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1. Agent Roderick enrolls retiree Mrs. Martinez in a med- This situation is
ical savings account (MSA) Medicare health plan. The MSA consid-
plan does not offer prescription drug coverage, so Agent ered a "dual
Roderick also enrolls Mrs. Martinez in a stand-alone enrollment," and
prescription drug plan (PDP). What CMS com-pensation rules CMS compensation
apply to this situation? rules are applied to
the two plans at
a. Regular CMS and renewal compensation rules apply to the once and in-
PDP enrollment, but compensation is limited to $100 for the dependently of each
MSA health plan enrollment to recom-pense CMS for other.
contributions made to the enrollee's MSA account.
b. MSA Medicare health plans are subject to special rules
limiting initial year compensation to 50 percent of the fair
market value (FMV) published annually by CMS. Regular
initial year enrollment rules apply to the PDP.
c. When an MSA Medicare health plan is combined with a PDP,
initial and renewal year(s) compensation is paid only for the
MSA enrollment to recompense CMS for contributions made to
th
2. Ms. Chase is interested in discussing various Medicare MA plans have a
Advantage (MA) Plans available in her area with you. maximum
out-of-pocket limit,
She has heard that MA plans have something called known
as the "MOOP", for
a "maximum out-of-pocket" limit. She asks you to ex- Part Part
and A B benefits.
plain what this means. What do you say? Oncemember
plan a pays a
ified amount of cost-
spec-
a. Each year, CMS specifies an optional MOOP, which shar-the health plan
ing,
health plans can exceed or lower. cov-
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b. Original Medicare, not MA plans, have a maximum out-of- ers 100 percent of
pocket limit, for Part A and Part B benefits. covered medical
services.
c. MA plans have a maximum out-of-pocket limit, known as
the "MOOP" for Part A and Part B bene-fits. Once a plan
member pays a specified amount of cost-sharing, the health
plan covers 80 percent of covered medical services.
d. MA plans have a maximum out-of-pocket limit, known as
the "MOOP", for Part A and Part B bene-fits. Once a plan
member pays a specified amount of cost-sharing, the health
plan covers 100 percent of covered medical services.
3. Agent Marvin Millner wants to reach out to his current Marvin should
clients for referrals. What advice would you give to consult
with the health plans
Marvin? he represents to de-
termine whether
a. CMS guidelines limit the value of gifts provided in those impose require-
plans
exchange for referrals to a value of $50 or less. ments around
referrals
beneficiary
b. Marvin should understand that under CMS guide-
lines he can no longer provide gifts, even of minimal
value, in exchange for referrals.
c. Marvin should consult with the health plans he rep-resents to
determine whether those plans impose re-quirements around
beneficiary referrals.
d. CMS guidelines limit the value of gifts provided in
exchange for referrals to a value of $100 or less.
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4. Mr. Perry is entitled to Medicare Part A but has not yet He is eligible for the
enrolled in Part B, even though he is 69 years old. He would Part D prescription
like to enroll in a Medicare Part D prescription drug plan but is drug ben-efit because
concerned that he will have to sign up for Part B as well in he is entitled to Part
order to qualify for enrollment in a Part D plan. What should A and he does not
you tell him? have to be enrolled in
Part B
a. He need not be entitled to Part A or enrolled in Part B to be
eligible for the Part D prescription drug benefit. He must only
be aged 65 or older to qualify for enrollment in Part D, so he
can go ahead and enroll in a Part D prescription drug plan.
b. He is eligible for the Part D prescription drug benefit because
he is entitled to Part A and he does not have to be enrolled in
Part B.
c. He does not have to enroll in Part B but, must pay a penalty
for his failure to do so when he first turned 65. After that, he can
enroll in a Part D prescription drug plan.
d. He will have to enroll in Part B
5. Mr. Moreno invited his neighbor, Agent Tom Smith, to A meal cannot be
discuss Medicare Advantage (MA) and Part D plans provid-
ed, but light snacks
that Agent Smith sells at the regular Tuesday brunch would
be permitted.
the neighbors have for senior citizens. What should
Agent Tom Smith tell Mr. Moreno about the kinds of
food that can be provided to potential enrollees who
attend the sales presentation?
