AHIP 2026 Comprehensive Exam Prep
Mrs. West wears glasses and dentures and has enjoyed considerable pain relief from arthritis through
B B B B B B B B B B B B B B B
acupuncture. She is concerned about whether or not Medicare will cover these items and services. What B B B B B B B B B B B B B B B B
should you tell her? - correct answers Medicare does not cover acupuncture, or, in general, glasses or
B B B B B B B B B B B B B B B B B
dentures.
Mr. Bickford did not quite qualify for the extra help low-income subsidy under the Medicare Part D
B B B B B B B B B B B B B B B B B
Prescription Drug program and he is wondering if there is any other option he has for obtaining help with his
B B B B B B B B B B B B B B B B B B B B
considerable drug costs. What should you tell him? - correct answers He could check with the manufacturers
B B B B B B B B B B B B B B B B B
of his medications to see if they offer an assistance program to help people with limited means obtain the
B B B B B B B B B B B B B B B B B B B
medications they need. Alternatively, he could check to see whether his state has a pharmacy assistance
B B B B B B B B B B B B B B B B
program to help him with his expenses. B B B B B B
Mr. Lombardi is interested in a Medicare Advantage (MA) PPO plan that you represent. It is one of three plans
B B B B B B B B B B B B B B B B B B B B
operated by the same organization in Mr. Lombardi's area. The MA PPO plan does not include drug coverage,
B B B B B B B B B B B B B B B B B B
but the other two plans do. Mr. Lombardi likes the PPO plan that does not include drug coverage and intends
B B B B B B B B B B B B B B B B B B B B
to obtain his drug coverage through a stand-alone Medicare prescription drug plan. What should you tell him
B B B B B B B B B B B B B B B B B
about this situation? - correct answers He could enroll in one of the MA plans that include prescription drug
B B B B B B B B B B B B B B B B B B B
coverage or a Medigap plan and a stand-alone prescription drug plan, but he cannot enroll in the MA-only PPO
B B B B B B B B B B B B B B B B B B
plan and a stand-alone prescription drug plan.
B B B B B B B
Mr. Torres has a small savings account. He would like to pay for his monthly Part D premiums with an
B B B B B B B B B B B B B B B B B B B B
automatic monthly withdrawal from his savings account until it is exhausted, and then have his premiums
B B B B B B B B B B B B B B B B
withheld from his Social Security check. What should you tell him? - correct answers In general, he must select
B B B B B B B B B B B B B B B B B B B
a single Part D premium payment mechanism that will be used throughout the year.
B B B B B B B B B B B B B
Agent Jennings makes a presentation on Medicare advertised as an educational event. Agent Jennings
B B B B B B B B B B B B B B
distributes materials that are solely educational in nature. However, she gives a brief presentation that
B B B B B B B B B B B B B B B
mentions plan-specific premiums. Is this a prohibited activity at an event that has been advertised as
B B B B B B B B B B B B B B B B
, educational? - correct answers Yes. When an event has been advertised as "educational," discussing plan- B B B B B B B B B B B B B B
specific premiums is impermissible. B B B
Mrs. Mulcahy is concerned that she may not qualify for enrollment in a Medicare prescription drug plan
B B B B B B B B B B B B B B B B B
because, although she is entitled to Part A, she is not enrolled under Medicare Part B. What should you tell
B B B B B B B B B B B B B B B B B B B B
her? - correct answers Everyone who is entitled to Part A or enrolled under Part B is eligible to enroll in a
B B B B B B B B B B B B B B B B B B B B B B
Medicare prescription drug plan. As long as Mrs. Mulcahy is entitled to Part A, she does not need to enroll
B B B B B B B B B B B B B B B B B B B B
under Part B before enrolling in a prescription drug plan.
