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AHIP Certification - Part 5 already graded A+ 2024/2025
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AHIP Certification - Part 5 already graded A+ 2024/2025
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AHIP Certification - Part 5d - ANSMrs. Walters is entitled to Part A and has medical coverage without drug coverage
through an employer retiree plan. She is not enrolled in Part B. Since the employer plan does
not cover prescription drugs, she wants to enroll in a Medicare prescription drug plan. Will she
be able to?
a. No. As long as her employer offers coverage that is equivalent to that available through
Medicare, Mrs. Walters cannot enroll in a Medicare prescription drug plan.
b. No. Mrs. Walters will have to enroll in Part B in order to qualify for enrollment into the
Medicare prescription drug program.
c. Yes, but Mrs. Walters must drop the employer coverage prior to enrolling in a Medicare
prescription drug plan.
d. Yes. Mrs. Walters must be entitled to Part A or enrolled in Part B to be eligible for coverage
under the Medicare prescription drug program.
a - ANSMr. Sanchez 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?
a. He will have to enroll in Part B.
b. He will not need to do anything. His entitlement to Part A makes him eligible to enroll in any
Medicare Advantage plan.
c. He must wait until the next Annual Election Period, at which time he can enroll in a Medicare
Advantage plan.
d. As long as his employer offers coverage that is equivalent to Medicare's, he cannot enroll in
Part B.
c - ANSMr. Kelly wants to know whether he is eligible to sign up for a Private fee-for-service
(PFFS) plan. What questions would you need to ask to determine his eligibility?
a. You would need to ask Mr. Kelly if he is enrolled in Part A and Part D and if he needs drug
coverage.
b. You would need to ask Mr. Kelly if he is enrolled in Part A and Part B and if his doctor will
accept the terms and conditions of payment of the PFFS plan
c. You would need to ask Mr. Kelly if he is enrolled in Part A and Part B and if he lives in the
PFFS plan's service area.
d. You would need to ask Mr. Kelly if he is enrolled in Part A and Part B, if he is healthy, and
how often he expects to visit a doctor.
a - ANSMr. Gonzalez is entitled to Part A, but has not yet enrolled in Part B. If he wants to enroll
in a Private Fee-for-Service (PFFS) plan, what will he have to do?
,a. He will have to enroll in Part B prior to enrolling in the PFFS plan.
b. He will need to do nothing. His entitlement to Part A makes him eligible to enroll in any
Medicare Advantage plan.
c. He will have to drop Part A and then will be eligible to enroll in a PFFS plan.
d. He will have to enroll in a Medicare prescription drug plan prior to enrolling in a PFFS plan.
b - ANSMrs. 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?
a. Mrs. Berkowitz can apply for any Medicare Advantage plan and, if it offers drug coverage,
ask to have that element of the coverage eliminated, after which she can enroll in a stand-alone
Medicare prescription drug plan in her service area.
b. 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.
c. Mrs. Berkowitz can enroll in any Medicare Advantage plan, regardless of whether it offers
drug coverage, and enroll in any stand-alone Medicare prescription drug plan.
d. This is not a possibility. If Mrs. Berkowitz wants health coverage and drug coverage through
a plan, she must purchase an MA-PD plan.
b - ANSMrs. Roberts has Original Medicare and would like to enroll in a Private Fee-for-Service
(PFFS) plan. All types of PFFS plans are available in her area. Which options could Mrs.
Roberts consider before selecting a PFFS plan?
a. A PFFS plan offering only medical benefits or a PFFS Medigap Supplemental Insurance
plan.
b. A Medicare Advantage Prescription Drug (MA-PD) PFFS plan that combines medical
benefits and Part D prescription drug coverage, a PFFS plan offering only medical benefits, or a
PFFS plan in combination with a stand-alone prescription drug plan.
c. A Medicare Advantage Prescription Drug (MA-PD) PFFS plan that combines medical
benefits and Part D prescription drug coverage, a PFFS plan offering only medical benefits, or
PFFS Medigap Supplemental Insurance plan.
d. A stand-alone prescription drug plan in combination with a PFFS plan or a PFFS Medigap
Supplemental Insurance plan.
c - ANSWhich of the following individuals is most likely to be eligible to enroll in a Medicare
Advantage or Part D Plan?
a. Betsy, a grandmother from overseas who has overstayed her visa.
b. Helena, an overseas college student who has overstayed her visa.
c. Jose, a grandfather who was granted asylum and has worked in the United States for many
years.
d. Guy, who has illegally crossed the Canadian border
, d - ANSMr. and Mrs. Nunez attended one of your sales presentations. They've asked you to
come to their home to clear up a few questions. During the presentation, Mrs. Nunez feels tired
and tells you that her husband can finish things up. She goes to bed. At the end of your
discussion, Mr. Nunez says that he wants to enroll both himself and his wife. What should you
do?
a. Legal spouses can sign enrollment forms for one another under federal law. You may enroll
both Mr. and Mrs. Nunez, as long as her husband signs on her behalf
b. You can countersign Mrs. Nunez' application, along with her husband, indicating that she
approved this choice verbally. This witness signature is sufficient to make the enrollment valid.
c. You should sign the form for Mrs. Nunez yourself, since she informed you, as the plan's
representative, that she wanted to enroll.
d. As long as she is able to do so, only Mrs. Nunez can sign her enrollment form. Mrs. Nunez
will have to wake up to sign her form or do so at another time.
b - ANSYou are visiting with Mr. Tully and his daughter at her request. He has advanced
Alzheimer's and is incapable of understanding the implications of choosing a Medicare
Advantage or prescription drug plan. Can his daughter fill out the enrollment form and sign it for
him?
a. If the enrollment form is countersigned by one of Mr. Tully's treating physicians, she can sign
it for him.
b. Mr. Tully's daughter can do so only, if she is authorized under state law as a court-appointed
legal guardian, has durable power of attorney for health care decisions, or is authorized under
state surrogate consent laws to make health decisions.
c. A signature is not necessary since Mr. Tully is not physically or mentally capable of filling out
and signing the form.
d. Mr. Tully's daughter can do so because she is an immediate family member who has taken
responsibility for her father's care.
a - ANSYou are meeting with Ms. Berlin and she has completed an enrollment form for a MA-PD
plan you represent. You notice that her handwriting is illegible and as a result, the spelling of her
street looks incorrect. She asks you to fill in the corrected street name. What should you do?
a. You may correct this information as long as you add your initials and date next to the
correction
b. You may correct the information since it was a simple mistake. You do not need to do
anything further to the application form.
c. Under no circumstances may you make corrections to information a beneficiary has
provided. Review of enrollment forms is the sole responsibility of the plan sponsor.
d. You may correct the information, but she will need to write a brief statement indicating she
authorized you to make the change.
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