AHIP Final Refined Exam With
Approved Solutions Latest
2025/2026
Mrs. West wears glasses and dentures and has enjoyed considerable pain relief
from arthritis through acupuncture. She is concerned about whether or not
Medicare will cover these items and services. What should you tell her? -
Correct Answers-Medicare does not cover acupuncture, or, in general, glasses
or dentures.
Mr. Bickford did not quite qualify for the extra help low-income subsidy under
the Medicare Part D Prescription Drug program and he is wondering if there is
any other option he has for obtaining help with his considerable drug costs.
What should you tell him? - Correct Answers-He could check with the
manufacturers of his medications to see if they offer an assistance program to
help people with limited means obtain the medications they need. Alternatively,
he could check to see whether his state has a pharmacy assistance program to
help him with his expenses.
Mr. Lombardi is interested in a Medicare Advantage (MA) PPO plan that you
represent. It is one of three plans operated by the same organization in Mr.
Lombardi's area. The MA PPO plan does not include drug coverage, but the
other two plans do. Mr. Lombardi likes the PPO plan that does not include drug
coverage and intends to obtain his drug coverage through a stand-alone
Medicare prescription drug plan. What should you tell him about this
situation? - Correct Answers-He could enroll in one of the MA plans that
include prescription drug coverage or a Medigap plan and a stand-alone
prescription drug plan, but he cannot enroll in the MA-only PPO plan and a
stand-alone prescription drug plan.
Mr. Torres has a small savings account. He would like to pay for his monthly
Part D premiums with an automatic monthly withdrawal from his savings
account until it is exhausted, and then have his premiums withheld from his
Social Security check. What should you tell him? - Correct Answers-In general,
he must select a single Part D premium payment mechanism that will be used
throughout the year.
Agent Jennings makes a presentation on Medicare advertised as an
educational event. Agent Jennings distributes materials that are solely
educational in nature. 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? - Correct Answers-Yes. When an event has been
advertised as "educational," discussing plan-specific premiums is
impermissible.
Mrs. Mulcahy is concerned that she may not qualify for enrollment in a
Medicare prescription drug plan because, although she is entitled to Part A,
she is not enrolled under Medicare Part B. What should you tell her? - Correct
Answers-Everyone who is entitled to Part A or enrolled under Part B is eligible
to enroll in a Medicare prescription drug plan. As long as Mrs. Mulcahy is
entitled to Part A, she does not need to enroll under Part B before enrolling in a
prescription drug plan.
Mr. Jacob understands that there is a standard Medicare Part D prescription
drug benefit, but when he looks at information on various plans available in
his area, he sees a wide range in what they charge for deductibles, premiums
and cost sharing. How can you explain this to him? - Correct Answers-
Medicare Part D drug plans may have different benefit structures, but on
average, they must all be at least as good as the standard model established by
the government.
Ms. Moore plans to retire when she turns 65 in a few months. She is in
excellent health and will have considerable income when she retires. She is
concerned that her income will make it impossible for her to qualify for
Medicare. What could you tell her to address her concern? - Correct Answers-
Medicare is a program for people age 65 or older and those under age 65 with
certain disabilities, end stage renal disease or Lou Gehrig's disease, so she will
be eligible for Medicare.
Agent Armstrong is employed by XYZ Agency, which is under contract with
ABC Health Plan, a Medicare Advantage (MA) plan that offers plans in multiple
states. XYZ Agency maintains a website marketing the MA plans with which it
has contracts. Agent Armstrong follows up with individuals who request more
information about ABC MA plans via the website and tries to persuade them to
enroll in ABC plans. What statement best describes the marketing and
compliance rules that apply to Agent Armstrong? - Correct Answers-Agent
Armstrong needs to be licensed and appointed in every state in which
beneficiaries to whom he markets ABC MA plans are located.
Mr. Schmidt would like to plan for retirement and has asked you what is
covered under Original Fee-for-Service (FFS) Medicare? What could you tell
him? - Correct Answers-Part A, which covers hospital, skilled nursing facility,
hospice and home health services and Part B, which covers professional
services such as those provided by a doctor are covered under Original
Medicare.
