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2024 MY AHIP EXAM WITH CORRECT ANSWERS
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2024 MY AHIP EXAM WITH CORRECT ANSWERS
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2024 MY AHIP EXAM WITHCORRECT ANSWERS
Mr.Gomez notes that a Private Fee for Service (PFFS) plan avaliable in his
area has an attractive preminum. He wants to know if he must use doctors in
a network as his current HMO plan requires him to do. What should you tell
him? - CORRECT-ANSWERSHe may receive health care services from any
doctor allowed to bill Medicare as long as he shows the doctor the plan's
identification card and the doctor agrees to accept the PFFS plan's payment
terms and conditions, which could include balance billing.
Which of the following individuals are likely to qualify for a special enrollment
period (SEP) for both MA and Part D due to a change of residence?
I. Edward (enrolled in MA and Part D) moves to a new home within the same
neighborhood in his existing plan's service area.
II. Fiona (enrolled in MA and Part D) moves cross-country to an area outside
her existing plan's service area.
III. Gilbert moves into a plan service area where there is now a Part D plan
available to him from a service area where no Part D plan was available.
IV. Henry makes a permanent move, providing him with new MA and Part D
options. - CORRECT-ANSWERSII, III, and IV only
If Mr. Johannsen gains the Part D low-income subsidy, how does that affect
his ability to enroll or disenroll in a Part D plan? - CORRECT-ANSWERSHe
qualifies for a special enrollment period and can enroll in or disenroll from a
Part D plan and the subsidy will apply to the plan he chooses.
Mrs. Schneider has Original Medicare Parts A and B and has just qualified for
her state's Medicaid program, so the state is now paying her Part B premium.
Will gaining eligibility for this program affect her ability to enroll in a
Medicare Advantage or Medicare Prescription Drug plan? - CORRECT-
ANSWERSYes. Qualifying for this state program gives Mrs. Schneider access
to a Special Enrollment Period that allows her to make changes to her MA
and/or Part D enrollment during the first 9 months of each calendar year
beginning 2019.
Mrs. Ridgeway enrolled in Original Medicare and Medigap coverage following
her retirements several years ago. Four months ago, Mrs. Ridgeway dropped
her Medigap policy to enroll in a Medicare Advantage (MA) plan for the first
time. Unfortunately, Mrs. Ridgeway has found out that many of her providers
are not in the MA plan's network. She has come to you for advice. What
,should you tell her? - CORRECT-ANSWERSShe qualifies for a special
enrollment period (SEP) that will allow her to make a one-time election to
return to Original Medicare and she also has a guaranteed eligibility period to
rejoin her Medigap plan.
Mr. Yoo's employer has recently dropped comprehensive creditable
prescription drug coverage that was offered to company retirees. The
company told Mr. Yoo that, because he was affected by this change, he
would qualify for a Special Election Period. Mr. Yoo contacted you to find out
more about what this means. What can you tell him? - CORRECT-ANSWERSIt
means that he qualifies for a one-time opportunity to enroll in an MA- PD or
Part D prescription drug plan
Mr. Roberts is enrolled in an MA plan. He recently suffered complications
following hip replacement surgery. As a result, he has spent the last three
months in Resthaven, a skilled nursing facility. Mr. Roberts is about to be
discharged. What advice would you give him regarding his health coverage
options? - CORRECT-ANSWERSHis open enrollment period as an
institutionalized individual will continue for two months after the month he
moves out of the facility.
Mary Samuels recently suffered a stroke while visiting her daughter and
grandchildren. As a result, Mary has been admitted to a rehabilitation
hospital where she is expected to reside for several months. The
rehabilitation hospital is located outside the geographic area served by her
current Medicare Advantage (MA) plan. What options are available to Mary
regarding her health plan coverage? - CORRECT-ANSWERSMary may make
an unlimited number of enrollment requests and may disenroll from her
current MA plan.
Mrs. Pierce would like to enroll in a Medicare Cost plan that offers Part D
prescription drug coverage. She comes to you for advice about when she can
enroll in a plan you have previously discussed. What should you tell her ? -
CORRECT-ANSWERSEnrollment in Cost plans offering Part D coverage is
available only during enrollment periods under the Part D program, and Cost
plans must accept enrollments during these periods.
