AHIP FINAL STUDY EXAM WITH COMPLETE QUESTIONS AND CORRECT ACTUAL ANSWERS RATED A+
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AHIP
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AHIP
AHIP FINAL STUDY EXAM WITH COMPLETE
QUESTIONS AND CORRECT ACTUAL
ANSWERS RATED A+
Another agent working for your agency claims that because you
are not employed by the Medicare Advantage plans that you
represent, you are not subject to the same marketing
requirements as the plans themsel...
AHIP FINAL STUDY EXAM WITH COMPLETE
QUESTIONS AND CORRECT ACTUAL
ANSWERS RATED A+
Another agent working for your agency claims that because you
are not employed by the Medicare Advantage plans that you
represent, you are not subject to the same marketing
requirements as the plans themselves. How should you respond
to such a statement? Correct Answer Your coworker is not
correct. Marketing on behalf of a plan is considered marketing by
the plan and requires that all contracted and employed agents
comply with all Medicare marketing rules.
Alonso receives some help paying for his two generic prescription
drugs from his employer's retiree coverage, but he wants to
compare it to a Part D prescription drug plan. He asks you what
costs he would generally expect to encounter when enrolling into
a standard MedicarePart D prescription drug plan. What should
you tell him? Correct Answer He generally would pay a monthly
premium, annual deductible, and per-prescription cost-sharing.
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? Correct Answer 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.
Xi will soon turn age 65 and has come to you for advice as to
what services are provided under Original Medicare. What should
you tell Mr. Xi that best describes the health coverage provided to
Medicare beneficiaries? Correct Answer Beneficiaries under
,Original Medicare have no cost-sharing for most preventive
services which include immunizations such as annual flu shots.
Duarte is enrolled in Original Medicare Parts A and B. She has
recently reviewed her Medicare Summary Notice (MSN) and
disagrees with a determination that partially denied one of her
claims for services. What advice would you give her? Correct
Answer Mrs. Duarte should file an appeal of this initial
determination within 120 days of the date she received the MSN
in the mail.
Capadona would like to purchase a Medicare Advantage (MA)
plan and a Medigap plan to pick up costs not covered by that
plan.
What should you tell him? Correct Answer It is illegal for you to
sell Mr. Capadona a Medigap plan if he is enrolled in an MA plan,
and besides, Medigap only works with Original Medicare.
Park is an elderly retiree. Mrs. Park has a low fixed income. What
could you tell Mrs. Park that might be of assistance? Correct
Answer She should contact her state Medicaid agency to see if
she qualifies for one of several programs that can help with
Medicare costs for which she is responsible.
Rainey is experiencing paranoid delusions and his physician feels
that he should be hospitalized. What should you tell Mr. Rainey
(or his representative) about the length of an inpatient psychiatric
hospital stay that Medicare will cover? Correct Answer Medicare
will cover a total of 190 days of inpatient psychiatric care during
Mr. Rainey's entire lifetime.
Schmidt would like to plan for retirement and has asked you what
is covered under Original Fee-for-Service (FFS) Medicare? What
could you tell him? Correct Answer Part A, which covers hospital,
skilled nursing facility, hospice, and home health services and
,Part B, which covers professional services such as those
provided by a doctor are covered under Original Medicare.
Agent John Miller is meeting with Jerry Smith, a new prospect.
Jerry is currently enrolled in Medicare Parts A and B. Jerry has
also purchased a Medicare Supplement (Medigap) plan which he
has had for several years. However, the plan does not provide
drug benefits. How would you advise Agent John Miller to
proceed? Correct Answer Tell prospect Jerry Smith that he should
consider adding a standalone Part D prescription drug coverage
policy to his present coverage.
Bauer is 49 years old, but eighteen months ago he was declared
disabled by the Social Security Administration and has been
receiving disability payments. He is wondering whether he can
obtain coverage under Medicare. What should you tell him?
Correct Answer After receiving such disability payments for 24
months, he will be automatically enrolled in Medicare, regardless
of age.
Buck has several family members who died from different
cancers. He wants to know if Medicare covers cancer screening.
What should you tell him? Correct Answer Medicare covers the
periodic performance of a range of screening tests that are meant
to provide early detection of disease. Mr. Buck will need to check
specific tests before obtaining them to see if they will be covered.
Which of the following statement is/are correct about a Medicare
Savings Account (MSA) Plans?
I. MSAs may have either a partial network, full network, or no
network of providers.
II. MSA plans cover Part A and Part B benefits but not Part D
prescription drug benefits.
, III. An individual who is enrolled in an MSA plan is responsible for
a minimal deductible of $500 indexed for inflation.
IV. Non-network providers must accept the same amount that
Original Medicare would pay them as payment in full. Correct
Answer I, II, and IV only
Lombardi is interested in a Medicare Advantage (MA) PPO plan
that you represent. It is one of three plans operated by the same
organization in Mr. Lombardi's area. The MA PPO plan does not
include drug coverage, but the other two plans do. Mr. Lombardi
likes the PPO plan that does not include drug coverage and
intends to obtain his drug coverage through a stand-alone
Medicare prescription drug plan. What should you tell him about
this situation? Correct Answer He could enroll either in one of the
MA plans that include prescription drug coverage or Original
Medicare with a Medigap plan and standalone Part D prescription
drug coverage, but he cannot enroll in the MA-only PPO plan and
a stand-alone prescription drug plan.
Ramos is considering a Medicare Advantage PPO and has
questions about which providers she can go to for her health care.
What should you tell her? Correct Answer Mrs. Ramos can obtain
care from any provider who participates in Original Medicare, but
generally will have a higher cost-sharing amount if she sees a
provider who/that is not a part of the PPO network.
Romero is 64, retiring soon, and considering enrollment in his
employer-sponsored retiree group health plan that includes drug
coverage with nominal copays. He heard about a neighbor's MA-
PD plan that you represent and because he takes numerous
prescription drugs, he is considering signing up for it. What should
you tell him? Correct Answer He should compare the benefits in
his employer-sponsored retiree group health plan with the
benefits in his neighbor's MA-PD plan to determine which one will
provide sufficient coverage for his prescription needs.
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