Notesale: Turn your study into money

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AHIP FINAL EXAM TEST QUESTIONS WITH
ACTUAL CORRECT ANSWERS
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West wears glasses and dentures and has enjoyed considerable pain
relief from arthritis through acupuncture
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What should you tell
her? - CorreCt Answers -Medicare does not cover acupuncture, or, in
general, glasses or dentures
...
Andrews asked how a Private Fee-for-Service (PFFS) plan might affect
her access to services since she receives some assistance for her health care
costs from the State
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Mrs
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She
contacted you to ask what a Special Election Period is
...
Typically the Special
Election Period is beneficiary specific and results from events, such as when
the beneficiary moves outside of the service area
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Quinn has just turned 65, is in excellent health, and has a relatively
high income
...

What could you tell her about the implications of such a decision? - CorreCt
Answers -If she does not sign up for a Medicare prescription drug plan as
soon as she is eligible to do so, if she does sign up at a later date, her

premium will be permanently increased by 1% of the national average
premium for every month that she was not covered
...
Ramos is considering a Medicare Advantage PPO and has questions
about which providers she can go to for her health care
...
Ramos can obtain care from any provider
who participates in Original Medicare, but generally will have a higher costsharing amount if she sees a provider who/that is not part of the PPO
network
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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
...


Mr
...
What could you tell Mr
...


Mrs
...
What can she expect will happen with respect
to her drug coverage? - CorreCt Answers -Unless she chooses a Medicare
Part D prescription drug plan on her own, she will be automatically
enrolled in one available in her area
...
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
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Young is going on
vacation
...
Young
complete the application together before she leaves
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What would you say If you were advising Agent Adams? - CorreCt Answers
-This is a bad idea
...


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
...
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
...
What should you
tell her? - CorreCt Answers -Marketing representatives may initiate
electronic contact through e-mail but the subject line must say "marketing"
and an opt-out process must be provided
...
What should you tell her? - CorreCt Answers -Tell her that the
Medicare agency does not endorse or recommend any plan
...
Lewis understands that Medicare prescription drug plans may use
various methods to control the use of specific drugs
...
What should you tell her? - CorreCt Answers -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
...
Radford asks whether there are any special eligibility requirements for
Medicare Advantage
...

Radford must be entitled to Part A and enrolled in Part B to enroll in
Medicare Advantage
...
Castillo, a naturalized citizen, previously enrolled in Medicare Part B
but has recently stopped paying his Part B premium
...
Castillo is still
covered by Part A
...
What should you tell him? - CorreCt
Answers -He is not eligible to enroll in a Medicare Advantage plan until he
re-enrolls in Medicare Part B
...
Under guidelines from the Medicare agency, what types
of gifts or prizes would not be allowed in this situation? - CorreCt Answers Gift cards or gift certificates of $15 or less that can be readily converted to
cash
...
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
...
Alternatively, he could check to see whether his state has a pharmacy
assistance program to help him with his expenses
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Lombardi is interested in a Medicare Advantage (MA) PPO plan that
you represent
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Lombardi's area
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Mr
...
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
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Torres has a small savings account
...
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 distributes materials that are solely
educational in nature
...
Is this a prohibited activity at an event
that has been advertised as educational? - CorreCt Answers -Yes
...


Mrs
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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
...

Mulcahy is entitled to Part A, she does not need to enroll under Part B
before enrolling in a prescription drug plan
...
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
...


Ms
...
She is in
excellent health and will have considerable income when she retires
...
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
...
XYZ Agency maintains a website marketing the MA plans
with which it has contracts
...
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
...
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
...
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
...


Mr
...
He would like to know his options since he has decided to drop his
retiree coverage and is eligible for Medicare
...
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
...
Davis is 52 years old and has recently been diagnosed with end-stage
renal disease (ESRD) and will soon begin dialysis
...
What should you tell him? - CorreCt
Answers -He may sign-up for Medicare at any time however coverage
usually begins on the fourth month after dialysis treatments start
...
Johannsen is entitled to Medicare Part A and Part B
...
How does that affect his ability to enroll or disenroll
in a Part D plan? - CorreCt Answers -He qualifies for a special election
period and can enroll in or disenroll from a Part D plan once during that
period
...
Lopez, who is fairly well-off financially, would like to enroll in a
Medicare prescription drug plan you represent and simply give you a check
to cover his premiums for the entire year
...


