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AHIP 2023 Final Exam Test Questions and Answers Updated
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AHIP 2023 Final Exam Test Questions and Answers Updated
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By: docwayne5 • 4 months ago
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AHIP 2023 Final Exam Test Questions and Answers Updated (Verified Answers) [100 questions] Mr. Xi will soon turn age 65 and has come to you for adv ice 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? - ✔✔ANSW✔✔Medicare Part B generally covers medically necessary physician and other health care professional services. Hector Hernandez is an independent agent. Hector sells plans on behalf of three Medicare Advantage organizations that offer a total of 10 plans but does not represent all Medicare Advantage organizations offering plans that are available in his area. Which of the following statements best describes any steps Hector is required to tak e? - ✔✔ANSW✔✔During the first minute, not during the first fifteen minutes of a sales call, Hector must verbally convey the prescribed TPMO disclaimer which references not only Medicare.gov but also 1 -800-Medicare and the local State Health Insurance Prog ram as sources of information about all plan options You are seeking to represent an individual Medicare Advantage plan and an individual Part D in your state. You have completed the required training for each plan, but you did not achieve a passing score on the tests that came after the training. What can you do in this situation? - ✔✔ANSW✔✔You will not be able to represent any Medicare Advantage or Part D plan until you complete the training and achieve and adequate score. However, you will not have to take a test if you exclusively market employer/ union group plans and the companies do not require testing Another agent working for you agency claims that because you are not employed by the Medicare Advantage plans that you represent, you are not subjec t to the same marketing requirements as the plans themselves. How should you respond to such a statement? - ✔✔ANSW✔✔Your coworker is not correct. Marketing on behalf of a plan is considered marketing by the plan and requires that all contracted and employ ed agents comply with all Medicare marketing rules Your friend's mother just moved to an assisted living facility and he asked if you could present a program for the residents about the MA -PD plans you market. What could you tell him? - ✔✔ANSW✔✔You appre ciate the opportunity and would be happy to schedule an appointment with anyone at their request Miguel Sanchez is a relatively new agent who has come to you for advice as to what he can do during the Medicare Advantage Open Enrollment Period. What advice should you give Miguel? - ✔✔ANSW✔✔During the MA -OEP, Miguel can have one -on-one meetings with beneficiaries who have requested such meetings Mrs. Lu is turning 65 in November and called to ask for your help deciding on a Medicare Advantage plan. She agr eed to sign a SOA form and meet with you in October 15. During the appointment, what are you permitted to do? - ✔✔ANSW✔✔Because Mrs. Lu only requested help regarding Medicare Advantage plan selection, that is her SOA. Therefore, you offer to discuss Medig ap and/or Part D would go beyond the SOA Another agent you know has engages in misconduct that has been verified by the plan she represented. What sort of penalty might the plan impose on this individual? - ✔✔ANSW✔✔The plan may withhold commission, requi re retraining, report the misconduct to a state department of insurance or terminate the contract Mr. Diaz continued working with his company and was insured under his employer's group plan until reached age 68. He has heard that there is a premium penalty for those who did not sign up for Part B when first eligible and wa nts to know how much he will have to pay. What should you tell him? - ✔✔ANSW✔✔Mr. Diaz will not pay any penalty because he had continuous coverage under his employer's plan Mr. Wu is eligible for Medicare. He has limited financial resources but failed to qualify for the part D low-income subsidy. Where might he turn for help with his prescription drug costs? - ✔✔ANSW✔✔Mr. Wu may still qualify for help in paying Part D costs through his State Pharmaceutical Assistance Program Edward IP suffered from seri ous kidney disease. As a result, Edward became eligible for Medicare coverage due to end -stage renal disease. A close relative donated their kidney and Edward successfully underwent transplant surgery 12 months ago. Edward is now age 50 and asks you if his Medicare coverage will continue, what should you say? - ✔✔ANSW✔✔Individuals eligible for Medicare based on ESRD generally lose eligibility 36 months after the month in which the individual receives a kidney transplant Anthony Retirement Benefits on his 65th birthday. He was interested in obtaining Medicare coverage and is eligible for premium -free Part A. Before he could enroll in Medicare, his entire area was impacted by a hurricane causing massive flooding and severe wind damage. The Federal government declared this to be a natural disaster which has recently ended. During this period Anthony's initial enrollment period expired. Anthony asks you how he can now obtain Medicare coverage. What should you say? - ✔✔ANSW✔✔Anthony is eligible for a SEP becaus e he missed an enrollment period due to the impact of the Federally declared disaster. This SEP will allow Anthony to enroll in Part B up to 6 months after the end of the emergency declaration. Anthony may enroll in premium -free Part A at any time and his Part A coverage will be retroactive for up to 6 months Shirly Thomas was enrolled in Medicaid during the Public Health Emergency. This coverage has recently been terminated due to the end of the PHE. While Shirley was enrolled in Medicaid, she missed an opportunity to enroll in Medicare and now wants Part B. Which of the following statements best describes Shirley's ability to now enroll in Medicare Part B? - ✔✔ANSW✔✔Shirley is eligible for SEP for up to 6 months after the termination of her Medicaid cove rage. Under this SEP, Shirley can choose retroactive coverage back to the date of termination from Medicaid or coverage beginning the month after the month of enrollment Mrs. Pena is 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? - ✔✔ANSW✔✔Mrs. Pena may enroll in Part B at any t ime while she has employer -sponsored coverage. Upon retirement, she will be able to enroll in Part B during SEP that lasts 8 months following the last month of her employer coverage Mr. Bauer is 49 years old, but eighteen months ago he was declared disabl ed 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? - ✔✔ANSW✔✔After receiving such disability payments for months, he will be automat ically enrolled in Medicare, regardless of age Mr. 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? - ✔✔ANSW✔✔The purpose of Medigap plans is to supplem ent Original Medicare benefits. Medigap plans do not work with Medicare Advantage plans. It is illegal to sell a Medigap plan to someone already in a Medicare Advantage health plan. Mr. Davis is 52 years old and has recently been diagnosed with end -stage renal disease (ESRD) and will soon begin dialysis. He is wondering if he can obtain coverage under Medicare. What should you tell him? - ✔✔ANSW✔✔Medicare coverage for individuals with ESRD typically begins on the 4th month after dialysis treatments start.The benefits of buying summaries with Stuvia:
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