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2025 AHIP FINAL EXAM
100% VERIFIED ANSWERS 2024/2025 CORRECT
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"Mrs. Walters is enrolled in her state's Medicaid program in addition to Medicare. What should
she be aware of when considering enrollment in a Medicare Advantage (MA) plan? - CORRECT
ANSWER She cannot enroll in an MA Medical Savings Account (MSA) plan."
"You are mailing invitations to new Medicare beneficiaries for a marketing event. You want an idea of how many people to expect, so you would like to request RSVPs. What should you keep in
mind? - CORRECT ANSWER You may request RSVPs, but you are not permitted to require
contact information." "When you market Medicare Advantage and Part D plans, what may you offer as a gift to induce
enrollment in a plan? - CORRECT ANSWER You may provide gifts or prizes to all potential
enrollees during an event that does not exceed $15 in retail value." "Mr. 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? - CORRECT
ANSWER As long as she can 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." "Ms. Lee is enrolled in an MA-PD plan but will be moving out of the plan's service area next month. She is worried that she will not be able to enroll in another plan available in her new
residence until the Annual Election Period. What should you tell her? - CORRECT ANSWER She
is eligible for a special election period (SEP) that begins either the month before her permanent move, if the plan is notified in advance, or the month she provides notice of the move, and this period typically lasts an additional two months." "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 ANSWER If Mr.
Block enrolls in the stand-alone Medicare prescription drug plan, he will be disenrolled from the Medicare Advantage plan." "Mr. Garcia was told he qualifies for a special election period (SEP), but he lost the paper that
explains what he could do during the SEP. What can you tell him? - CORRECT ANSWER If the
SEP is for MA coverage, he will generally have one opportunity to change his MA coverage." "Mrs. Young is currently enrolled in Original Medicare (Parts A and B), but she has been working with Agent Neil Adams in the selection of a Medicare Advantage (MA) plan. It is mid-September, and Mrs. Young is going on vacation. Agent Adams is considering suggesting that he and Mrs. Young complete the application together before she leaves. He will then submit the paper application before the start of the annual enrollment period (AEP). What would you say If you
were advising Agent Adams? - CORRECT ANSWER This is a bad idea. Agents are generally
prohibited from soliciting or accepting an enrollment form before the start of the AEP." "Ms. Morris will turn 65 on June 10th. She has never previously qualified for Medicare. She is entitled to Medicare Part A and intends to enroll in Part B. She wants to know if she is eligible to enroll in a Medicare Advantage plan that includes prescription drug coverage. What do you tell
her? - CORRECT ANSWER Ms. Morris can enroll in an MA-PD plan now since her initial election
period (IEP) for Part D prescription drug coverage and initial coverage period are occurring together beginning March 1st and ending September 30th." "Mrs. West wears glasses and dentures and has enjoyed considerable pain relief from arthritis through massage therapy. She is concerned about whether or not Medicare will cover these
items and services. What should you tell her? - CORRECT ANSWER Medicare does not cover
massage therapy, or, in general, glasses or dentures." "Mr. Alonso receives some help paying for his two generic prescription drugs from his employer's retiree coverage, but he wants to compare it to a Part D prescription drug plan. He asks you what costs he would generally expect to encounter when enrolling into a standard Medicare Part D
prescription drug plan. What should you tell him? - CORRECT ANSWER He generally would pay
a monthly premium, annual deductible, and per-prescription cost-sharing." "Mr. Davis is 52 years old and has recently been diagnosed with end-stage renal disease (ESRD) and will soon begin dialysis. He is wondering if he can obtain coverage under Medicare. What
"Mrs. Turner is comparing her employer's retiree insurance to Original Medicare and would like to know which of the following services Original Medicare will cover if the appropriate criteria are
met. What could you tell her? - CORRECT ANSWER Original Medicare covers ambulance
services." "Ms. Brooks has aggressive cancer and would like to know if Medicare will cover hospice services
in case she needs them. What should you tell her? - CORRECT ANSWER Medicare covers
hospice services, and they will be available for her." "Mr. Diaz continued working with his company and was insured under his employer's group plan until he reached age 68. He has heard that there is a premium penalty for those who did not sign up for Part B when first eligible and wants to know how much he will have to pay. What should
you tell him? - CORRECT ANSWER Mr. Diaz will not pay any penalty because he had
continuous coverage under his employer's plan." "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." "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."
