2025 AHIP Final Exam questions /accurate answers /verified and latest 2024-2025, Exams of Nursing

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2025 AHIP Final Exam questions /accurate answers

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1. 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?: 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.

2. 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?: Medicare does not cover massage therapy, or, in general, glasses or dentures.
3. Mrs. Park is an elderly retiree. Mrs. Park has a low fixed income. What could you tell Mrs. Park that might be of assistance?: 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. 4.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?: He generally would pay a monthly premium, annual deductible, and per-prescription cost-sharing.

5. 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?: 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.
6. 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 should you tell him?: He may sign-up for Medicare at any time however coverage usually begins on the fourth month after dialysis treatments start.
7. Mrs. Duarte is enrolled in Original Medicare Parts A and B. She has recently reviewed her Medicare Summary Notice (MSN) and disagrees with a determi- nation that partially denied one of her claims for services. What advice would you give her?: Mrs. Duarte should file an appeal of this initial determination within 120 days of the date she received the MSN in the mail.

8.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?: 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.

9. Mr. Rainey is experiencing paranoid delusions and his physician feels that he should be hospitalized. What should you tell Mr. Rainey (or his representa- tive) about the length of an inpatient psychiatric hospital stay that Medicare will cover?: Medicare will cover a total of 190 days of inpatient psychiatric care during Mr. Rainey's entire lifetime. 10. Mr. Xi will soon turn age 65 and has come to you for advice as to what services are provided under Original Medicare. What should you tell Mr. Xi that best describes the health coverage provided to Medicare beneficiaries?- : Beneficiaries under Original Medicare have no cost-sharing for most preventive services. 11.Mr. Singh would like drug coverage but does not want to be enrolled in a Medicare Advantage plan. What should you tell him?: 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. 12.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?: 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. 13.Mrs. Quinn recently turned 66 and decided after many years of work to retire and begin receiving Social Security benefits. Shortly thereafter Mrs. Quinn received a letter informing her that she had been automatically enrolled in Medicare Part B. She wants to understand what this means. What should you tell Mrs. Quinn?: Part B primarily covers physician services. She will be paying a monthly premium and, except for many preventive and screening tests, generally will have 20% co-payments for these services, in addition to an annual deductible. 14.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?: 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. 15.What impact, if any, have recent regulatory changes had on Medigap plans?: The Part B deductible is no longer covered for individuals newly eligible for Medicare starting January 1, 2020. 16.Mrs. Paterson is concerned about the deductibles and co-payments as- sociated with Original Medicare. What can you tell her about Medigap as an option to address this concern?: Medigap plans do not cover Original Medicare benefits, but they coordinate with Original Medicare coverage. 17.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?: Original Medicare covers ambulance services. 18.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?: Medicare covers hospice services, and they will be available for her. 19.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?: Mr. Diaz will not pay any penalty because he had continuous coverage under his employer's plan. 20.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?: 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.

21. 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?: 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. 22.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?: He will have to enroll in Part B. 23.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?: 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.

24. Which of the following statement(s) is/are correct about a Medicare Sav- ings 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 $500 indexed for inflation.

IV. Non-network providers must accept the same amount that Original Medicare would pay them as payment in full.: I, II, and IV only 25.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?: Mrs. Chi may enroll in a MA MSA plan and remain in her current standalone Part D prescription drug plan. 26.Mrs. Lyons is in good health, uses a single prescription, and lives indepen- dently 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?: 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.

27. 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?: She could file a grievance with her plan to complain about the lack of timeliness in getting an appointment. 28.Mrs. Radford asks whether there are any special eligibility requirements for Medicare Advantage. What should you tell her?: Mrs. Radford must be entitled to Part A and enrolled in Part B to enroll in Medicare Advantage. 29.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 deter- mine his eligibility?: 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. 30.Mr. Romero is 64, retiring soon, and considering enrollment in his em- ployer-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?: He should compare the

benefits in his em- ployer-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. 31.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?: She can enroll in the PPO, but she will not be able to purchase a stand-alone Medicare Part D prescription drug plan. 32.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?: Dr. Brennan can charge Mary Rogers no more than the cost sharing specified in the PFFS plan's terms and condition of payment which may include balance billing up to 15%of the Medicare rate. 33.Mrs. Kelly, age 65, is entitled to Part A but has not yet enrolled in Part B. She is considering enrollment in a Medicare Advantage plan (Part C). What should you advise her to do before she can enroll in a Medicare Advantage plan?: To join a Medicare Advantage plan, she also must enroll in Part B.

34.Mr. Wells is trying to understand the difference between Original Medicare and Medicare Advantage. What would be the correct description?: Medicare Advantage is a way of covering all the Original Medicare benefits through private health insurance companies.

