AHIP 2022/2023 Exam Questions and Answers Rated A+ LATEST UPDATE!!!, Exams of Nursing

Download AHIP 2022/2023 Exam Questions and Answers Rated A+ LATEST UPDATE!!! and more Exams Nursing in PDF only on Docsity! AHIP 2022/2023 Exam Questions and Answers Rated A+ LATEST UPDATE!!! Mr. Moy's wife has a Medicare Advantage plan, but he wants to understand what coverage Medicare Supplemental Insurance provides since his health care needs are different from his wife's needs. What could you tell Mr. Moy? - correct answer ✅Medicare Supplemental Insurance would help cover his Part A and Part B cost sharing in Original Fee-for-Service (FFS) Medicare as well as possibly some services that Medicare does not cover. Mr. Sinclair has diabetes and heart trouble and is generally satisfied with the care he has received under Original Medicare, but he would like to know more about Medicare Advantage Special Needs Plans (SNPs). What could you tell him? - correct answer ✅SNPs have special programs for enrollees with chronic conditions, like Mr. Sinclair, and they provide prescription drug coverage that could be very helpful as well. AHIP 2022/2023 Exam Questions and Answers Rated A+ LATEST UPDATE!!! Mrs. Quinn recently turned 66 and decided after many years of work to begin receiving Social Security benefits. Shortly thereafter Mrs. Quinn received a letter informing her that she has been automatically enrolled in Medicare Part B. She wants to understand what this means. What should you tell Mrs. Quinn? - correct answer ✅Part B primarily covers physician services. She will be paying a monthly premium and, with the exception of many preventive and screening tests, generally will have 20% coinsurance for these services, in addition to an annual deductible. Mrs. Turner is comparing her employer's retiree insurance to Original Medicare and would like to know which of the following services Original Medicare will cover if the appropriate criteria are met? What could you tell her? - correct answer ✅Original Medicare covers ambulance services. 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 penalty for those who did not sign up for Part B when first eligible and wants to know how much he will have to pay. What should you tell him? - correct answer ✅Mr. Diaz will not pay any penalty because he had continuous coverage under his employer's plan. AHIP 2022/2023 Exam Questions and Answers Rated A+ LATEST UPDATE!!! AHIP 2022/2023 Exam Questions and Answers Rated A+ LATEST UPDATE!!! her stay, after which she would have a copay until she has been in the facility for 100 days. Mr. Xi will soon turn age 65 and has come to you for advice 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? - correct answer ✅Beneficiaries under Original Medicare have no cost-sharing for most preventive services which include immunizations such as annual flu shots. Mrs. Geisler's neighbor told her she should look at her Part D options during the annual Medicare enrollment period because features of Part D might have changed. Mrs. Geisler can't remember what Part D is so she called you to ask what her neighbor was talking about. What could you tell her? - correct answer ✅Part D covers prescription drugs and she should look at her premiums, formulary, and cost-sharing among other factors to see if they have changed. What impact, if any, will recent regulatory changes have upon Medigap plans? - correct answer ✅The Part B deductible will no longer be covered for individuals newly eligible for Medicare starting January 1, 2020. AHIP 2022/2023 Exam Questions and Answers Rated A+ LATEST UPDATE!!! AHIP 2022/2023 Exam Questions and Answers Rated A+ LATEST UPDATE!!! 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? - correct answer ✅Mr. Wu may still qualify for help in paying Part D costs through his State Pharmaceutical Assistance Program. Madeline Martinez was widowed several years ago. Her husband worked for many years and contributed into the Medicare system. He also left a substantial estate which provides Madeline with an annual income of approximately $130,000. Madeline, who has only worked part-time for the last three years, will soon turn age 65 and hopes to enroll in Original Medicare. She comes to you for advice. What should you tell her? - correct answer ✅You should tell Madeline that she will be able to enroll in Medicare Part A without paying monthly premiums due to her husband's long work record and participation in the Medicare system. You should also tell Madeline that she will pay Part B premiums at more than the standard lowest rate but less than the highest rate due her substantial income. Agent John Miller is meeting with Jerry Smith, a new prospect. Jerry is currently enrolled in Medicare Parts A and B. Jerry has also purchased a Medicare Supplement (Medigap) plan which he has had for several years. However, the plan does not provide drug benefits. How would you advise Agent John Miller to proceed? - correct answer ✅Tell prospect Jerry Smith that he should consider AHIP 2022/2023 Exam Questions and Answers Rated A+ LATEST UPDATE!!! AHIP 2022/2023 Exam Questions and Answers Rated A+ LATEST UPDATE!!! Mr. Castillo, a naturalized citizen, previously enrolled in Medicare Part B but has recently stopped paying his Part B premium. Mr. Castillo is still covered by Part A. He would like to enroll in a Medicare Advantage (MA) plan and is still covered by Part A. What should you tell him? - correct answer ✅He is not eligible to enroll in a Medicare Advantage plan until he reenrolls in Medicare Part B. Mr. Kumar is considering a Medicare Advantage HMO and has questions about his ability to access