B B B B B B B B B
Mr. Jacob understands that there is a standard Medicare Part D prescription drug benefit, but when he looks
B B B B B B B B B B B B B B B B B B
at information on various plans available in his area, he sees a wide range in what they charge for deductibles,
B B B B B B B B B B B B B B B B B B B B
premiums and cost sharing. How can you explain this to him? - correct answers Medicare Part D drug plans
B B B B B B B B B B B B B B B B B B B
may have different benefit structures, but on average, they must all be at least as good as the standard model
B B B B B B B B B B B B B B B B B B B B
established by the government. B B B
Ms. Moore plans to retire when she turns 65 in a few months. She is in excellent health and will have
B B B B B B B B B B B B B B B B B B B B B
considerable income when she retires. She is concerned that her income will make it impossible for her to B B B B B B B B B B B B B B B B B B
qualify for Medicare. What could you tell her to address her concern? - correct answers Medicare is a program
B B B B B B B B B B B B B B B B B B B
for people age 65 or older and those under age 65 with certain disabilities, end stage renal disease or Lou
B B B B B B B B B B B B B B B B B B B B
Gehrig's disease, so she will be eligible for Medicare. B B B B B B B B
Agent Armstrong is employed by XYZ Agency, which is under contract with ABC Health Plan, a Medicare
B B B B B B B B B B B B B B B B B
Advantage (MA) plan that offers plans in multiple states. XYZ Agency maintains a website marketing the MA
B B B B B B B B B B B B B B B B B
plans with which it has contracts. Agent Armstrong follows up with individuals who request more information
B B B B B B B B B B B B B B B
about ABC MA plans via the website and tries to persuade them to enroll in ABC plans. What statement best
B B B B B B B B B B B B B B B B B B B B B
describes the marketing and compliance rules that apply to Agent Armstrong? - correct answers Agent
B B B B B B B B B B B B B B B
Armstrong needs to be licensed and appointed in every state in which beneficiaries to whom he markets ABC
B B B B B B B B B B B B B B B B B B
MA plans are located.
B B B
Mr. Schmidt would like to plan for retirement and has asked you what is covered under Original Fee-for-
B B B B B B B B B B B B B B B B B
Service (FFS) Medicare? What could you tell him? - correct answers Part A, which covers hospital, skilled
B B B B B B B B B B B B B B B B B
nursing facility, hospice and home health services and Part B, which covers professional services such as those
B B B B B B B B B B B B B B B B
provided by a doctor are covered under Original Medicare.
B B B B B B B B B
You are seeking to represent an individual Medicare Advantage plan and an individual Part D plan in your
B B B B B B B B B B B B B B B B B B
state. You have completed the required training for each plan, but you did not achieve a passing score on the
B B B B B B B B B B B B B B B B B B B B
tests that came after the training. What can you do in this situation? - correct answers You will not be able to
B B B B B B B B B B B B B B B B B B B B B B
represent any Medicare Advantage or Part D plan until you complete the training and achieve an adequate
B B B B B B B B B B B B B B B B B
Mrs. West wears glasses and dentures and has enjoyed considerable pain relief from arthritis through
B B B B B B B B B B B B B B B
acupuncture. She is concerned about whether or not Medicare will cover these items and services. What B B B B B B B B B B B B B B B B
should you tell her? - correct answers Medicare does not cover acupuncture, or, in general, glasses or
B B B B B B B B B B B B B B B B B
dentures.
Mr. Bickford did not quite qualify for the extra help low-income subsidy under the Medicare Part D
B B B B B B B B B B B B B B B B B
Prescription Drug program and he is wondering if there is any other option he has for obtaining help with his
B B B B B B B B B B B B B B B B B B B B
considerable drug costs. What should you tell him? - correct answers He could check with the manufacturers
B B B B B B B B B B B B B B B B B
of his medications to see if they offer an assistance program to help people with limited means obtain the
B B B B B B B B B B B B B B B B B B B
medications they need. Alternatively, he could check to see whether his state has a pharmacy assistance
B B B B B B B B B B B B B B B B
program to help him with his expenses. B B B B B B
Mr. Lombardi is interested in a Medicare Advantage (MA) PPO plan that you represent. It is one of three plans
B B B B B B B B B B B B B B B B B B B B
operated by the same organization in Mr. Lombardi's area. The MA PPO plan does not include drug coverage,
B B B B B B B B B B B B B B B B B B
but the other two plans do. Mr. Lombardi likes the PPO plan that does not include drug coverage and intends
B B B B B B B B B B B B B B B B B B B B
to obtain his drug coverage through a stand-alone Medicare prescription drug plan. What should you tell him
B B B B B B B B B B B B B B B B B
about this situation? - correct answers He could enroll in one of the MA plans that include prescription drug
B B B B B B B B B B B B B B B B B B B
coverage or a Medigap plan and a stand-alone prescription drug plan, but he cannot enroll in the MA-only PPO
B B B B B B B B B B B B B B B B B B
plan and a stand-alone prescription drug plan.