35. Mr. Lombardi is interested in a Medicare Advantage (MA) PPO plan that you represent. It is one of three plans operated by the same organization in Mr. Lombardi's area. The MA PPO plan does not include drug coverage, but the other two plans do. Mr. Lombardi likes the PPO plan that does not include drug coverage and intends to obtain his drug coverage through a stand-alone Medicare prescription drug plan. What should you tell him about this situation?: He could enroll either in one of the MA plans that include prescrip- tion drug coverage or Original Medicare with a Medigap plan and standalone Part D prescription drug coverage, but he cannot enroll in the MA-only PPO plan and a stand-alone prescription drug plan. 36.Mrs. Wang wants to know generally how the benefits under Original Medicare might compare to the benefits package of a Medicare Advantage Plan before she starts looking at specific plans. What could you tell her?: - Medicare Advantage Plans may offer extra benefits that Original Medicare does not offer such as vision, hearing, and dental services. It must include a maximum out-of-pocket limit on Part A and Part B services. 37.Mrs. Chou likes a Private Fee-for-Service (PFFS) plan available in her area that does not include drug coverage. She wants to enroll in the plan and enroll in a stand-alone

prescription drug plan. What should you tell her?: She could enroll in a PFFS plan and a stand- alone Medicare prescription drug plan. 38.Mr. Lopez has heard that he can sign up for a product called "Medicare Advantage" but is not sure about what type of plan designs are available through this program. What should you tell him about the types of health plans that are available through the Medicare Advantage program?: There are Medicare health plans such as HMOs, PPOs, PFFS, and MSAs. 39.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?: You can offer to review the plans appeal process to help him ask the plan to review the coverage decision.

40. 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?: She cannot enroll in an MA Medical Savings Account (MSA) plan. 41.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?: The extra help is available to beneficiaries whose income and assets do not exceed annual limits specified by the government. 42.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?: 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. 43.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 for- mulary, 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.: 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.

44. What types of tools can Medicare Part D prescription drug plans use that affect the way their enrollees can access medications?: Part D plans do not have to cover all medications. As a result, their formularies, or lists of covered drugs, will vary from plan to plan. In addition, they can use cost containment techniques such as tiered co-payments and step therapy. 45.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?: 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. 46. 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?: 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. 47.Mr. Jacob understands that there is a standard Medicare Part D prescrip- tion 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, premi- ums, and cost sharing. How can you explain this to him?: 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. 48.Who is most likely to benefit from the Medicare Prescription Payment Plan?: Kevin, who suffered a heart attack at the beginning of the year requiring him to take an expensive brand name blood thinner on a daily, as well as an equally expensive injectable cholesterol medication on a bi- weekly basis for which he incurs high out-of-pocket costs. 49.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?: 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. 50.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?: 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. 51.Mr. Bickford did not quite qualify for the extra help low-income subsidy under the Medicare Part D Prescription Drug program and he is wondering if there is any other option he has for obtaining help with his considerable drug costs. What should you tell him?: He could check with the manufacturers of his medications to see if they offer an assistance program to help people with limited means to obtain the medications they need. Alternatively, he could check to see whether his state has a pharmacy assistance program to help him with his expenses.

52.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?: 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. 53.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?: Medicare prescription drug plans are not permitted to cover the prescription medications the Vaughns are interested in under Part D coverage, however, plans may cover them as supplemental benefits and the Vaughns could look into that possibility.

54. Mr. Hildalgo complains to you that because he takes multiple expensive drugs, he has trouble paying his cost sharing for his prescription drugs, particularly at the beginning of the year during the deductible phase. He is happy with his plan and does not want to change. However, he said he had heard about a new program called the Medicare Prescription Payment Plan and asked whether it might

help. What do you tell him?: The Medicare Prescription Payment Plan helps spread out beneficiary cost-sharing payments but does not decrease the total amount owed. 55.Mr. Torres has a small savings account. He would like to pay for his monthly Part D premiums with an automatic monthly withdrawal from his savings account until it is exhausted, and then have his premiums withheld from his Social Security check. What should you tell him?: In general, he must select a single Part D premium payment mechanism that will be used throughout the year. 56.One of your clients, Lauren Nichols, has heard about a Medicare concept from one of her neighbors called TrOOP. She asks you to explain it. What do you say?: TrOOP stands for true out-of-pocket costs that count toward the Medicare Part D catastrophic limit and include not only expenses paid by a beneficiary but also in some instances amounts paid by or through qualified State Pharmaceutical Assistance Programs. 57.Mr. Zachow has a condition for which three drugs are available. He has tried two but had an allergic reaction to them. Only the third drug works for him and it is not on his Part D plan's formulary. What could you tell him to do?: Mr. Zachow has a right to request a formulary exception to obtain coverage for

