AHIP - FINAL EXAM BUNDLE(COMPLETE PACKAGE DEAL)QUESTIONS AND ANSWERS 100% CORRECT

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? Choose one answer. ...

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? - ANSWERd. Yes....

Medicare Advantage - ANSWER-Cover all Part A and Part B benefits; -Provide plan cost-sharing actuarially equivalent to cost sharing under Medicare Parts A and B, but may be different for specific services; and -Include an annual maximum out-of-pocket (MOOP) limit on total enrollee cost sharing (d...

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. Wha...

Which of the following requires intent to obtain payment and the knowledge that the actions are wrong? - ANSWERFraud Which of the following is not potentially a penalty for violation of the law or regulation prohibiting fraud, waste and abuse (fwa)? - ANSWERDeportation Your job is to submit ...

Ms. Jensen has heard about "Original Fee-for-Service Medicare" and "Private Fee-for-Service" plans. She wants to know what the difference is if any. What should you tell her? - ANSWERPFFS plans are a type of Medicare Advantage plan offered by private companies. This year you decide to focus y...

Willard works as a representative focused on the senior marketplace. What would be considered prohibited activity by Willard? - ANSWERImplying that only seniors can enroll in a Medicare Advantage plan when meeting with Mr. Hernandez, who is 58 but qualifies for Medicare because he is disabled. Mr...

Which of the following statements about Medicare Part D are correct? - ANSWERI, II, and III only -I. Part D plans must enroll any eligible beneficiary who applies regardless of health status except in limited circumstances. II. Private fee-for-service (PFFS) plans are not required to use a pharmac...

Under Section 1557, the 2020 Final Rule issued during the Trump Administration sex was initially defined____________ - ANSWERAs biologic sex only, meaning whether a person was determined to be male or female at birth. For a health plan, what are the possible consequences of violations of ACA Sect...

Mrs. Chou likes a PFFS plan available in her area that does not offer drug coverage. She wants to enroll in the plan and enroll in a stand-alone prescription drug plan. What should you tell her? - ANSWERShe could enroll in a PFFS plan and a stand-alone Medicare prescription drug plan. Mrs. Geisle...

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 determine his eligibility? - ANSWERYou 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...

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? - ANSWERa. Cost plan enrollees can choose to receive Medicare co...

Mrs. Park is an elderly retiree. Mrs. Park has a low fixed income. What could you tell Mrs. Park that might be of assistance? - ANSWERShe 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. Mr...

Mildred Savage enrolled in Allcare Medicare Advantage plan several years ago. Mildred recently learned that she is suffering from inoperable cancer and has just a few months to live. She would like to spend these final months in hospice care. Mildred's family asks you whether hospice benefits will ...

Agent Jennings makes a presentation on Medicare advertised as an educational 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 ed...

Mr. Chen is enrolled in his employer's group health plan and will be retiring soon. He would like to know his options since he has decided to drop his retiree coverage and is eligible for Medicare. What should you tell him? - ANSWERMr. Chen can disenroll from his employer-sponsored coverage to elec...

Mr. Ford enrolled in an MA-only plan in mid-November during the Annual Election Period (AEP). On December 1, he calls you up and says that he has changed his mind and would like to enroll in a MA-PD plan. What enrollment rules would apply in this case? - ANSWERHe can make as many enrollment changes ...