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2024 AHIP FINAL EXAMINATION WITH VALID ANSWERS
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2024 AHIP FINAL EXAMINATION WITH VALID ANSWERS
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2024 AHIP FINAL EXAMINATIONWITH VALID ANSWERS
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-ANSWERSBeneficiaries should
check with their employer or union group benefits administrator before
changing plans to avoid losing coverage they want to keep.
Which of the following steps may a Part D sponsor adopt for beneficiaries
who are at risk of misusing or abusing frequently abused drugs?
I. Identifying at risk individuals by using criteria that includes the number of
opioid prescriptions the beneficiary has and the number of prescribers who
have written those prescriptions.
II. Locking an at-risk beneficiary into one pharmacy.
III. Locking an at-risk beneficiary into one prescriber.
IV. Increasing deductibles and copays for at-risk beneficiaries. - CORRECT-
ANSWERSI, II and III only.
Mr. Wells is trying to understand the difference between Original Medicare
and Medicare Advantage. What would be the correct description? -
CORRECT-ANSWERSMedicare Advantage is a way of covering all the Original
Medicare
benefits through private health insurance
companies.
Agent Roderick enrolls retiree Mrs. Martinez in a medical savings account
(MSA) Medicare health plan. The MSA plan does not offer prescription drug
coverage, so Agent Roderick also enrolls Mrs. Martinez in a standalone
prescription drug plan (PDP). What CMS compensation rules apply to this
situation? - CORRECT-ANSWERSThis situation is considered a "dual
enrollment" and CMS compensation rules are applied to the two plans at
once and independently of each other.
Mrs. Ridgeway enrolled in Original Medicare and Medigap coverage following
her retirements several years ago. Four months ago, Mrs. Ridgeway dropped
her Medigap policy to enroll in a Medicare Advantage (MA) plan for the first
time. Unfortunately, Mrs. Ridgeway has found that many of her providers are
, not in the MA plan's network. She has come to you for advice? What should
you tell her? - CORRECT-ANSWERSShe qualifies for a special enrollment
period (SEP) that will allow her to make a one-time election to return to
Original
Medicare and she also has a guaranteed eligibility period to rejoin her
Medigap plan.
This year you decide to focus your efforts on marketing to employer and
union groups. Which of the following statements best describes what you can
and cannot do in order to stay in compliance? - CORRECT-ANSWERSYou are
not required to submit
copies of disseminated materials to CMS
at the time of use, but CMS may request and review copies if employee
complains occur.
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? - CORRECT-ANSWERS
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? - CORRECT-
ANSWERSHe may sign-up for Medicare at any time however coverage usually
begins on the fourth month after dialysis treatments start.
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-
ANSWERSIf 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.
Next week you will be participating in your first "educational event" for
prospective enrollees. In order to be sure that you do not violate any of the
applicable guidelines, in what activities should you plan to engage?
Choose one answer. - CORRECT-ANSWERSYou should plan to ensure that the
educational event is a social event, and must not conduct a sales
presentation or
distribute or accept enrollment forms at the event.
Eleanor takes several high-cost prescription drugs. She would like to enroll in
a standalone Part D prescription drug plan that is available in her area. In
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