AHIP Final Exam Test Questions and
Answers
Medicare does not cover acupuncture, or, in general, glasses or dentures. - ANSWER-
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?
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. - ANSWER-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?
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. - ANSWER-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?
In general, he must select a single Part D premium payment mechanism that will be
used throughout the year. - ANSWER-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?
Yes. When an event has been advertised as "educational," discussing plan-specific
premiums is impermissible. - ANSWER-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?
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. - ANSWER-
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?
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. -
ANSWER-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?
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. - ANSWER-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?
Agent Armstrong needs to be licensed and appointed in every state in which
beneficiaries to whom he markets ABC MA plans are located. - ANSWER-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?
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. - ANSWER-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?
You will not be able to represent any Medicare Advantage or Part D plan until you
complete the training and achieve an adequate score, although you will not have to take
a test if you exclusively market employer/union group plans and the companies do not
require testing. - ANSWER-You are seeking to represent an individual Medicare
Advantage plan and an individual Part D plan in your state. You have completed the
required training for each plan, but you did not achieve a passing score on the tests that
came after the training. What can you do in this situation?
Mr. Chen can disenroll from his employer-sponsored coverage to elect a Medicare
Advantage or Part D plan within 2 months of his disenrollment, but he should revaluate
if he really wants to drop his employer coverage. - ANSWER-Mr. Chen is enrolled in his
employer's group health plan and will be retiring soon. He would like to know his options
Answers
Medicare does not cover acupuncture, or, in general, glasses or dentures. - ANSWER-
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?
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. - ANSWER-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?
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. - ANSWER-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?
In general, he must select a single Part D premium payment mechanism that will be
used throughout the year. - ANSWER-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?
Yes. When an event has been advertised as "educational," discussing plan-specific
premiums is impermissible. - ANSWER-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?
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. - ANSWER-
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?
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. -
ANSWER-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?
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. - ANSWER-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?
Agent Armstrong needs to be licensed and appointed in every state in which
beneficiaries to whom he markets ABC MA plans are located. - ANSWER-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?
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. - ANSWER-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?
You will not be able to represent any Medicare Advantage or Part D plan until you
complete the training and achieve an adequate score, although you will not have to take
a test if you exclusively market employer/union group plans and the companies do not
require testing. - ANSWER-You are seeking to represent an individual Medicare
Advantage plan and an individual Part D plan in your state. You have completed the
required training for each plan, but you did not achieve a passing score on the tests that
came after the training. What can you do in this situation?
Mr. Chen can disenroll from his employer-sponsored coverage to elect a Medicare
Advantage or Part D plan within 2 months of his disenrollment, but he should revaluate
if he really wants to drop his employer coverage. - ANSWER-Mr. Chen is enrolled in his
employer's group health plan and will be retiring soon. He would like to know his options
