AHIP Practice Exam 2024 latest update 100% Correct
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Course
AHIP
Institution
AHIP
Mr. Carlini has heard that Medicare prescription drug plans are only offered through private companies under a program known as Medicare Advantage (MA), not by the government. He likes Original Medicare and does not want to sign up for an MA product, but he also wants prescription drug coverage. Wh...
AHIP Practice Exam 2024 latest update
100% Correct
Mr. Carlini has heard that Medicare prescription drug plans are only offered through private companies
under a program known as Medicare Advantage (MA), not by the government. He likes Original
Medicare and does not want to sign up for an MA product, but he also wants prescription drug coverage.
What should you tell him? - ANSWER Mr. Carlini can stay with Original Medicare and also enroll in a
Medicare prescription drug plan through a private company that has contracted with the government to
provide only such drug coverage to eligible Medicare beneficiaries.
During a sales presentation to Ms Daley for a Medicare Advantage plan that has a 5-star rating in
customer service and care coordination, and received an overall plan performance of a 4-star, which of
the following would be the correct statement to say to her? - ANSWER The Medicare Advantage plan
received a 5-star rating in customer service and care coordination with an overall performance rating of
4-stars
Mrs. Pena is 66 years old, has coverage under an employer plan and will retire next year. She heard she
must enroll in Part B at the beginning of the year to ensure no gap in coverage. What can you tell her? -
ANSWER She may enroll at any time while she is covered under her employer plan, but she will have a
special eight-month enrollment period that differs from the standard general enrollment period, during
which she may enroll in Medicare Part B
Mr. Bickford did not quite qualify for the extra help low-income subsidy under the Medicare Part D
Prescription Drug program and he is wondering if there is any other option he has for obtaining help
with his considerable drug costs. What should you tell him? - ANSWER He could check with the
manufacturers of his medications to see if they offer an assistance program to help people with limited
means obtain the medications they need. Alternatively, he could check to see whether his state has a
pharmacy assistance program to help him with his expenses.
Alice is a marketing representative employed by a health plan. Betty is a captive agent of a health plan
who markets to multiple plans and sponsors. Carl is a captive agent who markets to only one
plan/sponsor. Denise is an independent agent who markets to different types of groups. Edward is an
independent agent who markets only to employer and union groups. CMS marketing representative
compensation rules generally apply to: - ANSWER Betty and Denise, but not Alice (the employee) or Carl
or Edward (to whom exceptions apply).
, Mrs. Valentino is currently enrolled in a Medicare Cost plan. This plan is no longer meeting her needs,
but it is now mid-year and past the annual election period (AEP). What would you say to Mrs. Valentino
regarding her options? - ANSWER Mrs. Valentino can submit a written request to Medicare to be
disenrolled from the Cost plan and enroll in Original Medicare.
Mr. Buck has several family members who died from different cancers. He wants to know if Medicare
covers cancer screening. What should you tell him? - ANSWER Medicare covers 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.
Ms. 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 oculd you tell her to address her concern. - 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.
Mr. Wells is trying to understand the difference between Original Medicare and Medicare Advantage.
What would be a correct description? - ANSWER Medicare Advantage is a way of covering all the Original
Medicare benefits through private health insurance companies.
Which of the following steps may a Part D sponsor adopt for beneficiaries who are at risk of misusing or
abusing frequently abused drugs?
I. Identifying at risk individuals by using criteria that includes the number of opioid prescriptions the
beneficiary has and the number of prescribers who have written those prescriptions.
II. Locking an at-risk beneficiary into one pharmacy.
III. Locking an at-risk beneficiary into one prescriber.
IV. Increasing deductibles and copays for at-risk beneficiaries. - ANSWER I, II, and III only
Ms. Hernandez has marketed several different types of insurance products in her home state and has
typically sough approval of her materials from her State Department of Insurance.. What would you
advise her regarding seeking such approval for materials she uses to market Medicare Advantage plans?
- ANSWER Materials for marketing Medicare health plans to individuals are subject to Medicare's
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