his Part D drug. He or his physician could obtain the standardized request form on the plan's website, fill it out, and submit it to his plan. 58.Mrs. Lopez is enrolled in a cost plan for her Medicare benefits. She has recently lost creditable coverage previously available through her husband's employer. She is interested in enrolling in a Medicare Part D prescription drug plan (PDP). What should you tell her?: If a Part D benefit is offered through her plan she may choose to enroll in that plan or a standalone PDP. 59.Mrs. Hernandez is one of your clients. She has read that there is a new program that may help her manage prescription drug costs. What do you tell her about the Medicare Prescription Payment Plan?: Part D enrollees can opt into the Medicare Prescription Payment Plan at the beginning of the plan year or any point during the year. 60.Ms. Edwards is enrolled in a Medicare Advantage plan that includes pre- scription drug plan (PDP) coverage. She is traveling and wishes to fill two of the prescriptions that she has lost. How would you advise her?: She may fill prescriptions for covered drugs at non-network pharmacies, but likely at a higher cost than paid at an in-network pharmacy. 61.During a sales presentation to Ms. Daley for a Medicare Advantage plan that has a 5- star rating in customer service and care coordination, and re- ceived an overall plan performance rating of a 4-star, which of the following would be the best statement to say to her?: The Medicare Advantage plan received a 5-star rating in customer service and care coordination with an overall performance rating of 4 stars.

62.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?: You must have her sign a scope of appointment form, indicating which products she wishes to discuss. You may then proceed with the discussion. 63.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?: 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.

64. One of your colleagues argues that it is better to focus your time and ener- gy 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?: This could be considered discriminatory activity and a prohibited practice. 65.Agent Jennings makes a presentation on Medicare advertised as an educa- tional 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 edu- cational?: Yes. When an event has been advertised as "educational," discussing plan-specific premiums is impermissible. 66.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 prod- ucts.: Medicare Advantage (MA) and Prescription Drug (PDP) plans. 67.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?: 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. 68.You market many different types of insurance and ordinarily you spend time each evening calling potential clients. To comply with requirements for marketing Medicare Advantage and Part D plans, what must you do about contacting potential clients to market

those plansl?: You will have to avoid calling any potential client unless he or she initiates contact with you and specifically asks that you give him or her a call. 69.If you are to comply with Medicare's guidance regarding educational events, which of the following would be acceptable activities?: You may dis- tribute business cards to individuals who request information on how to contact you for further details on the plan(s) you represent. 70.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?: You may make comparisons between plans if you can support them with studies or statistical data and such comparisons are factually based and referenced. 71.You have set up an appointment for an in-home sales presentation with Mrs. Fernandez, who expressed interest in the Medicare plans you represent. In preparation for the sales presentation, what must you do?: Before conducting the presentation, obtain and document having obtained her permission to visit, along with her interest in the specific products you will present.

72.Winthrop Brokerage wishes to place an advertisement in the local newspa- per 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?: Winthrop Brokerage does not need to submit the advertise- ment 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. 73.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?: You may request RSVPs, but you are not permitted to require contact information. 74.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?: 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. 75.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?: 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. 76.You plan to participate in an educational event sponsored by a large regional health care system. One of your colleagues suggests that you do a presentation on one of the Medicare Health plans you market and modify it to include information about preventive screening tests showcased at the event. How should you respond to your colleague's suggestion?: You should tell your colleague no, because marketing representatives are not permitted to participate, in any way, in an educational event. 77.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: Gift cards or gift certificates of $15 or less that can be readily converted to cash.

78.When you market Medicare Advantage and Part D plans, what may you offer as a gift to induce enrollment in a plan?: You may provide gifts or prizes to all potential enrollees during an event that does not exceed $15 in retail value. 79.You would like to market a MA plan at a neighborhood pharmacy. What should you keep in mind to comply with the marketing requirements for MA plans?: You must set up your table, make marketing presentations, and accept enrollment applications only in common areas outside of where the patient waits for services from the pharmacist. 80.Agent Harriet Walker has recently begun marketing Medicare Advantage and related products aimed at meeting the needs of senior citizens. Client Mildred Jones has expressed interest in a Medicare Advantage plan. It is now the beginning of September. If you were in Agent Walker's position, what would you do?: Inquire whether the client qualifies for a special enrollment period, and if not, solicit an enrollment application once the annual open enrollment election period begins on October 15th.

81. Which of the following individuals are likely to qualify for a special election period (SEP) for either a MA and/or Part D due to a change of residence? I. Edward (enrolled in MA and Part D) moves to a new home within the same neighborhood in his existing plan's service area. II. Fiona (enrolled in MA and Part D) moves cross-country to an area outside her existing