"Mrs. Velasquez cares for her frail elderly mother, Maria, who lives in North Carolina. She is worried that without additional support, her mother will need to go into a nursing home. Mrs. Velasquez asks you if there is any Medicare plan that might allow her mother to remain in the
community rather than going into a nursing home. How should you advise Mrs. Velasquez? -
CORRECT ANSWER There are Programs of All-Inclusive Care for the Elderly (PACE) for frail
elderly beneficiaries certified as needing a nursing home level of care but are able to live safely in the community at the time of enrolment."
"Mrs. Chi is age 75 and enjoys a comfortable but not extremely high-income level. She wishes to enroll in a MA MSA plan that she heard about from her neighbor. She also wants to have prescription drug coverage since her doctor recently prescribed several expensive medications. Currently, she is enrolled in Original Medicare and a standalone Part D plan. How would you
advise Mrs. Chi? - CORRECT ANSWER Mrs. Chi may enroll in a MA MSA plan and remain in her
current standalone Part D prescription drug plan." "Mrs. Lyons is in good health, uses a single prescription, and lives independently in her own home. She is attracted by the idea of maintaining control over a Medical Savings Account (MSA) but is not sure if the plan associated with the account will fit her needs. What specific piece of information about a Medicare MSA plan would it be important for her to know, prior to enrolling
in such a plan? - CORRECT ANSWER All MSAs cover Part A and Part B benefits, but not Part D
prescription drug benefits, which could be obtained by also enrolling in a separate prescription drug plan." "Mrs. Burton is a retiree with substantial income. She is enrolled in an MA-PD plan and was disappointed with the service she received from her primary care physician because she was told she would have to wait five weeks to get an appointment when she was feeling ill. She called you to ask what she could do so she would not have to put up with such poor access to care. What
could you tell her? - CORRECT ANSWER She could file a grievance with her plan to complain
about the lack of timeliness in getting an appointment." "Mrs. Radford asks whether there are any special eligibility requirements for Medicare
Advantage. What should you tell her? - CORRECT ANSWER Mrs. Radford must be entitled to
Part A and enrolled in Part B to enroll in Medicare Advantage." "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 entitled to Part A, enrolled in Part B, and if he lives in the PFFS plan's service area." "Ms. Gibson recently lost her employer group health and drug coverage and now she wants to enroll in a PPO that does not include drug coverage. What should you tell her about obtaining
drug coverage? - CORRECT ANSWER She can enroll in the PPO, but she will not be able to
purchase a stand-alone Medicare Part D prescription drug plan." "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 Dr. Brennan can charge Mary Rogers no more than the
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. Shapiro gets by on a very small amount of 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 ANSWER The
extra help is available to beneficiaries whose income and assets do not exceed annual limits specified by the government." "Mrs. Allen has a rare condition for which two different brand name drugs are the only available treatment. She is concerned that since no generic prescription drug is available and these drugs are very high cost, she will not be able to find a Medicare Part D prescription drug plan that covers
either one of them. What should you tell her? - CORRECT ANSWER Medicare prescription
drug plans are required to cover drugs in each therapeutic category. She should be able to enroll in a Medicare prescription drug plan that covers the medications she needs." "Mr. Wingate is a newly enrolled Medicare Part D beneficiary and one of your clients. In addition to drugs on his plan's formulary, he takes several other medications. These include a prescription drug not on his plan's formulary, over-the-counter medications for colds and allergies, vitamins, and drugs from an Internet-based Canadian pharmacy to promote hair growth and reduce joint swelling. His neighbor recently told him about a concept called TrOOP and he asks you if any of his other medications could count toward TrOOP should he ever reach the Part D catastrophic limit.
