AHIP FINAL EXAM TEST QUESTIONS
AND CORRECT ANSWERS
Mr. Sanchez has just turned 65 and is entitled to Part A but has not enrolled in Part
B because he has coverage through an employer plan. If he wants to enroll in a
Medicare Advantage plan, what will he have to do? - ANS ... He will have to enroll
in Part B.
Mr. Moy's wife has a Medicare Advantage plan, but he wants to understand what
coverage Medicare Supplemental Insurance provides since his health care needs
are different from his wife's needs. What could you tell Mr. Moy? - ANS ...
Medicare Supplemental Insurance would help cover his Part A and Part B cost
sharing in Original Fee-for-Service (FFS) Medicare as well as possibly some services
that Medicare does not cover.
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 with respect to her drug
coverage? - ANS ... 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. Young is currently enrolled in Original Medicare (Parts A and B), but she has
been working with Agent Neil Adams in the selection of a Medicare Advantage
(MA) plan. It is mid-September, and Mrs. Young is going on vacation. Agent Adams
is considering suggesting that he and Mrs. Young complete the application together
before she leaves. He will then submit the paper application prior the start of the
annual enrollment period (AEP). What would you say If you were advising Agent
Adams? - ANS ... This is a bad idea. Agents are generally prohibited from soliciting
or accepting an enrollment form prior to the start of the AEP.
, Another agent working for your agency claims that because you are not employed
by the Medicare Advantage plans that you represent, you are not subject to the
same requirements as the plans themselves. How should you respond to such a
statement? - ANS ... Your coworker is not correct. Marketing on behalf of a plan is
considered marketing by the plan and requires that all contracted and employed
agents comply with all Medicare marketing rules.
Agent Martinez wishes to solicit Medicare Advantage prospects through e-mail and
asks you for advice as to whether this is possible. What should you tell her? - ANS
... Marketing representatives may initiate electronic contact through e-mail but the
subject line must say "marketing" and an opt-out process must be provided.
During a sales presentation, your client asks you whether the Medicare agency
recommends that she sign up for your plan or stay in Original Medicare. What
should you tell her? - ANS ... Tell her that the Medicare agency does not endorse or
recommend any plan.
Ms. Lewis understands that Medicare prescription drug plans may use various
methods to control the use of specific drugs. She has heard about a technique called
"step therapy" and is wondering if you can explain what that is. What should you
tell her? - ANS ... Step therapy involves using one or more lower priced drugs
before trying a more expensive drug when all are used to treat the same condition.
Mrs. Radford asks whether there are any special eligibility requirements for
Medicare Advantage. What should you tell her? - ANS ... Mrs. Radford must be
entitled to Part A and enrolled in Part B to enroll in Medicare Advantage.
Mr. Castillo, a naturalized citizen, previously enrolled in Medicare Part B but has
recently stopped paying his Part B premium. Mr. Castillo is still covered by Part A.
He would like to enroll in a Medicare Advantage (MA) plan and is still covered by
Part A. What should you tell him? - ANS ... He is not eligible to enroll in a Medicare
Advantage plan until he re-enrolls in Medicare Part B.
AND CORRECT ANSWERS
Mr. Sanchez has just turned 65 and is entitled to Part A but has not enrolled in Part
B because he has coverage through an employer plan. If he wants to enroll in a
Medicare Advantage plan, what will he have to do? - ANS ... He will have to enroll
in Part B.
Mr. Moy's wife has a Medicare Advantage plan, but he wants to understand what
coverage Medicare Supplemental Insurance provides since his health care needs
are different from his wife's needs. What could you tell Mr. Moy? - ANS ...
Medicare Supplemental Insurance would help cover his Part A and Part B cost
sharing in Original Fee-for-Service (FFS) Medicare as well as possibly some services
that Medicare does not cover.
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 with respect to her drug
coverage? - ANS ... 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. Young is currently enrolled in Original Medicare (Parts A and B), but she has
been working with Agent Neil Adams in the selection of a Medicare Advantage
(MA) plan. It is mid-September, and Mrs. Young is going on vacation. Agent Adams
is considering suggesting that he and Mrs. Young complete the application together
before she leaves. He will then submit the paper application prior the start of the
annual enrollment period (AEP). What would you say If you were advising Agent
Adams? - ANS ... This is a bad idea. Agents are generally prohibited from soliciting
or accepting an enrollment form prior to the start of the AEP.
, Another agent working for your agency claims that because you are not employed
by the Medicare Advantage plans that you represent, you are not subject to the
same requirements as the plans themselves. How should you respond to such a
statement? - ANS ... Your coworker is not correct. Marketing on behalf of a plan is
considered marketing by the plan and requires that all contracted and employed
agents comply with all Medicare marketing rules.
Agent Martinez wishes to solicit Medicare Advantage prospects through e-mail and
asks you for advice as to whether this is possible. What should you tell her? - ANS
... Marketing representatives may initiate electronic contact through e-mail but the
subject line must say "marketing" and an opt-out process must be provided.
During a sales presentation, your client asks you whether the Medicare agency
recommends that she sign up for your plan or stay in Original Medicare. What
should you tell her? - ANS ... Tell her that the Medicare agency does not endorse or
recommend any plan.
Ms. Lewis understands that Medicare prescription drug plans may use various
methods to control the use of specific drugs. She has heard about a technique called
"step therapy" and is wondering if you can explain what that is. What should you
tell her? - ANS ... Step therapy involves using one or more lower priced drugs
before trying a more expensive drug when all are used to treat the same condition.
Mrs. Radford asks whether there are any special eligibility requirements for
Medicare Advantage. What should you tell her? - ANS ... Mrs. Radford must be
entitled to Part A and enrolled in Part B to enroll in Medicare Advantage.
Mr. Castillo, a naturalized citizen, previously enrolled in Medicare Part B but has
recently stopped paying his Part B premium. Mr. Castillo is still covered by Part A.
He would like to enroll in a Medicare Advantage (MA) plan and is still covered by
Part A. What should you tell him? - ANS ... He is not eligible to enroll in a Medicare
Advantage plan until he re-enrolls in Medicare Part B.
