Download 2020 AHIP, 2022 AHIP, AHIP questions and more Exams Nursing in PDF only on Docsity!
2020 AHIP, 2022 AHIP, AHIP questions
Mr. Kelly has substantial financial means. He enrolled in Original Medicare and purchased a Medigap policy many years ago that offered prescription drug coverage. - ANSWER>>He will incur a late enrollment penalty
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? - ANSWER>>It is illegal for you to sell
What impact, if any will the medicare access and CHIP reauthorization act of 2015 - ANSWER>>The Part B...
You have approached a hospital administrator about marketing in her facility. The administrator is uncomfortable with the suggestion. - ANSWER>>Tell her that medicare guidelines allow you to conduct marketing activies in common areas of a providers facility
You would like to market an MA Plan - ANSWER>>You must set up your table... where people wait for services from the pharmacist
Your friend's mother just moved to an assisted living facility and he asked if you could present a program - ANSWER>>you appreciate the opportunity and would be happy to schedule an appointment
You have sought permission from a hospital to place brochures for your product in their gift shop and cafeteria. - ANSWER>>Marketing in health care facilities is an acceptable practice as long as...
Plan sponsors may undertake the following marketing activities with current Medicare Advantage plan members? - ANSWER>>Market non-medicare health related products such as dental insurance, to current members as permitted by HIPPA privacy rules
Next week you will be participating in your first "educational event" for prospective enrollees. - ANSWER>>You should plan to ENSURE
If you are able to be in compliance with medicares guidance regarding ... - ANSWER>>You may distribute business cards to individuals who request information
You are working with a number of plans and community organizations - ANSWER>>You must ensure that the advertisements indicate
You plan to participate in an educational event sponsored by a large regional health care system. One of your colleagues suggests that you do a suggestion? - ANSWER>>You should tell you colleague no because participation in an educational event may no include a sales presentation
Agent Mary Jennings makes a presentation on Medicare advertised as an educational event. Agent Jennings distributes materials that are solely - ANSWER>>Yes. When an event has been advertised as "educational"
Mrs. Walters is entitled to Part A and has medical coverage without drug coverage through an employer retiree plan. She is not enrolled in Part B. - ANSWER>>Yes. Mrs Walters must be entitled to part a or enrolled in part b to be eligible
Mr. Sanchez is entitled to Part A, but has not enrolled in Part B because he has coverage through an employer plan. If he wants to enroll in a Medicare - ANSWER>>He will have to enroll in part B.
Mr. Kelly wants to know whether he is eligible to sign up for a Private fee-for-service (PFFS) plan. What questions would you need to ask to determine his - ANSWER>>You need to ask Mr Kelly if he is enrolled... and if he lives in the PFF's plan's service area
Mr. Gonzalez is entitled to Part A, but has not yet enrolled in Part B. If he wants to enroll in a Private Fee-for-Service (PFFS) plan, what will he have to do? - ANSWER>>If the medicare advantage plan is private fee-for-service (PFFS) plan
Mrs. Roberts has Original Medicare and would like to enroll in a Private Fee-for-Service (PFFS) plan. All types of PFFS plans are available in her area. Which - ANSWER>>A medicare advantage prescription drug PFFS plan that combines medical benefits part D... or a PFFS plan in combination with a stand-alone plan
Which of the following individuals is most likely to be eligible to enroll in a Medicare advantage
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 - ANSWER>>As long as she is able to do so
Mr Wednt suffer from diabetes - ANSWER>>If there is a special needs plan... he may enroll in the SNP at any time under a SEP
which of the following individuals are likely to qualify for special enrollment period for both MA and Part D - ANSWER>>2 3 and 4 only
Mr. Rockwell, age 67, is enrolled in Medicare Part A, but because he continues to work and is covered by an employer health plan, he has not enrolled in Part B - ANSWER>>...the SEP begins in Jun and ends September 1...
Ms. Lee is enrolled in an MA-PD plan, but will be moving out of the plan's service area next month. She is worried that she will not be able to enroll in another - ANSWER>>She is eligible for a SEP that begins...
Mr. Yoo's employer has recently dropped comprehensive creditable prescription drug coverage that was offered to company retirees. The company - ANSWER>>It means that he qualifies for a one-time opportunity
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 - ANSWER>>Yes. Qualifying for this state program gives...
