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? ANSW - c. Yes....
AHIP Module 5 FINAL EXAM
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?
ANSW - 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?
ANSW - 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?
ANSW - 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?
ANSW - 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?
ANSW - 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?
ANSW - 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?
ANSW - 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?
ANSW - 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?
ANSW - 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?
ANSW - 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 Best Care Health Plan. Phiona is placed in charge
of Best Care’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.
ANSW - 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, because he has the means to do so, he
wishes to enroll in the stand-alone prescription drug plan in addition to his MA-PD plan.
What should you tell him?
ANSW - c. If Mr. Block enrolls in the stand-alone Medicare prescription drug plan, he
will be disenrolled from the Medicare Advantage plan. Correct
You are doing a sales presentation for Mrs. Pearson. You know that the Medicare
marketing guidelines prohibit certain types of statements. Apply those guidelines to the
following statements and identify which would be prohibited.
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