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AHIP 2024 Final Exam Practice Questions and Answers
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AHIP 2024 Final Exam Practice Questions and Answers Mr. Davies is turning 65 next month. He would like to enroll in a Medicare health plan, but does not want to be limited in terms of where he obtains his care. What should you tell him about how a Medicare Cost Plan might fit his needs? - ANSWE...

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  • October 31, 2024
  • 43
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers

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  • ahip 2024 final exam practice questions and answer

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  • 2025 AHIP
  • 2025 AHIP

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©EMILLECT2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED

FIRST PUBLISH OCTOBER 2024




AHIP 2024 Final Exam Practice Questions

and Answers


Mr. Davies is turning 65 next month. He would like to enroll in a Medicare health plan, but does not want

to be limited in terms of where he obtains his care. What should you tell him about how a Medicare Cost

Plan might fit his needs? - ANSWER✔✔-a. Cost plan enrollees can choose to receive Medicare covered

services under the plan's benefits by going to plan network providers and paying plan cost sharing, or

may receive services from non-network providers and pay cost-sharing due under Original Medicare.


b. Ms. Lopez is considered a marketing representative of BestCare and thus is obligated to comply with

CMS marketing requirements, including those regarding using only approved call scripts. - ANSWER✔✔-

Ms. Lopez is an independent agent under contract with MarketCo, a third-party marketing organization.

MarketCo has a contract with BestCare health plan, a Medicare Advantage (MA) organization, to offer

marketing services through its contracted agents and agencies. Ms. Lopez returns calls to individuals

who contact MarketCo in response to its mailers promoting BestCare health plan. Which of the following

best describes the responsibilities of Ms. Lopez?




a. Ms. Lopez is considered a marketing representative of BestCare but is exempt from the marketing

rules regarding approved call scripts because she works directly for MarketCo.

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, ©EMILLECT2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED

FIRST PUBLISH OCTOBER 2024




b. Ms. Lopez is considered a marketing representative of BestCare and thus is obligated to comply with

CMS marketing requirements, including those regarding using only approved call scripts.




c. Ms. Lopez no longer needs to be concerned about state licensure since she is marketing an MA

product subject to federal rules.




d. Ms. Lopez needs to maintain state licensure, but because she is working for a third-party marketing

organization she is exempt from CMS training requirements that apply to BestCare captive agents.


Mr. Edwards, a marketing representative of the ACME Insurance Company, scheduled a marketing event

and expects about 40 people to attend. He has hired a magician at a cost of $200 to entertain attendees.

Can he do this in a way that complies with guidance from the Medicare agency? - ANSWER✔✔-a. He can

do this because the estimated number of attendees is based on the venue size and response rate and

the value of the gift does not exceed $15.


Mrs. Ramos is considering a Medicare Advantage PPO and has questions about which providers she can

go to for her health care. What should you tell her? - ANSWER✔✔-b. Mrs. Ramos can obtain care from

any provider who participates in Original Medicare, but generally will have a higher cost-sharing amount

if she sees a provider who/that is not a part of the PPO network.


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, ©EMILLECT2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED

FIRST PUBLISH OCTOBER 2024




Julia Harris is turning 66 in July, at which time she will retire. She has contacted your office and

requested a meeting so that she can learn about Medicare and the products you represent. How should

you respond? - ANSWER✔✔-c. Tell Julia that you will meet with her to explain Medicare and should she

be interested you can accept and submit an enrollment request, since this is an initial enrollment

qualifying her for a special enrollment period.


Mr. Rivera has Qualified Medicare Beneficiary (QMB) eligibility and is thus covered by both Medicare and

Medicaid. He decides to enroll in a Medicare Advantage (MA) PPO plan. Later he sees an out-of-network

doctor to receive a Medicare covered service. How much The doctor may only collect from Mr. Rivera

the cost sharing allowable under the state's Medicaid program.may the doctor collect from Mr. Rivera? -

ANSWER✔✔-The doctor may only collect from Mr. Rivera the cost sharing allowable under the state's

Medicaid program.


During a sales presentation in Ms. Sullivan's home, she tells you that she has heard about a type of

Medicare health plan known as Private Fee-for-Service (PFFS). She wants to know if this would be

available to her. What should you tell her about PFFS plans? - ANSWER✔✔-


Choose one answer. - ANSWER✔✔-


- ANSWER✔✔-a. A PFFS plan is a type of Medicare Supplement plan and she may enroll in one if it is

available in her area.


- ANSWER✔✔-b. A PFFS plan is exactly the same as Original Medicare, only offered by a private entity

and she may enroll in one if it is available in her area.

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, ©EMILLECT2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED

FIRST PUBLISH OCTOBER 2024




- ANSWER✔✔-c. PFFS plans are designed to cover only prescription drugs and if that is the type of

coverage she wants, she may enroll in one if it is available in her area.


- ANSWER✔✔-d. A PFFS plan is one of the various types of Medicare Advantage plans offered by private

entities and she may enroll in one if it is available in her area.


Question8 - ANSWER✔✔-


Marks: 1 - ANSWER✔✔-


During an appointment scheduled to discuss a Medicare Advantage Prescription Drug plan (MA-PD), Mr.

Peters asked his agent to describe a stand-alone prescription drug plan (Part D plan) that his neighbor

told him about. What should his agent do? - ANSWER✔✔-


Choose one answer. - ANSWER✔✔-


- ANSWER✔✔-a. Since Mr. Peters requested a description of the Part D plan, his agent must leave the

Part D plan brochure, but not an enrollment form, and would have to schedule another appointment

after at least 48 hours have passed to discuss the Part D plan with Mr. Peters.


- ANSWER✔✔-b. Since Mr. Peters requested a description of the Part D plan, his agent must have Mr.

Peters sign a new scope of appointment form that includes Part D, and then the agent may discuss the

Part D plan so Mr. Peters can compare plans and make an informed enrollment choice during the

appointment.



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