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AHIP (America’s Health Insurance Plans) Newest 2025 Final Exam Test Bank featuring 500 accurate and verified questions covering Medicare Advantage, Medicare Part D, fraud, waste, and abuse (FWA), enrollment procedures, compliance guidelines, and ethics in health insurance marketing. Ideal for agents and brokers preparing for AHIP certification
Which of the following is a correct statement about state laws as
they pertain to marketing representatives? Correct Answer:
Medicare health plans must comply with requests for informationfrom state insurance departments investigating complaints about a marketing representative.
You are seeking to represent an individual Medicare Advantage plan and an individual Part D plan in yourstate. You have completed the required training for each plan, but you did not achieve a passing score onthe tests that came after the training.
What can you do in this situation? Correct Answer: You will not
beable to represent any Medicare Advantage or Part D plan until you complete the training and achieve anadequate score, although you will not have to take a test if you exclusively market employer/union groupplans and the companies do not require testing. 1 / 4
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Your colleague works at a third party marketing organization (TMO) and she said she did not need to takethe 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.
Agent Armstrong is employed by XYZ Agency, which is under contract with ABC Health Plan, a Medicare Advantage (MA) plan that offers plans in multiple states. XYZ Agency maintains a website marketing the MA plans with which it has contracts.Agent Armstrong follows up with individuals who request more information about ABC MA plans via the website and tries to persuade them to enroll in ABC plans. Whatstatement best describes the marketing and compliance rules that apply to
Agent Armstrong? Correct Answer: Agent Armstrong needs to
be licensed and appointed in every state in which beneficiaries to whom he markets ABC MA plans are located.
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You are mailing invitations to new Medicare beneficiaries for a marketing event. You want an idea of howmany 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.
Agent Antonio is preparing for a presentation on Medicare and Medicare Advantage before a local senior citizen civic group where he hopes to enroll some attendees. Which of the following steps should he take in order to be in compliance with
Medicare marketing rules? Correct Answer: Antonio should
include on the invitation a statement that a salesperson will be present with information and applications.
You have set up an appointment for an in-home sales presentation with Mrs. Fernandez, who expressedinterest in the Medicare plans you represent. In preparation for the sales
presentation, what must you do? Correct Answer: Prior to
conducting the presentation, obtain, and document having obtained her permission to visit, along with her interest in the specific products you will present.
Mrs. Lu is turning 65 in November and called to ask for your help deciding on a Medicare Advantageplan. She agreed to sign 3 / 4
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a scope of appointment form and meet with you October 15.During the
appointment, what are you permitted to do? Correct Answer:
You may provide her with the requiredenrollment materials and take her completed enrollment application.
While marketing Medicare Advantage and Part D plans, you collected a large number of scope of appointment forms from your clients, wherein they indicated their interest in specific products and their wish for you to provide information on those products in their homes. What should you do with those forms?
Correct Answer: The scope of appointment forms must be
retained for a period of ten (10) years.
A Medicare beneficiary has walked into your office and requested that you sit down with her and discussher 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, and note on the form that she is a "walk in." You may then proceed withthe discussion.
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