What should you say. - CORRECT ANSWER None of the costs of Mr. Wingate's other
medications would currently count toward TrOOP but he may wish to ask his plan for an exception to cover the prescription, not on its formulary." "Mrs. Mulcahy, age 65, is concerned that she may not qualify for enrollment in a Medicare prescription drug plan because, although she is entitled to Part A, she is not enrolled under
Medicare Part B. What should you tell her? - CORRECT ANSWER An individual who is entitled
to Part A or enrolled under Part B is eligible to enroll in a Medicare prescription drug plan. As long as Mrs. Mulcahy is entitled to Part A, she does not need to enroll under Part B before enrolling in a prescription drug plan." "Mr. Hutchinson has drug coverage through his former employer's retiree plan. He is concerned about the Part D premium penalty if he does not enroll in a Medicare prescription drug plan, but
does not want to purchase extra coverage that he will not need. What should you tell him? -
CORRECT ANSWER If the drug coverage he has is not expected to pay, on average, at least as
much as Medicare's standard Part D coverage expects to pay, then he will need to enroll in Medicare Part D during his initial eligibility period to avoid the late enrollment penalty." "Mr. Jacob understands that there is a standard Medicare Part D prescription drug benefit, but when he looks at information on various plans available in his area, he sees a wide range in what
they charge for deductibles, premiums, and cost sharing. How can you explain this to him? -
CORRECT ANSWER Medicare Part D drug plans may have different benefit structures, but on
average, they must all be at least as good as the standard model established by the government." "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. Rice's
retiree plan is required to take him back if, within 63 days of having voluntarily quit the employer's plan, he decides that he prefers it to his Medicare Part D plan." "Mrs. Roswell is a new Medicare beneficiary who has just retired from retail work. She is interested in selecting a Medicare Part D prescription drug plan. She takes several medications and is concerned that she has not been able to identify a plan that covers all of her medications. She does not want to make an abrupt change to new drugs that would be covered and asks what
she should do. What should you tell her? - CORRECT ANSWER Every Part D drug plan is
required to cover a single one-month fill of her existing medications sometime during a 90-day transition period." "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. and Mrs. Vaughn both take a specialized multivitamin prescription each day. Mr. Vaughn takes a prescription to help to regrow his hair. They are anxious to have their Medicare
prescription drug plan cover these drug needs. What should you tell them? - CORRECT
ANSWER Medicare prescription drug plans are not permitted to cover the prescription
The Medicare Advantage plan received a 5-star rating in customer service and care coordination with an overall performance rating of 4 stars." "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." "While making an appointment to discuss Medicare Advantage (MA) and Part D plans with a potential enrollee, you are asked to describe other types of insurance products that your client might wish to purchase. What additional types of insurance can you present during the MA and
Part D marketing appointments? - CORRECT ANSWER You can present only health care
related lines of business but must obtain the beneficiary's permission to do so before the presentation occurs and document that you have obtained that permission." "One of your colleagues argues that it is better to focus your time and energy exclusively on neighborhoods with single-family homes. He further argues that their older owners are more likely to have higher incomes and purchase the Medicare Advantage products you represent
compared to those living in apartment complexes. How should you respond? - CORRECT
ANSWER This could be considered discriminatory activity and a prohibited practice."