If Mr. Johannsen gains the Part D low-income subsidy, how does that affect his ability to enroll or disenroll in - ANSWER>>He qualifies for SEP
Mrs Ridgeway enrolled in Origional Medicare and Medigap - ANSWER>>She qualifies for SEP... Medigap Plan
Mr. Chen is enrolled in his employer's group health plan and will be retiring soon. He would like to know his options since he has decided to drop his retiree - ANSWER>>Mr chen can disenroll from his employer sponsored plan... he should reevaluate if he really wants to drop his employer coverage
Mrs. Burton is in an MA-PD plan and was disappointed in the service she received from her primary care physician because she was told she would have to - ANSWER>>She could file a grievance
Mr. Barker had surgery recently and expected that he would have certain services and items covered by the plan with minimal out-of-pocket costs because his MA- - ANSWER>>You can offer to review the plans appeal the process to help him ask the plan to review the coverage decision
Mrs Disraeli is enrolled in original medicare - ANSWER>>Enrolles in SNP must have access
Ms. O'Donnell learned about a new MA-PD plan that her neighbor suggested and that you represent. She plans to switch from her old MA HMO plan to the new - ANSWER>>She Only needs to enroll in the new MA-PD plan and she will automatically be disenrolled form her old MA plan
Mr. Fitzgerald is selling his home to permanently move into a retirement facility near his daughter in a neighboring state. He has a stand-alone prescription - ANSWER>>Because he is moving outside of the service area ...
Mr. Robinson was quite ill recently and forgot to pay his monthly premium for his MA-PD plan. He is worried that he will lose his coverage now when he - ANSWER>>Plan Sponsors have the option to disenroll members... less than two months
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 - ANSWER>>Mrs Valentino can submit a written request...
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 - ANSWER>>Medicare is a program for people 65 and older
Mr. Schmidt would like to plan for retirement and has asked you what is covered under Original Fee-for-Service (FFS) Medicare? What could you tell him? - ANSWER>>Part A, which covers hospital, skilled nurse facilities...
Mr. Hernandez is concerned that if he signs up for a Medicare Advantage plan, the health plan may, at some time in the future, reduce his benefits below - ANSWER>>Medicare health Plans must cover all benefits available undr medicare part a and part b
Mrs Roberts has just received a new Medicare Identity - ANSWER>>The card she received is valid... she should now destroy her old card
Mr. Diaz continued working with his company and was insured under his employer's group plan until he reached age 68. He has heard that there is a premium - ANSWER>>Mr Diaz will NOT pay any penalty because he had continuous coverage
Mr. Patel is in good health and is preparing a budget in anticipation of his retirement when he turns 66. He wants to understand the health care costs he might be - ANSWER>>Under original Medicare, there is a single deductible...
Mrs. Shields is covered by Original Medicare. She sustained a hip fracture and is being successfully treated for that condition. However, she and her facility? - ANSWER>>Medicare will cover Mrs Shields' skilled...
Mr. Rainey is experiencing paranoid delusions and his physician feels that he should be hospitalized. What should you tell Mr. Rainey (or his representative) - ANSWER>>Medicare will cover a total of 190 days
Mrs Quinn recently turned 66 an decided after many years of work - ANSWER>>Part B primarily covers physicians services. She will be paying a month premium....
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
Mrs. Turner is comparing her employer's retiree insurance to Original Medicare and would like to know which of the following services Original - ANSWER>>Original medicare covers ambulance services
Mr Denton is 52 years old and has recently been diagnosed - ANSWER>>he may sign up for medicare at anytime however coverage usually begins on the fourth month of...
Ms. Henderson believes that she will qualify for Medicare coverage when she turns 65, without paying any premiums, because she has been working for 40? - ANSWER>>In order to obtain part b
Mrs pena is 66 years old - ANSWER>>she may enroll at anytime while she is covered
mrs Kelly, age 65, is entitled to part A - ANSWER>>In order to join a medicare health plan she must also enroll in part B
Mrs. Young is currently enrolled in Original Medicare (Parts A and B), but she has been working with Agent Neil Adams in the selection of a Medicare Advantage - ANSWER>>This is a bad idea... Agents are generally prohibited from soliciting...
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 - ANSWER>>Typically her coverage would begin on the first day of the next month
Monica is an agent focused on serving seniors eligible for Medicare. As she reviews her records, she is trying to determine which of the following items are - ANSWER>>1 2 and 4 only
Wendy Park becomes eligible for Medicare for the first time in July. With the help of Agent James Chan, she enrolls in FeelBetter Medicare Advantage plan - ANSWER>>Feel better will pay agent chain initial year compensation for the months July through...
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 - ANSWER>>Betty and Denise, but no alice
Agent Lopez helps Ralph to enroll in top choice Medicare advantage plan... - ANSWER>>Agent Lopez entire compensation must be recoped
Agent Higgins help Mrs O'Malley to enroll in AB - ANSWER>>AB MA plan does not have to recoup agent Higgins compensation because she has moved
This year you have decided to focus your efforts on marketing to employer group plans. One employer provides you with a list of their retirees and asks you - ANSWER>>You may go ahead and call them
Another agent you know has engaged in misconduct that has been verified by the plan she represented. What sort of penalty might the plan impose on this - ANSWER>>The plan may withhold commission require retraining report the misconduct