providers. What should you tell him? - correct answer ✅In most Medicare Advantage HMOs, Mr. Kumar must generally obtain his services only from providers who have a contractual relationship with the plan (except in an emergency or where care is unavailable within the network). Mr. Lopez has heard that he can sign up for a product called "Medicare Advantage" but is not sure about what type of plan designs are available through this program. What should you tell him about the types of health plans that are available through the Medicare Advantage program? - correct answer ✅They are Medicare health plans such as HMOs, PPOs, PFFS, and MSAs. Mr. Greco is in excellent health, lives in his own home, and has a sizeable income from his investments. He has a friend enrolled in a Medicare Advantage AHIP 2022/2023 Exam Questions and Answers Rated A+ LATEST UPDATE!!! AHIP 2022/2023 Exam Questions and Answers Rated A+ LATEST UPDATE!!! Special Needs Plan (SNP). His friend has mentioned that the SNP charges very low cost-sharing amounts and Mr. Greco would like to join that plan. What should you tell him? - correct answer ✅SNPs limit enrollment to certain subpopulations of beneficiaries. Given his current situation, he is unlikely to qualify and would not be able to enroll in the SNP. 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 answer ✅Enrollment 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. Mrs. Kendrick is in good health, has worked for many years and is six months away from turning 65. She wants to know what she will have to do to enroll in a Medicare Advantage (MA) plan as soon as possible. What could you tell her? - correct answer ✅She may enroll in an MA plan beginning three months immediately before her first entitlement to both Medicare Part A and 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 eligibility? - correct answer ✅You would need to ask Mr. Kelly if he is entitled to Part A, enrolled in Part B, and if he lives in the PFFS plan's service area. AHIP 2022/2023 Exam Questions and Answers Rated A+ LATEST UPDATE!!! AHIP 2022/2023 Exam Questions and Answers Rated A+ LATEST UPDATE!!! During an appointment scheduled to discuss a Medicare Advantage Prescription Drug plan (MA-PD), Mr. Peters asked his agent to describe a stand-alone prescription drug plan (Part D plan) that his neighbor told him about. What should his agent do? - correct answer ✅Since Mr. Peters requested a description of the Part D plan, his agent must have Mr. Peters sign a new scope of appointment form that includes Part D, and then the agent may discuss the Part D plan so Mr. Peters can compare plans and make an informed enrollment choice during the appointment. Mrs. Wu was primarily a homemaker and employed in jobs that provided taxable income only sporadically. Her husband worked full-time throughout his long career. She has heard that to qualify for Medicare Part A she has to have worked and paid Medicare taxes for a sufficient time. What should you tell her? - correct answer ✅Since her husband paid Medicare taxes during the entire time he was working, she will automatically qualify for Medicare Part A without having to pay any premiums. Mr. Cole has been a Medicaid beneficiary for some time, and recently qualified for Medicare as well. He is concerned about changes in his cost-sharing. What should you tell him? - correct answer ✅He should know that Medicaid will pay cost sharing only for services provided by Medicaid participating providers. AHIP 2022/2023 Exam Questions and Answers Rated A+ LATEST UPDATE!!! AHIP 2022/2023 Exam Questions and Answers Rated A+ LATEST UPDATE!!! practice, as long as it takes place in common areas where patients are not receiving health care services. Who is most likely to be eligible to enroll in a Part D prescription drug plan? - correct answer ✅Ms. Davis who recently turned age 65 and is eligible for Part A and has just enrolled in Part B. Mr. Moreno invited his neighbor, Agent Tom Smith, to discuss Medicare Advantage (MA) and Part D plans that Agent Smith sells at the regular Tuesday brunch the neighbors have for senior citizens. What should Agent Tom Smith tell Mr. Moreno about the kinds of food that can be provided to potential enrollees who attend the sales presentation? - correct answer ✅A meal cannot be provided, but light snacks would be permitted. Ms. Levi is considering enrollment in a Medicare Advantage HMO plan offered in her area. Ms. Levi often travels to visit relatives and is concerned that she may need emergency care outside of her plan's service area. What should you tell her about coverage of emergency care? - correct answer ✅Plans are required to cover out-of-network emergency care. AHIP 2022/2023 Exam Questions and Answers Rated A+ LATEST UPDATE!!! AHIP 2022/2023 Exam Questions and Answers Rated A+ LATEST UPDATE!!! Mr. Albert has heard about something called the Star Rating system for Medicare Advantage plans. He asks you to explain it to him since he is interested in enrolling in a plan that is newly available in his area. After you explain that it is the way for consumers to judge plan performance, what else would you say? - correct answer ✅New plans and Part D sponsors that do not have any Star Rating are not required to provide Star Rating information until the next contract year. Ms. Lewis understands that Medicare prescription drug plans may use various methods to control the use of specific drugs. She has heard about a technique called "step therapy" and is wondering if you can explain what that is. What should you tell her? - correct answer ✅Step therapy involves using one or more lower priced drugs