"Agent Jennings makes a presentation on Medicare advertised as an educational event. Agent Jennings distributes materials that are solely educational. However, she gives a brief presentation that mentions plan-specific premiums. Is this a prohibited activity at an event that has been
advertised as educational? - CORRECT ANSWER Yes. When an event has been advertised as
"educational," discussing plan-specific premiums is impermissible." "Mr. Prentice has many clients who are Medicare beneficiaries. He should review the Centers for Medicare & Medicaid Services (CMS) Communication and Marketing Guidelines to ensure he is
compliant with which type of products. - CORRECT ANSWER Medicare Advantage (MA) and
Prescription Drug (PDP) plans." "Next week you will be participating in your first "educational event" for prospective enrollees. To be sure that you do not violate any of the applicable guidelines, in what activities should you plan
to engage? - CORRECT ANSWER You should plan to ensure that the educational event is
informative and must not conduct a sales presentation or distribute or accept enrollment forms at the event."
"If you are to comply with Medicare's guidance regarding educational events, which of the
following would be acceptable activities? - CORRECT ANSWER You may distribute business
cards to individuals who request information on how to contact you for further details on the plan(s) you represent." "By contacting plans available in your area, you have learned that the plan you represent has a significantly lower monthly premium than the others. Furthermore, you see that the plan you represent has a unique benefits package. What should you do to make sure your clients know
about these pieces of information? - CORRECT ANSWER You may make comparisons between
plans if you can support them with studies or statistical data and such comparisons are factually based and referenced." "Winthrop Brokerage wishes to place an advertisement in the local newspaper that says: "We offer Medicare Advantage plans offered by AB Health and Top Choice Health. Contact us if you would like to learn more." Which of the following best describes the obligation(s) of Winthrop
Brokerage regarding the advertisement? - CORRECT ANSWER Winthrop Brokerage does not
need to submit the advertisement to CMS for prior approval because it does not include information about the plans' benefits structures, cost-sharing, or information about measures or ranking standards." "Your colleague works at a third-party marketing organization (TMO) and she said she did not need to take the Medicare training for brokers and agents or pass a test to market Medicare plans since her contract is with the TMO, not the plans that have the products she sells. What could you
say to her? - CORRECT ANSWER You could tell her she is wrong, and that only agents selling
employer/union group plans are permitted an exemption from testing, but some employer/union group plans may require testing to promote agent compliance with CMS marketing requirements." "You are meeting with Mrs. Hall in her home. On her scope of appointment form, she asked to discuss Medicare Advantage plans. During the meeting, she asked to discuss a stand-alone prescription drug plan. She is leaving the next day to visit her family for a week in another state, so she needs to decide before she leaves. What must happen before that additional discussion can
take place? - CORRECT ANSWER Since Mrs. Hall specifically asked that you discuss the stand-
alone Part D plan, you may do so, as long as she signs a new scope of appointment form first, indicating that she wants to discuss the Part D plan."
"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 on January 1 next year. He is currently enrolled in
Original Medicare. What should you do? - CORRECT ANSWER Tell Mr. Anderson that you
cannot accept any enrollment forms until the annual election period begins." "Mr. Ford enrolled in an MA-only plan in mid-November during the Annual Election Period (AEP). On December 1, he calls you up and says that he has changed his mind and would like to enroll in
a MA-PD plan. What enrollment rules would apply in this case? - CORRECT ANSWER He can
make as many enrollment changes as he likes during the Annual Election Period and the last choice made before the end of the period will be the effective one as of January 1." "Mrs. Pierce would like to enroll in a Medicare Cost plan that offers Part D prescription drug coverage. She comes to you for advice about when she can enroll in a plan you have previously
discussed. What should you tell her? - CORRECT ANSWER Enrollment in Cost plans offering
Part D coverage is available only during enrollment periods under the Part D program, and Cost plans must accept enrollments during these periods." "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 He can
switch to a MA-PD plan." "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 period (AEP) before enrolling in such a plan. What should you tell him? -
CORRECT ANSWER If 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)." "Ms. Claggett is sixty-six (66) years old. She has been covered under Original Medicare for the last six years due to her disability and has never been enrolled in a Medicare Advantage or a Part D plan before. She wants to enroll in a Part D plan. She knows that there is such a thing as the "Part D Initial Enrollment Period" (IEP) and has concluded that, since she has never enrolled in such a plan before, she should be eligible to enroll under this period. What should you tell her about how
the Part D Initial Enrollment Period applies to her situation? - CORRECT ANSWER Ms. Claggett
has had two IEPs and missed them both. The first occurred three months before and three months after the month when she was first entitled to Part A OR enrolled in Part B. Because she was eligible for Medicare before age 65, Ms. Claggett had a second IEP based on turning age 65, which has also expired." "Ms. Thomas has worked for many years and is turning 68 in June. She is eligible for Medicare Part A and did not enroll for Part B when first eligible because she has insurance through her employer
- Coffee Brew, Inc. She also did not enroll in Part D because she had creditable coverage. She would like to retire in June and enroll in a Medicare Advantage plan. She has been informed that her group coverage will end on her retirement effective date. How would you advise Ms.
