Ahip 2023 stuvia - Study guides, Class notes & Summaries

Types of Medicare Advantage Plans - ANSWERPPO, HMO, MSA, Cost Plan, PFFS Medicare-Medicaid plans - ANSWERServe both Medicare and Medicaid individuals. Include Part D coverage. Individuals sometimes referred to as dual eligibles Medicare Cost Plan - ANSWERType of Medicare health plan. Have Part B to enroll. Can join anytime plan is accepting new members. A non network provider will can charge higher coinsurances and deuctibles. Different enrollment/disenrollment periods apply. Can get Part ...

As a result of violations of ACA Section 1557 nondiscrimination rules, - ANSWERSa health plan may revoke an agent or broker's appointment with the health plan. Which of the following statements best describes Section 1557 of the Affordable Care Act (ACA)? - ANSWERSSection 1557 incorporates earlier civil rights protections in regard to race, color, national origin, disability, age and sex. Under ACA Section 1557, a health plan premium sold through a state exchange may, based on an individu...

Which of the following requires intent to obtain payment and the knowledge that the actions are wrong? - ANSWERSFraud Which of the following is NOT potentially a penalty for violation of a law or regulation prohibiting Fraud, Waste, and Abuse (FWA)? - ANSWERSDeportation A person comes to your pharmacy to drop off a prescription for a beneficiary who is a "regular" customer. The prescription is for a controlled substance with a quantity of 160. This beneficiary normally receives a quantit...

Which of the following requires intent to obtain payment and the knowledge that the actions are wrong? - ANSWERFraud

AHIP Final Exam Questions with 100% Correct Answers AHIP Final Exam Questions with 100% Correct Answers AHIP Final Exam Questions with 100% Correct Answers

Stuvia--ahip-module-2-questions-and-answers-verified-answer-2022 questions and answers(2023) (verified answers)

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? - ANSWERHe may sign-up for Medicare at any time however coverage usually begins on the fourth month after dialysis treatments start. Juan Perez, who is turning age 65 next month, intends to work for several more years at Smallcap, Incorporated. Smallcap has a workforce of15 employees and offe...

Mr. Lopez, who is fairly well-off financially, would like to enroll in a Medicare prescription drug plan you represent and simply give you a check to cover his premiums for the entire year. What should you tell him? - ANSWERHe will need to mail in his payment with his enrollment form. Mrs. Chou likes a Private Fee-for-Service (PFFS) plan available in her area that does not include drug coverage. She wants to enroll in the plan and enroll in a stand-alone prescription drug plan. What should yo...

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. Wendt suffers from diabetes which has gotten progressively worse during the last year. He is currently enrolled in Original Medicare (Parts A and B) and a Part D prescription drug plan and did not e...

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? - ANSWER He may sign-up for Medicare at any time however coverage usually begins on the fourth month after dialysis treatments start. Juan Perez, who is turning age 65 next month, intends to work for several more years at Smallcap, Incorporated. Smallcap has a workforce of15 employees and...