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2024 AHIP MEDICARE TRAINING EXAM WITH CORRECT ANSWERS
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2024 AHIP MEDICARE TRAINING EXAM WITH CORRECT ANSWERS
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2024 AHIP MEDICARE TRAININGEXAM WITH CORRECT ANSWERS
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? - CORRECT-ANSWERSPFFS plans are a type of Medicare
Advantage plan offered by private companies.
Mr. Anderson is a very organized individual and has filled out and brought to
you an enrollment form on October 10 for a new plan available January 1
next year. He is currently enrolled in OriginalMedicare. What should you do? -
CORRECT-ANSWERSTell Mr. Anderson that you cannot accept any enrollment
forms until the annual election periodbegins.
Ms. Claggett is sixty-six (66) years old. She has been covered under Original
Medicare for the last six years due to her disability and has never been
enrolled in a Medicare Advantage or a Part D plan before. She wants to enroll
in a Part D plan. She knows that there is such a thing as the "Part D Initial
Enrollment Period" (IEP) andhas concluded that, since she has never enrolled
in such a plan before, she should be eligible to enroll under this period. What
should you tell her about how the Part D Initial Enrollment Period applies to
her situation? - CORRECT-ANSWERSIt occurs three months before and three
months after the month when a beneficiary meets the eligibility
requirements for Part B, so she will not be able to use it as a justification for
enrolling in a Part D plan now.
Phiona works in the IT Department of BestCare Health Plan. Phiona is placed
in charge of BestCare's efforts to facilitate electronic enrollment in its
Medicare Advantage plans. In setting up the enrollment site, which of the
following must Phiona consider?
I. If a legal representative is completing an electronic enrollment request, he
or she must first upload proof of his or her authority.
II. All data elements required to complete an enrollment request must be
captured.
III. The mechanism must advise each individual at the beginning of the
process that he or she is completing an actual enrollment request.
IV. The mechanism must capture an accurate time and date stamp at the
time the applicant enters the online site. - CORRECT-ANSWERSII and III only
Mrs. Goodman enrolled in an MA-PD plan during the Annual Election Period.
In mid-January of the following year, she wants to switch back to Original
,Medicare and enroll in a stand-alone prescription drug plan. What should you
tell her? - CORRECT-ANSWERSDuring the MA Open Enrollment Period, from
January 1 - March 31, she may disenroll from the MA-PD plan into Original
Medicare and also may add a stand-alone prescription drug plan.
Mrs. Pierce would like to enroll in a Medicare Cost plan that offers Part D
prescription drug coverage. She comes to you for advice about when she can
enroll in a plan you have previously discussed. What should you tell her? -
CORRECT-ANSWERSEnrollment in Cost plans offering Part D coverage is
available only during enrollment periods under the Part D program, and Cost
plans must accept enrollments during these periods.
Mrs. Kendrick is in good health, has worked for many years and is six months
away from turning 65. She wants to know what she will have to do to enroll
in a Medicare Advantage (MA) plan as soon as possible. What could you tell
her? - CORRECT-ANSWERSShe may enroll in an MA plan beginning three
months immediately before her first entitlement to both Medicare Part A and
Part B.
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? - CORRECT-ANSWERSYou 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
area.
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? - CORRECT-ANSWERSSince 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.
Mrs. Wu was primarily a homemaker and employed in jobs that provided
taxable income only sporadically. Her husband worked full-time throughout
his long career. She has heard that to qualify for Medicare Part A she has to
have worked and paid Medicare taxes for a sufficient time. What should you
tell her? - CORRECT-ANSWERSSince her husband paid Medicare taxes during
the entire time he was working, she will automatically qualify for Medicare
Part A without having to pay any premiums.
Mr. Cole has been a Medicaid beneficiary for some time, and recently
qualified for Medicare as well. He is concerned about changes in his cost-
sharing. What should you tell him? - CORRECT-ANSWERSHe should know that
, Medicaid will pay cost sharing only for services provided by Medicaid
participating providers.
Ms. Gardner is currently enrolled in an MA-PD plan. However, she wants to
disenroll from the MA-PD plan and instead enroll in a Part D only plan and go
back to Original Medicare. According to Medicare's enrollment guidelines,
when could she do this? - CORRECT-ANSWERSShe may make such a change
during the Annual Election Period that runs from Oct. 15 to December 7, or
during the MA Open Enrollment Period which takes place from January 1-
March 31 of each year.
Mr. Jackson just turned 65. He has been seeing the same general practitioner
for annual check-ups for the past 15 years, likes these yearly visits, and
would like to continue obtaining these services as a Medicare beneficiary.
What should you tell him about annual check-ups? - CORRECT-
ANSWERSMedicare will cover an annual wellness visit, even if he has no
illnesses or injuries.
Ms. Brooks has an aggressive cancer and would like to know if Medicare will
cover hospice services in case she needs them. What should you tell her? -
CORRECT-ANSWERSMedicare covers hospice services and they will be
available for her.
Mr. Barker enjoys a comfortable retirement income. He recently had surgery
and expected that he would have certain services and items covered by the
plan with minimal out-of-pocket costs because his MA-PD coverage has been
very good. However, when he received the bill, he was surprised to see large
charges in excess of his maximum out-of-pocket limit that included a number
of services and items he thought would be fully covered. He called you to ask
what he could do? What could you tell him? - CORRECT-ANSWERSYou can
offer to review the plans appeal process to help him ask the plan to review
the coverage decision.
Mr. Lee was intending to enroll in MaxCare's Medicare Advantage plan this
year. However, due to his current medical condition, his daughter Debbie has
been appointed as his legal representative over both health and financial
matters. Debbie would like to ensure that her father is still able to enroll in
MaxCare's plan, but she is unsure what her role is to help with his enrollment
request. What advice can you give her? - CORRECT-ANSWERSDebbie can
submit an electronic enrollment request on Mr. Lee's behalf as long as she
attests that she has the legal authority to do so. (not sure)
You have sought permission from a hospital to place brochures for your
product in their gift shop and cafeteria. The hospital administration
expresses some hesitation about allowing marketing in a health care facility.
What should you tell them? - CORRECT-ANSWERSMarketing in health care
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