Approved Solutions Latest
2025/2026
Mrs. West wears glasses and dentures and has enjoyed considerable pain relief
from arthritis through acupuncture. She is concerned about whether or not
Medicare will cover these items and services. What should you tell her? -
Correct Answers-Medicare does not cover acupuncture, or, in general, glasses
or dentures.
Mr. Bickford did not quite qualify for the extra help low-income subsidy under
the Medicare Part D Prescription Drug program and he is wondering if there is
any other option he has for obtaining help with his considerable drug costs.
What should you tell him? - Correct Answers-He could check with the
manufacturers of his medications to see if they offer an assistance program to
help people with limited means obtain the medications they need. Alternatively,
he could check to see whether his state has a pharmacy assistance program to
help him with his expenses.
Mr. Lombardi is interested in a Medicare Advantage (MA) PPO plan that you
represent. It is one of three plans operated by the same organization in Mr.
Lombardi's area. The MA PPO plan does not include drug coverage, but the
other two plans do. Mr. Lombardi likes the PPO plan that does not include drug
coverage and intends to obtain his drug coverage through a stand-alone
Medicare prescription drug plan. What should you tell him about this
situation? - Correct Answers-He could enroll in one of the MA plans that
include prescription drug coverage or a Medigap plan and a stand-alone
prescription drug plan, but he cannot enroll in the MA-only PPO plan and a
stand-alone prescription drug plan.
Mr. Torres has a small savings account. He would like to pay for his monthly
Part D premiums with an automatic monthly withdrawal from his savings
account until it is exhausted, and then have his premiums withheld from his
Social Security check. What should you tell him? - Correct Answers-In general,
he must select a single Part D premium payment mechanism that will be used
throughout the year.
Agent Jennings makes a presentation on Medicare advertised as an
educational event. Agent Jennings distributes materials that are solely
educational in nature. 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? - Correct Answers-Yes. When an event has been
advertised as "educational," discussing plan-specific premiums is
impermissible.
Mrs. Mulcahy is concerned that she may not qualify for enrollment in a
Medicare prescription drug plan because, although she is entitled to Part A,
she is not enrolled under Medicare Part B. What should you tell her? - Correct
Answers-Everyone who is entitled to Part A or enrolled under Part B is eligible
to enroll in a Medicare prescription drug plan. As long as Mrs. Mulcahy is
entitled to Part A, she does not need to enroll under Part B before enrolling in a
prescription drug plan.
Mr. Jacob understands that there is a standard Medicare Part D prescription
drug benefit, but when he looks at information on various plans available in
his area, he sees a wide range in what they charge for deductibles, premiums
and cost sharing. How can you explain this to him? - Correct Answers-
Medicare Part D drug plans may have different benefit structures, but on
average, they must all be at least as good as the standard model established by
the government.
Ms. Moore plans to retire when she turns 65 in a few months. She is in
excellent health and will have considerable income when she retires. She is
concerned that her income will make it impossible for her to qualify for
Medicare. What could you tell her to address her concern? - Correct Answers-
Medicare is a program for people age 65 or older and those under age 65 with
certain disabilities, end stage renal disease or Lou Gehrig's disease, so she will
be eligible for Medicare.
Agent Armstrong is employed by XYZ Agency, which is under contract with
ABC Health Plan, a Medicare Advantage (MA) plan that offers plans in multiple
states. XYZ Agency maintains a website marketing the MA plans with which it
has contracts. Agent Armstrong follows up with individuals who request more
information about ABC MA plans via the website and tries to persuade them to
enroll in ABC plans. What statement best describes the marketing and
compliance rules that apply to Agent Armstrong? - Correct Answers-Agent
Armstrong needs to be licensed and appointed in every state in which
beneficiaries to whom he markets ABC MA plans are located.
Mr. Schmidt would like to plan for retirement and has asked you what is
covered under Original Fee-for-Service (FFS) Medicare? What could you tell
him? - Correct Answers-Part A, which covers hospital, skilled nursing facility,
hospice and home health services and Part B, which covers professional
services such as those provided by a doctor are covered under Original
Medicare.
