AHIP Final Exam Test Questions and Answers (2022/2023) (Verified Answers) latest updated
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AHIP Final Exam Test Questions and Answers (2022/2023)
(Verified Answers) latest updatedAHIP Final Exam Test Questions and Answers (2022/2023)
(Verified Answers) latest updated
AHIP Final Exam Test Questions and Answers (2022/2023)
(Verified Answers) latest updated
Mrs. Kendrick is in good health, has worked for many years and is six months away
from turning 65. She wants to know what she will have to do to enroll in a Medicare
Advantage (MA) plan as soon as possible. What could you tell her?correct answersShe
may enroll in an MA plan beginning three months immediately before her first
entitlement to both Medicare Part A and Part B.
Mrs. Reynolds is in her Medicare initial coverage election period (ICEP) and the date of her entitlement
to Part A and B has already occurred. Mrs. Reynolds has just signed up for a Medicare Advantage plan
on the second of the month. She is leaving for vacation in two weeks and wants to know if her new
coverage will start before she leaves. What should you tell her?correct answersTypically, her coverage
would begin on the first day of the next month, so she should not expect her coverage to begin before
she leaves.
Mr. Robinson was quite ill recently and forgot to pay his monthly premium for his MA-PD plan. He is
worried that he will lose his coverage now when he needs it the most. He is certain his plan will
disenroll him because that is what happened to a friend of his in a similar type of plan. What can you
tell Mr. Robinson about his situation?correct answersPlan sponsors have the option to do nothing
when a plan member does not pay their premiums or disenroll the member after a grace period and
notice.
Mrs. Johnson calls to tell you she has not received her new plan ID card yet, but she needs to see a
doctor. What can she expect to receive from the plan after the plan has received her enrollment
form?correct answersEvidence of plan membership, information on how to obtain services, and the
effective date of coverage.
Mr. Anderson is a very organized individual and has filled out and brought to you an enrollment form
on October 10 for a new plan available January 1 next year. He is currently enrolled in Original
Medicare. What should you do?correct answersTell Mr. Anderson that you cannot accept any
enrollment forms until the annual election period begins.
Mr. Wendt suffers from diabetes which has gotten progressively worse during the last year. He is
currently enrolled in Original Medicare (Parts A and B) and a Part D prescription drug plan and did not
enroll in a Medicare Advantage (MA) plan during the last annual open enrollment period (AEP) which
has just closed. Mr. Wendt has heard certain MA plans might provide him with more specialized
coverage for his diabetes and wants to know if he must wait until the next annual open enrollment
,AHIP Final Exam Test Questions and Answers (2022/2023)
(Verified Answers) latest updated
period (AEP) before enrolling in such a plan. What should you tell him?correct answersIf there is a
special needs plan (SNP) in Mr. Wendt's area that specializes in caring for individuals with diabetes, he
may enroll in the SNP at any time under a special election period (SEP)
Richard is a licensed agent who represents Spartan Health Plan and its Medicare Advantage (MA) plans.
Richard has several clients who have recently come to him for help who are in their initial coverage
election period (ICEP) and are interested in enrolling in one of Spartan Health Plan's MA plans. Alice will
soon turn 65 and retire. Alice has coverage through Spartan Health Plan offered by her employer. Bob
had health coverage through Spartan but dropped the coverage when he retired early to travel
overseas. Bob, who has just turned age 65, is now back in the United States. Charlotte, who will turn 65
next month, has coverage through Athena Health plan - a
company Richard also represents. Who qualifies for the opt-in simplified enrollment
mechanism?correct answersAlice because she will not have a break between her non-
Medicare and Medicare coverage through Spartan Health Plan. ???????????????
You would like to offer gifts of nominal value to potential enrollees who call for more information
about a plan you represent. You would then like to offer additional gifts if they come to a marketing
event. Each of the gifts meets the CMS definition of nominal value, but together, the gifts are more
than the nominal value. Is this permissible?correct answersNo, the total value of the gifts given to an
enrollee in a year cannot exceed the CMS definition of nominal value.
