AHIP
AHIP 2025 FINAL EXAM 50 QUESTIONS AND
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. Able, Baker, and Charles are engaged in the marketing to and enrollment of
beneficiaries into Medicare health plans. Mr. Able is an independent agent paid
directly by a health plan. Ms. Baker is an independent agent paid through a field
marketing organization (FMO). Mr. Charles is an independent agent paid for his
work by a third-party marketing organization (TMO). How do the CMS
compensation rules apply to these three agents?
- answer-Baker and Charles are subject to CMS compensation rules
because they are paid by third parties. Able is not because he is paid directly by
a health plan.
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. 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
AHIP 2025 FINAL EXAM 50 QUESTIONS AND 100% VERIFIED ANSWERS GRADED A+ GUARANTEED PASS!
, AHIP
instead consider other Medigap plans that offer foreign travel benefits but do not
cover the Part B deductible.
5. 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.
6. 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.
7. 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.
8. 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.
9. Mr. Barker enjoys a comfortable retirement income. He recently had surgery and
expected that he would have certain services and items covered by the plan with
minimal out-of-pocket costs because his MA-PD coverage has been very good.
However, when he received the bill, he was surprised to see large charges in
excess of his maximum out-of-pocket limit that included some services and items
he thought would be fully covered. He called you to ask what he could do? What
could you tell him?
AHIP 2025 FINAL EXAM 50 QUESTIONS AND 100% VERIFIED ANSWERS GRADED A+ GUARANTEED PASS!
AHIP 2025 FINAL EXAM 50 QUESTIONS AND
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. Able, Baker, and Charles are engaged in the marketing to and enrollment of
beneficiaries into Medicare health plans. Mr. Able is an independent agent paid
directly by a health plan. Ms. Baker is an independent agent paid through a field
marketing organization (FMO). Mr. Charles is an independent agent paid for his
work by a third-party marketing organization (TMO). How do the CMS
compensation rules apply to these three agents?
- answer-Baker and Charles are subject to CMS compensation rules
because they are paid by third parties. Able is not because he is paid directly by
a health plan.
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. 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
AHIP 2025 FINAL EXAM 50 QUESTIONS AND 100% VERIFIED ANSWERS GRADED A+ GUARANTEED PASS!
, AHIP
instead consider other Medigap plans that offer foreign travel benefits but do not
cover the Part B deductible.
5. 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.
6. 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.
7. 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.
8. 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.
9. Mr. Barker enjoys a comfortable retirement income. He recently had surgery and
expected that he would have certain services and items covered by the plan with
minimal out-of-pocket costs because his MA-PD coverage has been very good.
However, when he received the bill, he was surprised to see large charges in
excess of his maximum out-of-pocket limit that included some services and items
he thought would be fully covered. He called you to ask what he could do? What
could you tell him?
AHIP 2025 FINAL EXAM 50 QUESTIONS AND 100% VERIFIED ANSWERS GRADED A+ GUARANTEED PASS!