a. A meal cannot be provided, but light snacks would
Study online at
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1. Agent Roderick enrolls retiree Mrs. Martinez in a med- This situation is
ical savings account (MSA) Medicare health plan. The MSA consid-
plan does not offer prescription drug coverage, so Agent ered a "dual
Roderick also enrolls Mrs. Martinez in a stand-alone enrollment," and
prescription drug plan (PDP). What CMS com-pensation rules CMS compensation
apply to this situation? rules are applied to
the two plans at
a. Regular CMS and renewal compensation rules apply to the once and in-
PDP enrollment, but compensation is limited to $100 for the dependently of each
MSA health plan enrollment to recom-pense CMS for other.
contributions made to the enrollee's MSA account.
b. MSA Medicare health plans are subject to special rules
limiting initial year compensation to 50 percent of the fair
market value (FMV) published annually by CMS. Regular
initial year enrollment rules apply to the PDP.
c. When an MSA Medicare health plan is combined with a PDP,
initial and renewal year(s) compensation is paid only for the
MSA enrollment to recompense CMS for contributions made to
th
2. Ms. Chase is interested in discussing various Medicare MA plans have a
Advantage (MA) Plans available in her area with you. maximum
out-of-pocket limit,
She has heard that MA plans have something called known
as the "MOOP", for
a "maximum out-of-pocket" limit. She asks you to ex- Part Part
and A B benefits.
plain what this means. What do you say? Oncemember
plan a pays a
ified amount of cost-
spec-
a. Each year, CMS specifies an optional MOOP, which shar-the health plan
ing,
health plans can exceed or lower. cov-
, 2026 Ahip Extras
Study online at
https://quizlet.com/_hh10xp
b. Original Medicare, not MA plans, have a maximum out-of- ers 100 percent of
pocket limit, for Part A and Part B benefits. covered medical
services.
c. MA plans have a maximum out-of-pocket limit, known as
the "MOOP" for Part A and Part B bene-fits. Once a plan
member pays a specified amount of cost-sharing, the health
plan covers 80 percent of covered medical services.
d. MA plans have a maximum out-of-pocket limit, known as
the "MOOP", for Part A and Part B bene-fits. Once a plan
member pays a specified amount of cost-sharing, the health
plan covers 100 percent of covered medical services.
3. Agent Marvin Millner wants to reach out to his current Marvin should
clients for referrals. What advice would you give to consult
with the health plans
Marvin? he represents to de-
termine whether
a. CMS guidelines limit the value of gifts provided in those impose require-
plans
exchange for referrals to a value of $50 or less. ments around
referrals
beneficiary
b. Marvin should understand that under CMS guide-
lines he can no longer provide gifts, even of minimal
value, in exchange for referrals.
c. Marvin should consult with the health plans he rep-resents to
determine whether those plans impose re-quirements around
beneficiary referrals.
d. CMS guidelines limit the value of gifts provided in
exchange for referrals to a value of $100 or less.
, 2026 Ahip Extras
Study online at
https://quizlet.com/_hh10xp
4. Mr. Perry is entitled to Medicare Part A but has not yet He is eligible for the
enrolled in Part B, even though he is 69 years old. He would Part D prescription
like to enroll in a Medicare Part D prescription drug plan but is drug ben-efit because
concerned that he will have to sign up for Part B as well in he is entitled to Part
order to qualify for enrollment in a Part D plan. What should A and he does not
you tell him? have to be enrolled in
Part B
a. He need not be entitled to Part A or enrolled in Part B to be
eligible for the Part D prescription drug benefit. He must only
be aged 65 or older to qualify for enrollment in Part D, so he
can go ahead and enroll in a Part D prescription drug plan.
b. He is eligible for the Part D prescription drug benefit because
he is entitled to Part A and he does not have to be enrolled in
Part B.
c. He does not have to enroll in Part B but, must pay a penalty
for his failure to do so when he first turned 65. After that, he can
enroll in a Part D prescription drug plan.
d. He will have to enroll in Part B
5. Mr. Moreno invited his neighbor, Agent Tom Smith, to A meal cannot be
discuss Medicare Advantage (MA) and Part D plans provid-
ed, but light snacks
that Agent Smith sells at the regular Tuesday brunch would
be permitted.
the neighbors have for senior citizens. What should
Agent Tom Smith tell Mr. Moreno about the kinds of
food that can be provided to potential enrollees who
attend the sales presentation?
a. A meal cannot be provided, but light snacks would
