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AHIP Module 5 - Questions And Answers
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AHIP Module 5 - Questions And Answers
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AHIP Module 5 - Questions And AnswersMrs. 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? Correct Ans
- c. Yes. Mrs. Walters must be entitled to Part A or enrolled in Part B to be
eligible for coverage under the Medicare prescription drug program. Correct
Mr. Sanchez is entitled to Part A, but has not enrolled in Part B because he
has coverage through an employer plan. If he wants to enroll in a Medicare
Advantage plan, what will he have to do? Correct Ans - c. He will have to
enroll in Part B. Correct
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 Ans - a. You would need to ask Mr. Kelly if he is
enrolled in Part A and Part B and if he lives in the PFFS plan's service area.
Correct
Mr. Gonzalez is entitled to Part A, but has not yet enrolled in Part B. If he
wants to enroll in a Private Fee-for-Service (PFFS) plan, what will he have to
do? Correct Ans - d. He will have to enroll in Part B prior to enrolling in
the PFFS plan. Correct
Mrs. Berkowitz wants to enroll in a Medicare Advantage plan that does not
include drug coverage and also enroll in a stand-alone Medicare prescription
drug plan. Under what circumstances can she do this? Correct Ans - c. If
the Medicare Advantage plan is a Private Fee-for-Service (PFFS) plan that
does not offer drug coverage or a Medical Savings Account, Mrs. Berkowitz
can do this. Correct
Mrs. Roberts has Original Medicare and would like to enroll in a Private Fee-
for-Service (PFFS) plan. All types of PFFS plans are available in her area.
Which options could Mrs. Roberts consider before selecting a PFFS plan?
Correct Ans - d. A Medicare Advantage Prescription Drug (MA-PD) PFFS plan
that combines medical benefits and Part D prescription drug coverage, a
PFFS plan offering only medical benefits, or a PFFS plan in combination with
a stand-alone prescription drug plan. Correct
Which of the following individuals is most likely to be eligible to enroll in a
Medicare Advantage or Part D Plan? Correct Ans - d. Jose, a grandfather
who was granted asylum and has worked in the United States for many
years. Correct
, Mr. and Mrs. Nunez attended one of your sales presentations. They've asked
you to come to their home to clear up a few questions. During the
presentation, Mrs. Nunez feels tired and tells you that her husband can finish
things up. She goes to bed. At the end of your discussion, Mr. Nunez says
that he wants to enroll both himself and his wife. What should you do?
Correct Ans - d. As long as she is able to do so, only Mrs. Nunez can sign
her enrollment form. Mrs. Nunez will have to wake up to sign her form or do
so at another time. Correct
You are visiting with Mr. Tully and his daughter at her request. He has
advanced Alzheimer's and is incapable of understanding the implications of
choosing a Medicare Advantage or prescription drug plan. Can his daughter
fill out the enrollment form and sign it for him? Correct Ans - c. Mr. Tully's
daughter can do so only, if she is authorized under state law as a court-
appointed legal guardian, has durable power of attorney for health care
decisions, or is authorized under state surrogate consent laws to make
health decisions. Correct
You are meeting with Ms. Berlin and she has completed an enrollment form
for a MA-PD plan you represent. You notice that her handwriting is illegible
and as a result, the spelling of her street looks incorrect. She asks you to fill
in the corrected street name. What should you do? Correct Ans - c. You
may correct this information as long as you add your initials and date next to
the correction Correct
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 process must include a clear and distinct step that requires the
applicant to activate an "Enroll Now" or "I Agree" type of button or tool.
IV. The mechanism must capture an accurate time and date stamp at the
time the applicant enters the online site. Correct Ans - b. II and III only
Correct
Mr. Block is currently enrolled in a Medicare Advantage plan that includes
drug coverage. He found a stand-alone Medicare prescription drug plan in his
area that offers better coverage than that available through his MA-PD plan
and in addition has a low premium. It won't cost him much more and,
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