AHIP 2020 Final Exam Questions And Correct Answers, Complete Solution.
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AHIP 2020
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AHIP 2020
AHIP 2020 Final Exam Questions And Correct Answers, Complete Solution.
Mr. Davies is turning 65 next month. He would like to enroll in a Medicare health plan, but does not want to be limited in terms of where he obtains his care. What should you tell him about how a Medicare Cost Plan might fit ...
ahip 2020 final exam questions and correct answers
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AHIP 2020 Final Exam Questions And Correct
Answers, Complete Solution.
Mr. Davies is turning 65 next month. He would like to enroll in a Medicare health
plan, but does not want to be limited in terms of where he obtains his care. What
should you tell him about how a Medicare Cost Plan might fit his needs?
a. Cost plan enrollees can choose to receive Medicare covered services under the
plan's benefits by going to plan network providers and paying plan cost sharing, or may
receive services from non-network providers and pay cost-sharing due under Original
Medicare.
b. Ms. Lopez is considered a marketing representative of BestCare and thus is
obligated to comply with CMS marketing requirements, including those regarding
using only approved call scripts.
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?
a. 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.
b. Ms. Lopez is considered a marketing representative of BestCare and thus is
obligated to comply with CMS marketing requirements, including those regarding using
only approved call scripts.
c. Ms. Lopez no longer needs to be concerned about state licensure since she is
marketing an MA product subject to federal rules.
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.
Mr. Edwards, a marketing representative of the ACME Insurance Company,
scheduled a marketing event and expects about 40 people to attend. He has hired
a magician at a cost of $200 to entertain attendees. Can he do this in a way that
complies with guidance from the Medicare agency?
a. He can do this because the estimated number of attendees is based on the venue
size and response rate and the value of the gift does not exceed $15.
Mrs. Ramos is considering a Medicare Advantage PPO and has questions about
which providers she can go to for her health care. What should you tell her?
,b. Mrs. Ramos can obtain care from any provider who participates in Original Medicare,
but generally will have a higher cost-sharing amount if she sees a provider who/that is
not a part of the PPO network.
Julia Harris is turning 66 in July, at which time she will retire. She has contacted
your office and requested a meeting so that she can learn about Medicare and the
products you represent. How should you respond?
c. Tell Julia that you will meet with her to explain Medicare and should she be interested
you can accept and submit an enrollment request, since this is an initial enrollment
qualifying her for a special enrollment period.
Mr. Rivera has Qualified Medicare Beneficiary (QMB) eligibility and is thus
covered by both Medicare and Medicaid. He decides to enroll in a Medicare
Advantage (MA) PPO plan. Later he sees an out-of-network doctor to receive a
Medicare covered service. How much The doctor may only collect from Mr. Rivera
the cost sharing allowable under the state's Medicaid program.may the doctor
collect from Mr. Rivera?
The doctor may only collect from Mr. Rivera the cost sharing allowable under the state's
Medicaid program.
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?
Choose one answer.
a. A PFFS plan is a type of Medicare Supplement plan and she may enroll in one if
it is available in her area.
b. A PFFS plan is exactly the same as Original Medicare, only offered by a private
entity and she may enroll in one if it is available in her area.
c. PFFS plans are designed to cover only prescription drugs and if that is the type
of coverage she wants, she may enroll in one if it is available in her area.
d. A 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.
Question8
Marks: 1
During an appointment scheduled to discuss a Medicare Advantage Prescription
Drug plan (MA-PD), Mr. Peters asked his agent to describe a stand-alone
prescription drug plan (Part D plan) that his neighbor told him about. What should
his agent do?
Choose one answer.
a. Since Mr. Peters requested a description of the Part D plan, his agent must
leave the Part D plan brochure, but not an enrollment form, and would have to
schedule another appointment after at least 48 hours have passed to discuss the
Part D plan with Mr. Peters.
b. Since Mr. Peters requested a description of the Part D plan, his agent must
have Mr. Peters sign a new scope of appointment form that includes Part D, and
then the agent may discuss the Part D plan so Mr. Peters can compare plans and
make an informed enrollment choice during the appointment.
, c. Since Mr. Peters requested a description of the Part D plan, his agent must
inform Mr. Peters that he can only sign up for the MA-PD plan and cannot receive
a brochure or any other information about the Part D plan now because he did not
agree in advance to discuss that plan
d. Since Mr. Peters requested a description of the Part D plan, his agent must
discuss both the Part D and the MA-PD plans and return after at least 48 hours to
complete the Part D plan enrollment form with Mr. Peters.
Question9
Marks: 1
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?
Choose one answer.
a. In general, he must select a single Part D premium payment mechanism that
will be used throughout the year.
b. As long as he fills out the paperwork to begin withholding from his Social
Security check at least 63 days before such withholding should begin, he can
change his method of Part D premium payment and withholding will begin the
month after his savings account is exhausted.
c. During 2017, many people experienced significant problems with deductions
from their Social Security check for their Part D premium. As a result, this method
of payment is no longer an option for Part D premium payments
d. In general, to pay his Part D premium, he only can have automatic withdrawals
made from a checking account, so he will need to transfer the funds prior to
beginning such withdrawals.
Question10
Marks: 1
Since 2004 Ms. Eisenberg has had a Medigap plan that provides some drug
coverage. She has recently received a letter from her Medigap carrier informing
her that her drug coverage is not "creditable." She wants to know what this
means. What should you tell her?
Choose one answer.
a. The letter is to inform her that her Medigap drug coverage must be
supplemented by purchasing coverage under a Part D plan. If she does not do so
within 63 days, she will not be able to obtain Part D coverage at a later date.
b. The letter is to inform her that the drug coverage offered through her Medigap
plan does not offer drug coverage that is at least comparable to that provided
under the Medicare Part D prescription drug program. If she does not have such
creditable coverage during periods when she is first eligible for the Part D
program, she will face a premium penalty if she enrolls in a Part D plan at a later
date.
c. The letter is to inform her that her Medigap plan's coverage has been
determined by the Federal government to be inadequate and the plan must
therefore discontinue offering such coverage. Ms. Eisenberg will have to select a
different Medigap plan if she wants drug coverage.
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