100% satisfaction guarantee Immediately available after payment Both online and in PDF No strings attached
logo-home
Previously searched by you
Previously searched by you
logo
2025 AHIP Final Exam Questions and Answers 100% Verified CA$11.60   Add to cart
Quickly navigate to
Preview
  2.  
  3. 2025 AHIP F
  4.  
  5. 2025 AHIP F

Exam (elaborations)

2025 AHIP Final Exam Questions and Answers 100% Verified

1 review
 68 views  1 purchase
  • Course
  • 2025 AHIP F
  • Institution
  • 2025 AHIP F

A Medicare beneficiary has walked into your office and requested that you sit down with her and discuss her options under the Medicare Advantage program. Before engaging in such a discussion, what should you do? - Answer-You must have her sign a scope of appointment form, indicating which product...

[Show more]

Preview 3 out of 17  pages

Document information

  • July 27, 2024
  • 17
  • 2023/2024
  • Exam (elaborations)
  • Questions & answers

Subjects

  • 2025 ahip

Written for

  • 2025 AHIP F
  • 2025 AHIP F

1  review

review-writer-avatar

By: jascole1982 • 1 month ago

Seller

avatar-seller
ACADEMICMATERIALS

Reviews received

Content preview

2025 AHIP Final Exam A Medicare beneficiary has walked into your office and requested that you sit down with her and discuss her options under the Medicare Advantage program. Before engaging in such a discussion, what should you do? - Answer -You must have her sign a scope of a ppointment form, indicating which products she wishes to discuss. You may then proceed with the discussion. Agent Harriet Walker has recently begun marketing Medicare Advantage and related products aimed at meeting the needs of senior citizens. Client Mildred Jones has expressed interest in a Medicare Advantage plan. It is now the beginning of September. If you were in Agent Walker's position, what would you do? - Answer -Inquire whether the client qualifies for a special enrollment period, and if not, solicit an enrollment application once the annual open enrollment election period begins on October 15th. Agent Jennings makes a presentation on Medicare advertised as an educational event. Agent Jennings distributes materials that are solely educational. However, she gives a brief presentation that mentions plan -specific premiums. Is this a prohibited activit y at an event that has been advertised as educational? - Answer -Yes. When an event has been advertised as "educational," discussing plan -specific premiums is impermissible. Alice is enrolled in a MA -PD plan. She makes a permanent move across the country and wonders what her options are for continuing MA -PD coverage. What would you say to her in regard to a special enrollment period (SEP)? - Answer -She is likely to qualify for a SEP . She can choose an effective date of up to three months after the month in which the enrollment form is received by the new plan, but the effective date may not be earlier than the date of her permanent move. Anita Magri will turn age 65 in August 2023. Anita intends to enroll in Original Medicare Part A and Part B. She would also like to enroll in a Medicare Supplement (Medigap) plan. Anita's older neighbor Mel has told her about the Medigap Plan F in which he is enrolled. It not only provides foreign travel emergency benefits but also covers his Medicare Part B deductible. Anita comes to you for advice. What should you tell her? - Answer -You are sorry to disappoint Anita, but a Medigap F plan is no longer avai lable to those who turn age 65 after January 1, 2020. Anita might instead consider other Medigap plans that offer foreign travel benefits but do not cover the Part B deductible. By contacting plans available in your area, you have learned that the plan you represent has a significantly lower monthly premium than the others. Furthermore, you see that the plan you represent has a unique benefits package. What should you do to make s ure your clients know about these pieces of information? - Answer -You may make comparisons between plans if you can support them with studies or statistical data and such comparisons are factually based and referenced. Dr. Elizabeth Brennan does not contract with the ABC PFFS plan but accepts the plan's terms and conditions for payment. Mary Rodgers sees Dr. Brennan for treatment. How much may Dr. Brennan charge? - Answer -Dr. Brennan can charge Mary Rogers no more than t he cost sharing specified in the PFFS plan's terms and condition of payment which may include balance billing up to 15%of the Medicare rate. 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 rating of a 4 -star, which of the following would be the best statement to sa y 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. Hank's Fish Store, Inc. is a small company with just 15 employees located in Florida. Hank, the store owner, has provided excellent health benefits to the store's workforce. William, one of the store's long -
time employees, will soon be reaching age 65 and eligible for Medicare. William is in good health. He intends to remain an active full -time employee, working several years after becoming eligible for Medicare. What type(s) of retiree health benefit will Hank's Fish Store be able to offer William? - Answe r-Hank's can continue to offer William the same employee health benefit plan, or, if William enrolls in Medicare Part B, it can enroll him in a Medicare Advantage plan that is offered to the public. If you are to comply with Medicare's guidance regarding educational events, which of the following would be acceptable activities? - Answer -You may distribute business cards to individuals who request information on how to contact you for further details o n the plan(s) you represent. Mr. 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 in to a standard Medicare Part D prescription drug plan. What should you tell him? - Answer -He generally would pay a monthly premium, annual deductible, and per -prescription cost -sharing. 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 e nd of your discussion, Mr. Nunez says that he wants to enroll both himself and his wife. What should you do? - Answer -As long as she can 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. Mr. and Mrs. Vaughn both take a specialized multivitamin prescription each day. Mr. Vaughn takes a prescription to help to regrow his hair. They are anxious to have their Medicare prescription drug plan cover these drug needs. What should you tell them? - Answer -Medicare prescription drug plans are not permitted to cover the prescription medications the Vaughns are interested in under Part D coverage, however, plans may cover them as supplemental benefits and the Vaughns could look into that possibility. Mr. Anderson is a very organized individual and has filled out and brought to you an enrollment form on October 10 for a new plan available on January 1 next year. He is currently enrolled in Original Medicare. What should you do? - Answer -Tell Mr. Anderso n that you cannot accept any enrollment forms until the annual election period begins. Mr. Barker enjoys a comfortable retirement income. He recently had surgery and expected that he would have certain services and items covered by the plan with minimal out -of-pocket costs because his MA -PD coverage has been very good. However, when he recei ved the bill, he was surprised to see large charges in excess of his maximum out -of-pocket limit that included some services and items he thought would be fully covered. He called you to ask what he could do? What could you tell him? - Answer -You can offer to review the plans appeal process to help him ask the plan to review the coverage decision. 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 h im? - Answer -He could check with the manufacturers of his medications to see if they offer an assistance program to help people with limited means to obtain the medications they need. Alternatively, he could check to see whether his state has a pharmacy as sistance program to help him with his expenses. 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 p remium. 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? - Answer -If Mr. Block enrolls in the stand -alone Medicare prescription drug plan, he will be disenrolled from the Medicare Advantage plan. 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

The benefits of buying summaries with Stuvia:

Guaranteed quality through customer reviews

Guaranteed quality through customer reviews

Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.

Quick and easy check-out

Quick and easy check-out

You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.

Focus on what matters

Focus on what matters

Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!

Frequently asked questions

What do I get when I buy this document?

You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.

Satisfaction guarantee: how does it work?

Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.

Who am I buying these notes from?

Stuvia is a marketplace, so you are not buying this document from us, but from seller ACADEMICMATERIALS. Stuvia facilitates payment to the seller.

Will I be stuck with a subscription?

No, you only buy these notes for CA$11.60. You're not tied to anything after your purchase.

Can Stuvia be trusted?

4.6 stars on Google & Trustpilot (+1000 reviews)

75632 documents were sold in the last 30 days

Founded in 2010, the go-to place to buy study notes for 14 years now

Start selling
CA$11.60  1x  sold
  • (1)
  Add to cart