B B B B B B B
Mr. Torres has a small savings account. He would like to pay for his monthly Part D premiums with an
B B B B B B B B B B B B B B B B B B B B
automatic monthly withdrawal from his savings account until it is exhausted, and then have his premiums
B B B B B B B B B B B B B B B B
withheld from his Social Security check. What should you tell him? - correct answers In general, he must select
B B B B B B B B B B B B B B B B B B B
a single Part D premium payment mechanism that will be used throughout the year.
B B B B B B B B B B B B B
Agent Jennings makes a presentation on Medicare advertised as an educational event. Agent Jennings
B B B B B B B B B B B B B B
distributes materials that are solely educational in nature. However, she gives a brief presentation that
B B B B B B B B B B B B B B B
mentions plan-specific premiums. Is this a prohibited activity at an event that has been advertised as
B B B B B B B B B B B B B B B B
, educational? - correct answers Yes. When an event has been advertised as "educational," discussing plan- B B B B B B B B B B B B B B
specific premiums is impermissible. B B B
Mrs. Mulcahy is concerned that she may not qualify for enrollment in a Medicare prescription drug plan
B B B B B B B B B B B B B B B B B
because, although she is entitled to Part A, she is not enrolled under Medicare Part B. What should you tell
B B B B B B B B B B B B B B B B B B B B
her? - correct answers Everyone who is entitled to Part A or enrolled under Part B is eligible to enroll in a
B B B B B B B B B B B B B B B B B B B B B B
Medicare prescription drug plan. As long as Mrs. Mulcahy is entitled to Part A, she does not need to enroll
B B B B B B B B B B B B B B B B B B B B
under Part B before enrolling in a prescription drug plan.
B B B B B B B B B
Mr. Jacob understands that there is a standard Medicare Part D prescription drug benefit, but when he looks
B B B B B B B B B B B B B B B B B B
at information on various plans available in his area, he sees a wide range in what they charge for deductibles,
B B B B B B B B B B B B B B B B B B B B
premiums and cost sharing. How can you explain this to him? - correct answers Medicare Part D drug plans
B B B B B B B B B B B B B B B B B B B
may have different benefit structures, but on average, they must all be at least as good as the standard model
B B B B B B B B B B B B B B B B B B B B
established by the government. B B B
Ms. Moore plans to retire when she turns 65 in a few months. She is in excellent health and will have
B B B B B B B B B B B B B B B B B B B B B
considerable income when she retires. She is concerned that her income will make it impossible for her to B B B B B B B B B B B B B B B B B B
qualify for Medicare. What could you tell her to address her concern? - correct answers Medicare is a program
B B B B B B B B B B B B B B B B B B B
for people age 65 or older and those under age 65 with certain disabilities, end stage renal disease or Lou
B B B B B B B B B B B B B B B B B B B B
Gehrig's disease, so she will be eligible for Medicare. B B B B B B B B
Agent Armstrong is employed by XYZ Agency, which is under contract with ABC Health Plan, a Medicare
B B B B B B B B B B B B B B B B B
Advantage (MA) plan that offers plans in multiple states. XYZ Agency maintains a website marketing the MA
B B B B B B B B B B B B B B B B B
plans with which it has contracts. Agent Armstrong follows up with individuals who request more information
B B B B B B B B B B B B B B B
about ABC MA plans via the website and tries to persuade them to enroll in ABC plans. What statement best
B B B B B B B B B B B B B B B B B B B B B
describes the marketing and compliance rules that apply to Agent Armstrong? - correct answers Agent
B B B B B B B B B B B B B B B
Armstrong needs to be licensed and appointed in every state in which beneficiaries to whom he markets ABC
B B B B B B B B B B B B B B B B B B
MA plans are located.
B B B
Mr. Schmidt would like to plan for retirement and has asked you what is covered under Original Fee-for-
B B B B B B B B B B B B B B B B B
Service (FFS) Medicare? What could you tell him? - correct answers Part A, which covers hospital, skilled
B B B B B B B B B B B B B B B B B
nursing facility, hospice and home health services and Part B, which covers professional services such as those
B B B B B B B B B B B B B B B B
provided by a doctor are covered under Original Medicare.
B B B B B B B B B
You are seeking to represent an individual Medicare Advantage plan and an individual Part D plan in your
B B B B B B B B B B B B B B B B B B
state. You have completed the required training for each plan, but you did not achieve a passing score on the
B B B B B B B B B B B B B B B B B B B B
tests that came after the training. What can you do in this situation? - correct answers You will not be able to
B B B B B B B B B B B B B B B B B B B B B B
represent any Medicare Advantage or Part D plan until you complete the training and achieve an adequate
B B B B B B B B B B B B B B B B B