Phiona works in the IT Department of BestCare Health Plan. Phiona is placed
in charge of BestCare's efforts to facilitate electronic enrollment in its
Medicare Advantage plans. In setting up the enrollment site, which of the
following must Phiona consider?
I. If a legal representative is completing an electronic enrollment request, he
or she must first upload proof of his or her authority.
,II. All data elements required to complete an enrollment request must be
captured.
III. The process must include a clear and distinct step that requires the
applicant to activate an "Enroll Now" or "I Agree" type of button or tool.
IV. The mechanism must capture an accurate time and date stamp at the
time the applicant enters the online site. - CORRECT-ANSWERSII and III only
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 end of your discussion, Mr. Nunez says
that he wants to enroll both himself and his wife. What should you do? -
CORRECT-ANSWERSAs long as she is able to 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.
You are meeting with Ms. Berlin and she has completed an enrollment form
for a MA-PD plan you represent. You notice that her handwriting is illegible
and as a result, the spelling of her street looks incorrect. She asks you to fill
in the corrected street name. What should you do? - CORRECT-ANSWERSYou
may correct this information as long as you add your initials and date next to
the correction.
You are visiting with Mr. Tully and his daughter at her request. He has
advanced Alzheimer's and is incapable of understanding the implications of
choosing a Medicare Advantage or prescription drug plan. Can his daughter
fill out the enrollment form and sign it for him? - CORRECT-ANSWERSMr.
Tully's daughter can do so only, if she is authorized under state law as a
court appointed legal guardian, has a durable power of attorney for
healthcare decisions, or is authorized under state surrogate consent laws to
make health decisions.
You are doing a sales presentation for Mrs. Pearson. You know that Medicare
marketing guidelines prohibit certain types of statements. Apply those
guidelines to the following statements and identify which would be
prohibited. - CORRECT-ANSWERS"If you're not in very good health, you would
probably do better with a different product."
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 premium. 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? - CORRECT-ANSWERSIf Mr. Block enrolls in the stand-alone Medicare
, prescription drug plan, he will be disenrolled from the Medicare prescription
drug plan, he will be disenrolled from the Medicare Advantage plan.
Willard works as a representative focused on the senior marketplace. What
would be considered prohibited activity by Willard? - CORRECT-
ANSWERSImplying that only seniors can enroll in a Medicare Advantage plan
when meeting with Mr. Hernandez who is 58, but qualifies for Medicare
because he is disabled.
You have come to Mrs. Midler's home for a sales presentation. At the
beginning of the presentation, Mrs. Midler tells you that she has a copy of
her medical record available because she thinks this will help you
understand her needs. She suggests that you will know which questions to
ask her about her health status in order to best assist her in selecting a plan.
What should you do? - CORRECT-ANSWERSYou can only ask Mrs. Midler
questions about conditions that affect eligibility, specifically, whether she has
end-stage renal disease or one of the conditions that would qualify her for a
special needs plan.
You are completing a PFFS plan sale to Mr. West who is new to Medicare and
prefers to be contacted by telephone. As you are finishing up, what should
you tell him about the next steps in the enrollment process? - CORRECT-
ANSWERSYou need to get Mr. West's phone number and include it on the
enrollment form because the plan must call him after you leave to ensure
that he understood the nature of the PFFS plan he selected and to verify his
intent to enroll.
Mrs. Reynolds just signed up for a Medicare Advantage plan on the second of
the month. She is leaving for vacation in two weeks and wants to know if her
new coverage will start before she leaves. What should you tell her? -
CORRECT-ANSWERSTypically, her coverage would begin on the first day of
the next month, so she should not expect her coverage to begin before she
leaves.
Mrs. Johnson calls to tell you she has not received her new plan ID card yet,
but she needs to see a doctor. What can she expect to receive from the plan
after the plan has received her enrollment form? - CORRECT-
ANSWERSEvidence of plan membership, information on how to obtain
services and the effective date of coverage.
You meet with Mrs. Wilson to complete her enrollment in a Medicare
Advantage plan. You tell her that there will be an enrollment verification
process to confirm that she is enrolled in the plan that she requested and
understands the plan features and rules. What should Mrs. Wilson expect
regarding the verification process? - CORRECT-ANSWERSMrs. Wilson will be
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