Thomas? - CORRECT ANSWER Ms. Thomas can enroll in Part B without a late penalty at any
time she is still covered by her employer group and 8 months after her last month of employer group coverage without a penalty. However, because she wants to enroll in a MA plan after retirement, she should make sure her Part B coverage is effective in time to use the Medicare Advantage/Part D special election period for individuals changing from employer group coverage to enroll in a MA plan or MA-PD. The SEP begins while she has employer group coverage and will last until 2 months after the month after the month her employer coverage ends. If she wants Part D coverage she should enroll in an MA-PD or a PDP (depending on how she decides to receive her Part A and B benefits) during this time." "Mrs. Schmidt is moving and a friend told her she might qualify for a "special election period" to enroll in a new Medicare Advantage plan. She contacted you to ask what a special election period
is. What could you tell her? - CORRECT ANSWER It is a period, outside of the Annual Election
Period, when a Medicare beneficiary can select a new or different Medicare Advantage and/or Part D prescription drug plan. Typically, the special election period is beneficiary specific and results from events, such as when the beneficiary moves outside of the service area." "Mrs. Kendrick is in good health, has worked for many years, and is six months away from turning
- 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 ANSWER She may enroll in an MA plan
beginning three months immediately before her first entitlement to both Medicare Part A and Part B."
"Which of the following individuals has enrolled in a plan based on a fixed enrollment period? -
CORRECT ANSWER Ben enrolls in a Medicare Advantage plan during the Medicare Advantage
Open Enrollment Period (MA OEP)."
“Mrs. Shields is covered by Original Medicare. She sustained a hip fracture and is being successfully treated for that condition. However, she and her physicians feel that after her lengthy hospital stay, she will need a month or two of nursing and rehabilitative care. What
should you tell them about Original Medicare's coverage of care in a skilled nursing facility? -
CORRECT ANSWER Medicare will cover Mrs. Shield's skilled nursing services provided during
the first 20 days of her stay, after which she would have a copay until she has been in the facility for 100 days." "Mrs. Park is an elderly retiree. Mrs. Park has a low fixed income. What could you tell Mrs. Park
that might be of assistance? - CORRECT ANSWER She should contact her state Medicaid
agency to see if she qualifies for one of several programs that can help with Medicare costs for which she is responsible." "Mrs. Gonzalez is enrolled in Original Medicare and has a Medigap policy as well, but it provides no drug coverage. She would like to keep the coverage she has but replace her existing Medigap
plan with one that provides drug coverage. What should you tell her? - CORRECT ANSWER
Mrs. Gonzalez cannot purchase a Medigap plan that covers drugs, but she could keep her Medigap policy and enroll in a Part D prescription drug plan." "Mrs. Geisler's neighbor told her she should look at her Part D options during the annual Medicare enrollment period because the features of Part D might have changed. Mrs. Geisler can't remember what Part D is so she called you to ask what her neighbor was talking about. What
could you tell her? - CORRECT ANSWER Part D covers prescription drugs and she should look
at her premiums, formulary, and cost-sharing among other factors to see if they have changed." "Mr. Singh would like drug coverage but does not want to be enrolled in a Medicare Advantage
plan. What should you tell him? - CORRECT ANSWER Mr. Singh can enroll in a stand-alone
prescription drug plan and continue to be covered for Part A and Part B services through Original Fee-for-Service Medicare." "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
