AHIP 2020 Final Exam_ Final Exam Medicare Course Home Transcript Final Exam - Attempt 1
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Course
AHIP 2020
Institution
AHIP 2020
AHIP 2020 Final Exam_ Final Exam
Medicare Course Home Transcript
Final Exam - Attempt 1
1
Marks: 1
Agent Higgins helps Mrs. O'Malley to enroll in AB Medicare Advantage (MA) plan during the Annual Open
Enrollment Period. Mrs. O'Malley's effective enrollment date is January 1st. Subsequently, M...
Agent Higgins helps Mrs. O'Malley to enroll in AB Medicare Advantage (MA) plan during the Annual Open
Enrollment Period. Mrs. O'Malley's effective enrollment date is January 1st. Subsequently, Mrs. O'Malley
disenrolls on February 12th following a move outside the plan's service area. What impact will this have on
Agent Higgins compensation?
Choose one a. Agent Higgins entire compensation must be recouped because Mrs. O’Malley has
answer. disenrolled within 3 months of enrollment.
b. AB MA plan must recoup a pro rata amount of Agent Higgins’ compensation if Mrs.
O’Malley subsequently enrolls in Original Medicare and Part D
c. AB MA plan does not have to recoup Agent Higgins’ compensation because she
has moved away from its service area.
d. AB MA plan must recoup a pro rata amount of Agent Higgins’ compensation and
pay him only for the month of January.
2
Marks: 1
1/18
,AHIP 2020 Final Exam
Mrs. Mulcahy 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?
Choose one a. Everyone who is entitled to Part A or enrolled under Part B is eligible to enroll in a
answer. 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.
b. To qualify for enrollment into a Medicare prescription drug plan, Mrs. Mulcahy must
be entitled to Part A and enrolled under Part B. She should contact her local Social
Security office and make arrangements to enroll in Part B prior to selecting a
prescription drug plan.
c. Like all Medicare beneficiaries, Mrs. Mulcahy will be automatically enrolled in a
Medicare prescription drug plan when she turns 65. She will have a six-month window
during which she can select a plan other than the one into which she has been
automatically enrolled.
d. As long as Mrs. Mulcahy is 65, eligibility for a Medicare prescription drug plan is not
dependent on entitlement to Part A or enrollment under Part B, so she should not be
concerned.
3
Marks: 1
2/18
, AHIP 2020 Final Exam
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)?
Choose one a. She is unlikely to qualify for a SEP but will be automatically covered by Original
answer. Medicare and a standalone Part D prescription drug plan.
b. She is likely to qualify for a SEP. She can choose an effective date of up to six
months after the month in which the enrollment form is received by the new plan, but
the effective date may not be earlier than 30 days prior to the date of her move.
c. She is unlikely to qualify for a SEP and should remain on her current plan, relying
on her current plan’s out-of-network benefits.
d. She is likely to qualify for a SEP. She can choose an effective date of up to three
months after the month in which the enrollment form is received by the new plan, but
the effective date may not be earlier than the date of her permanent move.
4
Marks: 1
Mrs. Walters is entitled to Part A and has medical coverage without drug coverage through an employer retiree
plan. She is not enrolled in Part B. Since the employer plan does not cover prescription drugs, she wants to
enroll in a Medicare prescription drug plan. Will she be able to?
Choose one a. Yes, but Mrs. Walters must drop the employer coverage prior to enrolling in a
answer. Medicare prescription drug plan.
b. No. Mrs. Walters will have to enroll in Part B in order to qualify for enrollment into
the Medicare prescription drug program.
c. Yes. Mrs. Walters must be entitled to Part A or enrolled in Part B to be eligible for
coverage under the Medicare prescription drug program.
d. No. As long as her employer offers coverage that is equivalent to that available
through Medicare, Mrs. Walters cannot enroll in a Medicare prescription drug plan.
5
Marks: 1
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?
Choose one a. Ms. Lopez is considered a marketing representative of BestCare and thus is
answer. obligated to comply with CMS marketing requirements, including those regarding
using only approved call scripts.
b. Ms. Lopez no longer needs to be concerned about state licensure since she is
marketing an MA product subject to federal rules.
c. 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.
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.
3/18
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