AHIP (AHIP)

Ms. Moore plans to retire when she turns 65 in a few months. She is in excellent health and will have considerable income when she retires. She is concerned that her income will make it impossible for her to qualify for Medicare. What could you tell her to address her concern? - Medicare is a program for people age 65 or older and those under age 65 with certain disabilities, end stage renal disease or Lou Gehrig's disease, so she will be eligible for Medicare. Mr. Schmidt would like to p...

ABC is a Medicare Advantage (MA) plan sponsor. It would like to use its enrollees' protected health information to market non-health related products such as life insurance and annuities. To do so it must obtain authorization from the enrollees. Which statement best describes the authorization process? - Authorization may be obtained by directing a beneficiary to a website to provide consent. During a sales presentation to Ms. Daley for a Medicare Advantage plan that has a 5- star rating ...

A Medicare beneficiary has walked into your office and requested that you sit down with her and discuss her options under the Medicare Advantage program. Before engaging in such a discussion, what should you do? - You must have her sign a scope of appointment form, indicating which products she wishes to discuss. You may then proceed with the discussion. You will be holding a sales event in the near future, at which you would like to offer door prizes to attendees. Under guidelines from th...

A Medicare beneficiary has walked into your office and requested that you sit down with her and discuss her options under the Medicare Advantage program. Before engaging in such a discussion, what should you do? - c. You must have her sign a scope of appointment form, indicating which products she wishes to discuss. You may then proceed with the discussion. Next week you will be participating in your first "educational event" for prospective enrollees. In order to be sure that you do not...

Mr. Sinclair has diabetes and heart trouble and is generally satisfied with the care he has received under Original Medicare, but he would like to know more about Medicare Advantage Special Needs Plans (SNPs). What could you tell him? - a. SNPs have special programs for enrollees with chronic conditions, like Mr. Sinclair, and they provide prescription drug coverage that could be very helpful as well. Ms. Gibson recently lost her employer group health and drug coverage and now she wants to...

One of your clients, Lauren Nichols, has heard about a Medicare concept from one of her neighbors called TrOOP. She asks you to explain it. What do you say? - d. TrOOP stands for true out-of-pocket expenses that count toward the Medicare Part D catastrophic limit and include not only expenses paid by a beneficiary but also in some instances drug manufacturer discounts. Mrs. Allen has a rare condition for which two different brand name drugs are the only available treatment. She is concerne...

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. What should you tell him? - b. Mr. Carlini can stay with Original Medicare and also enroll in a Medicare prescription drug plan through a private company that has contracted with the government to ...

Mr. Lopez has heard that he can sign up for a product called "Medicare Advantage" but is not sure about what type of plan designs are available through this program. What should you tell him about the types of health plans that are available through the Medicare Advantage program? - They are Medicare health plans such as HMOs, PPOs, PFFS, SNPs, and MSAs (W) Mr. Wells is trying to understand the difference between Original Medicare and Medicare Advantage. What would be a correct descripti...

Ms. Moore plans to retire when she turns 65 in a few months. She is in excellent health and will have considerable income when she retires. She is concerned that her income will make it impossible for her to qualify for Medicare. What could you tell her to address her concern? - Medicare is a program for people age 65 or older and those under age 65 with certain disabilities, end stage renal disease and Lou Gehrig's disease, so she will be eligible for Medicare. Mr. Schmidt would like to ...

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 US. (Medicare Entitlement Part A) - Most individuals who are citizens and over age 65 are covered under Part A by virtue of having paid Medicare taxes while working, though some may be covered as a result of paying monthly premiums. BAUER is 49 years old, but eig...