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Ahip 2025 final exam with 100- correct answers
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Ahip 2025 final exam with 100% correctanswers
A Medicare beneficiary has walked into your office and requested that you sit down with her and discuss
her options under the Medicare Advantage program. Before engaging in such a discussion, what should
you do? - correct answer-You must have her sign a scope of appointment form, indicating which products
she wishes to discuss. You may then proceed with the discussion.
Agent Chan is conducting a sales presentation on senior issues where he hopes to enroll some attendees
in the Medicare Advantage (MA) plans he represents. What action(s) may Agent Chan take during the
event? - correct answer-Discuss plan specific information such as premiums and benefits.
Anita Magri will turn age 65 in August 2023. Anita intends to enroll in Original Medicare Part A and Part
B. She would also like to enroll in a Medicare Supplement (Medigap) plan. Anita's older neighbor Mel has
told her about the Medigap Plan F in which he is enrolled. It not only provides foreign travel emergency
benefits but also covers his Medicare Part B deductible. Anita comes to you for advice. What should you
tell her? - correct answer-You are sorry to disappoint Anita, but a Medigap F plan is no longer available to
those who turn age 65 after January 1, 2020. Anita might instead consider other Medigap plans that
offer foreign travel benefits but do not cover the Part B deductible.
Dr. Elizabeth Brennan does not contract with the ABC PFFS plan but accepts the plan's terms and
conditions for payment. Mary Rodgers sees Dr. Brennan for treatment. How much may Dr. Brennan
charge? - correct answer-
Mr. Barker enjoys a comfortable retirement income. He recently had surgery and expected that he would
have certain services and items covered by the plan with minimal out-of-pocket costs because his MA-PD
coverage has been very good. However, when he received the bill, he was surprised to see large charges
in excess of his maximum out-of-pocket limit that included some services and items he thought would be
fully covered. He called you to ask what he could do? What could you tell him? - correct answer-You can
offer to review the plans appeal process to help him ask the plan to review the coverage decision.
Mr. Carlini has heard that Medicare prescription drug plans are only offered through private companies
under a program known as Medicare Advantage (MA), not by the government. He likes Original
Medicare and does not want to sign up for an MA product, but he also wants prescription drug coverage.
What should you tell him? - correct answer-Mr. Carlini can stay with Original Medicare and also enroll in
, a Medicare prescription drug plan through a private company that has contracted with the government
to provide only such drug coverage to eligible Medicare beneficiaries.
Mr. 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? - correct answer-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.
Mr. Landry is approaching his 65th birthday. He has signed up for Medicare Part A, but he did not enroll
in Part B because he has employer-sponsored coverage and intends to keep working for several more
years. But he is considering enrolling in Part D prescription drug coverage because he believes it is
superior to his employer plan. How would you advise him? - correct answer-Mr. Landry is eligible for Part
D since he has Part A, and his initial enrollment period (IEP) for Part D will continue for three months
after his 65th birthday.
Mr. Liu turns 65 on June 19. He has never previously qualified for Medicare so his first Medicare
eligibility date will be June 1. Mr. Liu's ICEP and Part D IEP begin on March 1 and end on September 30.
He wants prescription drug coverage with his Part A and Part B benefits. What advice can you provide
him? - correct answer-
Mr. Rainey is experiencing paranoid delusions and his physician feels that he should be hospitalized.
What should you tell Mr. Rainey (or his representative) about the length of an inpatient psychiatric
hospital stay that Medicare will cover? - correct answer-Medicare will cover a total of 190 days of
inpatient psychiatric care during Mr. Rainey's entire lifetime.
Mr. Rice is 68, actively working, and has coverage for medical services and medications through his
employer's group health plan. He is entitled to premium free Part A and thinking of enrolling in Part B
and switching to an MA-PD because he is paying a very large part of his group coverage premium, and it
does not provide coverage for a number of his medications. Which of the following is NOT a
consideration when making the change? - correct answer-
Mr. Rodriguez is currently enrolled in a MA plan, but his plan doesn't sufficiently cover his prescription
drug needs. He is interested in changing plans during the upcoming MA Open Enrollment Period. What
are his options during the MA OEP? - correct answer-
Mr. 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. If he wants to enroll in a Medicare Advantage plan, what will he
have to do? - correct answer-He will have to enroll in Part B.
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