicare prescription drug plans are not permitted to cover the
prescription medications the Vaughns are interested in under Part D
coverage, however, plans may cover them as supplemental benefits and the
Vaughns could look into that possibility.
14.Mr. Anderson is a very organized individual and has filled out and brought
to you an enrollment form on October 10 for a new plan available on
January 1 next year. He is currently enrolled in Original Medicare. What
