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AHIP Practice Exam questions with complete solutions.
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AHIP Practice Exam questions with completesolutions
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? |- |correct |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? |- |correct |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? |- |correct |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? |- |correct |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: |- |correct |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? |- |correct |answer-Mrs. |Valentino |can |submit |a |written |
request |to |Medicare |to |be |disenrolled |from |the |Cost |plan |and |enroll |in |Original |Medicare.
When |Myra |first |became |eligible |for |Medicare, |she |enrolled |in |Original |Medicare |(Parts |A |and |B). |
She |is |now |67 |and |will |turn |68 |on |July |1. |She |would |now |like |to |enroll |in |a |Medicare |Advantage |
(MA) |plan |and |approaches |you |about |her |options. |What |advice |would |you |give |her? |- |correct |
answer-She |should |remain |in |Original |Medicare |until |the |annual |election |period |running |from |
October |15 |to |December |7, |during |which |she |can |select |an |MA |plan.
Mrs. |Tanner |is |enrolled |in |a |Medicare |Advantage |HMO |that |offers |a |point |of |service |options. |This |
allows |Mrs. |Tanner |to |do |which |of |the |following? |- |correct |answer-Mrs. |Tanner |can |go |to |non-plan
|doctors |for |certain |services |without |receiving |prior |approval
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? |- |correct |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.
Mrs. |Chen |will |be |65 |soon, |has |been |a |citizen |for |twelve |years, |has |been |employed |full |time, |and
|paid |taxes |during |that |entire |period. |She |is |concerned |that |she |will |not |qualify |for |coverage |under
|part |A |because |she |was |not |born |in |the |United |States. |What |should |you |tell |her? |- |correct |
answer-Most |individuals |who |are |citizens |and |over |age |65 |are |covered |under |Part |A |by |virtue |of |
having |paid |Medicare |taxes |while |working, |though |some |may |be |covered |as |a |result |of |paying |
monthly |premiums.
Mr. |Katz |reached |the |Part |D |coverage |gap |in |August |last |year. |His |prescriptions |have |not |been |
changed, |he |is |keeping |the |same |Part |D |plan |and |the |benefits, |cost-sharing, |and |coverage |of |his |
drugs |are |all |the |same |as |last |year. |He |asked |what |to |expect |for |this |year |about |his |out-of-pocket
|costs. |What |could |you |tell |him? |- |correct |answer-Because |he |reached |the |coverage |gap |last |year, |
he |will |probably |reah |it |again |this |year |close |to |the |same |time.
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