Ahip Test Exam Latest Updated 2024
Mr. James has end stage renal disease (ESRD). He has been covered under Original Medicare but would like to know if he can enroll in a Medicare Advantage plan. What should you tell him?
Individuals with end stage renal disease may enroll in a Medicare Advantag...
Ahip Test Exam Latest Updated 2024
Mr. James has end stage renal disease (ESRD). He has been covered under Original Medicare but would like to kno
if he can enroll in a Medicare Advantage plan. What should you tell him?
Individuals with end stage renal disease may enroll in a Medicare Advantage plan, but only if they are willing to pa ex
premium to do so.
Individuals with end stage renal disease can only enroll in a Medicare Advantage plan after they have been on dia fo
12 months.
Individuals with end stage renal disease can enroll in any Medicare Advantage plan that they choose without payin
extra premium.
He will not be able to enroll in a Medicare Advantage plan because he has end stage renal disease, unless a spec
needs
plan for beneficiaries with ESRD is available in his service area.
Ms. Jensen has heard about “Original Fee-for-Service Medicare” and “Private Fee-for-Service” plans. She wants to
know what the difference is, if any. What should you tell her?
Original Medicare and PFFS plans are essentially the same thing.
PFFS plans are a type of Medicare Advantage plan offered by private companies.
PFFS plans primarily cover drugs that Original FFS Medicare does not cover.
PFFS is a form of supplemental coverage that fills in the gaps where Original Medicare leaves
, off.
Agent Herman works in the senior marketplace and depends on referrals and leads to grow and maintain his busines
Which of the following situations may Agent Herman contact and speak with the Medicare Advantage prospect?
14.
Agent Herman recognizes some elderly neighbors in the lobby of his condominium complex and would like to appr
them about how Medicare Advantage compares to Original Medicare.
Agent Herman’s wife called a former neighbor and told her about Herman’s extensive knowledge of Medicare and
rules.
The neighbor agreed to meet with Herman about the Medicare Advantage products he represents.
Agent Herman has left business cards with Edgar, one of his clients. Edgar passes one of the cards to Sam who
expresses
an interest in meeting with Herman about Medicare Advantage. Sam subsequently calls Herman’s office.
Agent Herman learns during a meeting of his book club that fellow member Eleanor is voluntarily disenrolling from he
current Medicare Advance plan.
What impact, if any, will the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) have upon
Medigap plans?
The Part A deductible will no longer be covered for individuals newly eligible for Medicare starting January 1, 2020.
The Part B deductible will no longer be covered for individuals newly eligible for Medicare starting January 1, 2020.
The Part A deductible is no longer covered under Medigap plans for all enrollees staring January 1, 2020.
MACRA provides funding to help individuals age 59 and above enroll in Medigap plans.
Able, Baker, and Charles are engaged in the marketing to and enrollment of beneficiaries into Medicare health plans
Mr. Able is an independent agent paid directly by a health plan. Ms. Baker is an independent agent paid through a fie
marketing organization (FMO). Mr. Charles is an independent agent paid for his work by a third-party marketing
organization (TMO). How do the CMS compensation rules apply to these three agents?
All three are treated as independent agents under CMS compensation rules.
Baker and Charles are subject to CMS compensation rules because they are paid by third parties. Able is not bec he
is paid directly by a health plan.
Able is subject to CMS compensation rules because he is paid directly by a health plan. Agents Baker and Charle no
because they are paid by third parties.
Charles is subject to CMS compliance rules because he works for a TMO and CMS applies an extra layer of scru su
organizations. Able and Baker are not.
Mrs. Paterson is concerned about the deductibles and co-payments associated with Original Medicare. What can yo
tell her about Medigap as an option to address this concern?
Medigap plans are not sold by private companies and are a government insurance product.
All costs not covered by Medicare are covered by some Medigap plans.
If Mrs. Paterson applies during the Medigap open enrollment period, she will have to undergo a medical review to
determine if she has a pre-existing condition that would increase the premium for a Medigap policy.
Medigap plans help beneficiaries cover coinsurance, co-payments, and/or deductibles for medically necessary
services.
Mr Valesquez asked if the Private Fee-for-Service plan you have discussed is like Original Medicare or a Medigap
supplement plan. What should you say about a Private Fee-for-Service (PFFS) plan to explain it to Mr. Valesquez?
It is a type of Medicare Advantage plan that allows you to go to any doctor anywhere.
c. It is the same as Original Medicare, but offered by a private company.
d. It is not Original Medicare and it works differently than a Medicare supplement plan.
Which of the following statements about Medicare Part D are correct?
Part D plans must enroll any eligible beneficiary who applies regardless of health status except in limited
circumstances.
Private fee-for-service (PFFS) plans are not required to use a pharmacy network but may choose to have one.
Beneficiaries enrolled in a MA-Medical Savings Account (MSA) plan may only obtain Part D benefits through a
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