You are doing a sales presentation for Ms. Duarte and her son. Ms. Duarte has some cognitive
impairment and her son informs you that he has power of attorney to only make financial not health
care decisions for her. Can he execute the enrollment for her?correct answersNo, he cannot execute
the enrollment for her. He must have a legal authorization, under state law that explicitly allows him to
make health care decisions for his mother.
Agent Willis had several clients who disenrolled from the plans he represents during the AEP to enroll
in Medicare Advantage plans that are competitors of his. Agent Willis believes that the choices they
made are not ideal for them and would like to get their business back during the Medicare Advantage
Open Enrollment Period (MA-OEP). What can agent Willis do?correct answersHe can call them to let
them know that if they do not like their new plans, they can change back during the MA-OEP.
,AHIP Final Exam Test Questions and Answers (2022/2023)
(Verified Answers) latest updated
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?correct answersA 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.
Mrs. Sanchez lives in a state located near Canada. She has recently become eligible for Medicare and is
considering enrollment in Part D prescription drug coverage. One of her friends has told her that she
needs to be aware of something called TrOOP. What should you tell her when she asks you about
TrOOP?correct answersTrOOP are out-of- pocket costs that count toward the annual out-of-pocket
threshold to move into catastrophic coverage and generally include the annual deductible(s) and costs
for drugs on the plan's formulary purchased at a plan's participating pharmacy. In some instances,
amounts not directly paid by the enrollee (like manufacturer discounts) count toward TrOOP.
Mr. Polanski likes the cost of an HMO plan available in his area but would like to be able
to visit one or two doctors who aren't participating providers. He wants to know if the
Point of Service (POS) option available with some HMOs will be of any help in this
situation. What should you tell him?correct answersThe POS option might be a good
solution for him as it will allow him to visit out-of-network providers, generally without
prior approval. However, he should be aware that it is likely he will have to pay higher
cost-sharing for services from out-of-network providers.
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 answersMr. 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.
You have decided to focus on doing in-home presentations to market the Medicare Advantage (MA)
plans you represent. Before you conduct such sales presentations, what must you do?correct
answersYou must receive an invitation from the beneficiary and document the specific types of
products the beneficiary wants to discuss prior to making an in-home presentation.
, AHIP Final Exam Test Questions and Answers (2022/2023)
(Verified Answers) latest updated
This year you decide to focus your efforts on marketing to employer and union groups. Which of the
following statements best describes what you can and cannot do in order to stay in compliance?correct
answersYou are not required to submit communication and marketing materials specific only to those
employer plans to CMS at the time of use, but CMS may request and review copies if employee
complaints occur.
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 answersDiscuss plan specific information such as premiums and benefits.
Ms. Hernandez has marketed several different types of insurance products in her home state and has
typically sought approval of her materials from her State Department of Insurance. What would you
advise her regarding seeking such approval for materials she uses to market Medicare Advantage
plans?correct answersMaterials need only be reviewed and approved by the company(s) she
represents.
Mr. Lee was intending to enroll in MaxCare's Medicare Advantage plan this year. However, due to his
current medical condition, his daughter Debbie has been appointed as his legal representative over
both health and financial matters. Debbie would like to ensure that her father is still able to enroll in
MaxCare's plan, but she is unsure what her role is to help with his enrollment request. What advice can
you give her?correct answersLegal representatives are only permitted to submit a paper enrollment
request.
???????????
Last year Agent Melanie Meyers marketed and enrolled several clients in Medicare Advantage (MA)
health plans. This year she has decided to focus on non-MA products. What advice would you give
Melanie if she wishes to continue to receive renewal
fees?correct answersMelanie must remain trained, tested, licensed, and appointed,
regardless of whether she is actively selling MA products.
Alice is enrolled in a MA-PD plan. She makes a permanent move across the country and wonders what
her options are for continuing MA-PD coverage. What would you say to her in regard to a special
enrollment period (SEP)?correct answersShe is likely to qualify for a SEP. She can choose an effective
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