ANSWER Most individuals who are citizens and age 65 or over 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." "Mr. Patel is in good health and is preparing a budget in anticipation of his retirement when he turns 66. He wants to understand the health care costs he might be exposed to under Medicare if
he were to require hospitalization because of an illness. In general terms, what could you tell him
about his costs for inpatient hospital services under Original Medicare? - CORRECT ANSWER
Under Original Medicare, there is a single deductible amount due for the first 60 days of any inpatient hospital stay, after which it converts into a per-day coinsurance amount through day 90. After day 90, he would pay a daily amount up to 60 days over his lifetime, after which he would be responsible for all costs." "Hank's Fish Store, Inc. is a small company with just 15 employees located in Florida. Hank, the store owner, has provided excellent health benefits to the store's workforce. William, one of the store's long-time employees, will soon be reaching age 65 and eligible for Medicare. William is in good health. He intends to remain an active full-time employee, working several years after becoming eligible for Medicare. What type(s) of retiree health benefit will Hank's Fish Store be
able to offer William? - CORRECT ANSWER Hank's can continue to offer William the same
employee health benefit plan, or, if William enrolls in Medicare Part B, it can enroll him in a Medicare Advantage plan that is offered to the public." "Which of the following statement(s) is/are correct about a Medicare Savings Account (MSA) Plans? I. MSAs may have either a partial network, full network, or no network of providers. II. MSA plans cover Part A and Part B benefits but not Part D prescription drug benefits. III. An individual who is enrolled in an MSA plan is responsible for a minimal deductible of $ indexed for inflation. IV. Non-network providers must accept the same amount that Original Medicare would pay them
as payment in full. - CORRECT ANSWER I, II, and IV only"
"Mr. Romero is 64, retiring soon, and considering enrollment in his employer-sponsored retiree group health plan that includes drug coverage with nominal copays. He heard about a neighbor's MA-PD plan that you represent and because he takes numerous prescription drugs, he is
considering signing up for it. What should you tell him? - CORRECT ANSWER He should
compare the benefits in his employer-sponsored retiree group health plan with the benefits in his neighbor's MA-PD plan to determine which one will provide sufficient coverage for his prescription needs." "Mr. Wells is trying to understand the difference between Original Medicare and Medicare
Advantage. What would be the correct description? - CORRECT ANSWER Medicare Advantage
is a way of covering all the Original Medicare benefits through private health insurance companies." "What types of tools can Medicare Part D prescription drug plans use that affect the way their
enrollees can access medications? - CORRECT ANSWER Part D plans do not have to cover all
"You will be holding a sales event soon, at which you would like to offer door prizes to attendees. Under guidelines from the Medicare agency, what types of gifts or prizes would not be allowed in
this situation - CORRECT ANSWER Gift cards or gift certificates of $15 or less that can be
readily converted to cash." "Mr. Chen is enrolled in his employer's group health plan and will be retiring soon. He would like to know his options since he has decided to drop his retiree coverage and is eligible for Medicare.
What should you tell him? - CORRECT ANSWER Mr. Chen can disenroll from his employer-
sponsored coverage to elect a Medicare Advantage or Part D plan within 2 months of his disenrollment." "Mr. Yoo's employer has recently dropped comprehensive creditable prescription drug coverage that was offered to company retirees. The company told Mr. Yoo that, because he was affected by this change, he would qualify for a special election period. Mr. Yoo contacted you to find out
more about what this means. What can you tell him? - CORRECT ANSWER It means that he
qualifies for a one-time opportunity to enroll in an MA-PD or Part D prescription drug plan."