You have approached a hospital administrator about marketing in her
facility
...
How could
you address her concerns? - CorreCt Answers -Tell her that Medicare
guidelines allow you to conduct marketing activities in common areas of a
provider's facility
...
Midler's home for a sales presentation
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Midler tells you that she has a copy of
her medical record available because she thinks this will help you
understand her needs
...

What should you do? - CorreCt Answers -You can only ask Mrs
...


Mrs
...
Which of
the following can she not do during the ICEP? - CorreCt Answers -She can
enroll in a Medigap plan to supplement the benefits of the MA plan that
she's also enrolling in
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Chi is age 75 and enjoys a comfortable but not extremely high-income
level
...
She also wants to have prescription drug coverage since her
doctor recently prescribed several expensive medications
...
How would
you advise Mrs
...
Chi may enroll in a MS MSA
plan and remain in her current standalone Part D prescription drug plan
...
She makes a permanent move across the
country and wonders what her options are for continuing MA-PD coverage
...
She can choose an
effective date of up to three months after the month in which the
enrollment form is received by the new plan, but the effective date may not
be earlier than the date of her permanent move
...


When Myra first became eligible for Medicare, she enrolled in Original
Medicare (Parts A and B)
...
She
would now like to enroll in a Medicare Advantage (MA) plan and
approaches you about her options
...


Mr
...
What should you tell him? - CorreCt

Answers -Under the Medicare Advantage program
...
Medicare will make contributions to this savings account
to help him pay his health care expenses while in the deductible
...
Chen will be 65 soon, has been a citizen for twelve years, has been
employed full time, and paid taxes during that entire period
...
What should you tell her? - CorreCt
Answers -Most individuals who are citizens and over age 65 are covered
under Part A by virtue of having paid Medicare taxes while working, though
some may be covered as a result of paying monthly premiums
...
Edwards is enrolled in a Medicare Advantage plan that includes
prescription drug plan (PDP) coverage
...
How would you advise her? CorreCt Answers -She may fill prescriptions for covered drugs at nonnetwork pharmacies, but likely at a higher cost than paid at an in-network
pharmacy
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Rockwell, age 67, is enrolled in Medicare Part A, but because he
continues to work and is covered by an employer health plan, he has not
enrolled in Part B or Part D
...
He has come to you for advice
...
Rockwell about special enrollment periods
(SEPs)? - CorreCt Answers -Mr
...


Mr
...
What should you tell Mr
...
Rainey's entire lifetime
...
Rainey is experiencing paranoid delusions and his physician feels that
he should be hospitalized
...
Rainey (or his
representative) about the length of an inpatient psychiatric hospital stay
that Medicare will cover? - CorreCt Answers -Medicare will cover a total of
190 days of inpatient psychiatric care during Mr
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Mr
...
Nunez attended one of your sales presentations
...
During the
presentation, Mrs
...
She goes to bed
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Nunez
says that he wants to enroll both himself and his wife
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Nunez can sign
her enrollment form
...
Nunez will have to wake up to sign her form or
do so at another time
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Cole has been a Medicaid beneficiary for some time, and recently
qualified for Medicare as well
...
What should you tell him? - CorreCt Answers -He should know
that Medicaid will pay cost sharing only for services provided by Medicaid
participating providers
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Barker enjoys a comfortable retirement income
...
However, when he received the bill, he was surprised to

see large charges in excess of his maximum out-of-pocket limit that
included a number of services and items he thought would be fully covered
...


Mr
...
He has
tried two, but had an allergic reaction to them
...
What could you tell him
to do? - CorreCt Answers -Mr
...
He or his physician could
obtain the standardized request form on the plan's website, fill it out, and
submit it to his plan
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Patel is in good health and is preparing a budget in anticipation of his
retirement when he turns 66
...
In general terms, what could you tell him about his
costs for inpatient hospital services under Original Medicare? - CorreCt
Answers -Under Original Medicare, there is a single deductible amount due
for the first 60 days of any inpatient
hospital stay, after which it converts into a per-day amount through day 90
...
Duarte is enrolled in Original Medicare Parts A and B
...
What
advice would you give her? - CorreCt Answers -Mrs
...
What could you tell him? - CorreCt Answers -You appreciate the
opportunity and would be happy to schedule an appointment with anyone
at their request

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