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AHIP EXAM STUDYGUIDE TEST(COMPLETE QUESTION AND ANSWER GUIDE 2022/2023)
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AHIP EXAM STUDYGUIDE TEST(COMPLETE QUESTION AND ANSWER GUIDE 2022/2023)
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AHIP EXAM STUDYGUIDE TEST(COMPLETEQUESTION AND ANSWER GUIDE 2022/2023)
Which of the following steps may a Part D sponsor adopt for beneficiaries who are at risk of misusing or
abusing frequently abused drugs? (correct answers)I. Identifying at risk individuals by using criteria that
includes the number of opioid prescriptions the beneficiary has and the number of prescribers who have
written those prescriptions.
II. Locking an at-risk beneficiary into one pharmacy.
III. Locking an at-risk beneficiary into one prescriber.
Mrs. Wolf 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.
Which statement best describes PACE plans? (correct answers)It includes comprehensive medical and
social service delivery systems using an interdisciplinary team approach in an adult day health center,
supplemented by in-home and referral services.
Mr. Shultz was still working when he first qualified for Medicare. At that time, he had employer group
coverage that was creditable. During his initial Part D eligibility period, he decided not to enroll because
he was satisfied with his drug coverage. It is now a year later and Mr. Shultz has lost his employer group
coverage. How would you advise him? (correct answers)Mr. Schultz should enroll in a Part D plan before
he has a 63-day break in coverage in order to avoid a premium penalty.
For which of the following individuals would a Cost Plan be most appropriate? (correct answers)Ms.
Baker who is enrolled in Medicare Part B and is willing to continue paying Part B premiums plus any plan
premiums.
Mrs. Berkowitz wants to enroll in a Medicare Advantage plan that does not include drug coverage and
also enroll in a stand-alone Medicare prescription drug plan. Under what circumstances can she do this?
(correct answers)If the Medicare Advantage plan is a Private Fee-for-Service (PFFS) plan that does not
offer drug coverage or a Medical Savings Account, Mrs. Berkowitz can do this.
Ms. Goldstein is required by the plan she represents to obtain enrollment forms that have carbon copies
in the back. She gives one to the beneficiary, sends another to the plan and retains the third. What
should she do with her copies of the enrollment forms? (correct answers)She should make every effort
to safeguard the beneficiary information on those enrollment forms.
, Mr. Lopez takes several high cost prescription drugs. He would like to enroll in a standalone Part D
prescription drug plan that is available in his area. In what type of Medicare Health Plan can he enroll?
(correct answers)Private Fee-for-Service (PFFS) plan that does not include drug coverage.
Mr. Block is currently enrolled in a Medicare Advantage plan that includes drug coverage. He found a
stand-alone Medicare prescription drug plan in his area that offers better coverage than that available
through his MA-PD plan and in addition has a low premium. It won't cost him much more and, because
he has the means to do so, he wishes to enroll in the stand-alone prescription drug plan in addition to
his MA-PD plan. What should you tell him? (correct answers)If Mr. Block enrolls in the stand-alone
Medicare prescription drug plan, he will be disenrolled from the Medicare Advantage plan.
Mrs. Chen will be 65 soon, has been a citizen for twelve years, has been employed full time, and paid
taxes during that entire period. She is concerned that she will not qualify for coverage under part A
because she was not born in the United States. 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.
Mrs. Lopez is enrolled in a Medicare Advantage cost plan. She has recently lost creditable coverage
previously available through her husband's employer. She is interested in enrolling in a Medicare Part D
prescription drug plan (PDP). What should you tell her? (correct answers)If a Part D benefit is offered
through her plan she must enroll in this plan.
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.
Mrs. Wellington is enrolled in Parts A and B of Original Medicare. A friend recently told her that there is
an excellent Medicare Advantage (MA) plan with a five-star rating serving her area. On January 15 she
comes to you for advice as to what options, if any, she has. What should you say regarding special
enrollment periods (SEPs)? (correct answers)Mrs. Wellington is eligible for a SEP that may be used once
until November 30 to enroll in the five-star plan.
Mr. Shapiro gets by on a very small fixed income. He has heard there may be extra help paying for Part D
prescription drugs for Medicare beneficiaries with limited income. He wants to know whether he might
qualify. What should you tell him? (correct answers)The extra help is available to beneficiaries whose
income and assets do not exceed annual limits specified by the government.
A client wants to give you an enrollment application on October 1 prior to the beginning of the Annual
Election Period because he is leaving on vacation for two weeks and does not want to forget about
turning it in. What should you tell him? (correct answers)You must tell him you are not permitted to
take the form. If he sends the form directly to the plan, the plan will process the enrollment on the day
the Annual Election Period begins.
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