before trying a more expensive drug when all are used to treat the same condition. You have decided to focus on doing in-home presentations to market the Medicare Advantage (MA) plans you represent. Before you conduct such sales presentations, what must you do? - correct answer ✅You must receive an invitation from the beneficiary and document the specific types of products the beneficiary wants to discuss prior to making an in-home presentation. AHIP 2022/2023 Exam Questions and Answers Rated A+ LATEST UPDATE!!! AHIP 2022/2023 Exam Questions and Answers Rated A+ LATEST UPDATE!!! Mrs. Chou likes a Private Fee-for-Service (PFFS) plan available in her area that does not include drug coverage. She wants to enroll in the plan and enroll in a stand-alone prescription drug plan. What should you tell her? - correct answer ✅She could enroll in a PFFS plan and a stand-alone Medicare prescription drug plan. Mrs. Walters is enrolled in her state's Medicaid program in addition to Medicare. What should she be aware of when considering enrollment in a Medicare Advantage (MA) plan? - correct answer ✅She cannot enroll in an MA Medical Savings Account (MSA) plan. Mrs. Kelly, age 65, is entitled to Part A but has not yet enrolled in Part B. She is considering enrollment in a Medicare Advantage plan (Part C). What should you advise her to do before she will be able to enroll in a Medicare Advantage plan? - correct answer ✅In order to join a Medicare Advantage plan, she also must enroll in Part B. 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 received the bill, he was surprised to see large charges in excess of his maximum out-of-pocket limit that included a number of services AHIP 2022/2023 Exam Questions and Answers Rated A+ LATEST UPDATE!!! AHIP 2022/2023 Exam Questions and Answers Rated A+ LATEST UPDATE!!! D prescription drug benefits, which could be obtained by also enrolling in a separate prescription drug plan. Mrs. Burton is a retiree with substantial income. She is enrolled in an MA-PD plan and was disappointed with the service she received from her primary care physician because she was told she would have to wait five weeks to get an appointment when she was feeling ill. She called you to ask what she could do so she would not have to put up with such poor access to care. What could you tell her? - correct answer ✅She could file a grievance with her plan to complain about the lack of timeliness in getting an appointment. Daniel is a middle-income Medicare beneficiary. He has chronic bronchitis, putting him at severe risk for pneumonia. Otherwise, he has no problems functioning. Which type of SNP is likely to be most appropriate for him? - correct answer ✅C-SNP Ms. Gibson recently lost her employer group health and drug coverage and now she wants to enroll in a PPO that does not include drug coverage. What should you tell her about obtaining drug coverage? - correct answer ✅She can enroll in AHIP 2022/2023 Exam Questions and Answers Rated A+ LATEST UPDATE!!! AHIP 2022/2023 Exam Questions and Answers Rated A+ LATEST UPDATE!!! the PPO, but she will not be able to purchase a standalone Medicare Part D prescription drug plan. Mrs. Willard wants to know generally how the benefits under Original Medicare might compare to the benefits package of a Medicare Advantage Plan before she starts looking at specific plans. What could you tell her? - correct answer ✅Medicare Advantage Plans may offer extra benefits that Original Medicare does not offer such as vision, hearing, and dental services and must include a maximum out-of-pocket limit on Part A and Part B services. All plans must cover at least the standard Part D coverage or its actuarial equivalent. Which of the following statements best describes some of the costs a beneficiary would incur for prescription drugs under the standard coverage? - correct answer ✅Standard Part D coverage would require payment of an annual AHIP 2022/2023 Exam Questions and Answers Rated A+ LATEST UPDATE!!! AHIP 2022/2023 Exam Questions and Answers Rated A+ LATEST UPDATE!!! deductible, and once past the catastrophic coverage threshold, the beneficiary pays whichever is greater of either the co-pays for generic and brand name drugs or coinsurance of 5%. Mr. Torres has a small savings account. He would like to pay for his monthly Part D premiums with an automatic monthly withdrawal from his savings account until it is exhausted, and then have his premiums withheld from his Social Security check. What should you tell him? - correct answer ✅In general, he must select a single Part D premium payment mechanism that will be used throughout the year. What types of tools can Medicare Part D prescription drug plans use that affect the way their enrollees can access medications? - correct answer ✅Part D plans do not have to cover all medications. As a result, their formularies, or lists of covered drugs, will vary from plan to plan. In addition, they can use cost containment techniques such as tiered copayments and prior authorization. Mr. Wingate is a newly enrolled Medicare Part D beneficiary and one of your clients. In addition to drugs on his plan's formulary he takes several other medications. These include a prescription drug not on his plan's formulary, over- AHIP 2022/2023 Exam Questions and Answers Rated A+ LATEST UPDATE!!! AHIP 2022/2023 Exam Questions and Answers Rated A+ LATEST UPDATE!!! currently does not have creditable coverage. What could you tell her about the implications of such a decision? - correct answer ✅If she does not sign up for a Medicare prescription drug plan as soon as she is eligible to do so, and if she does sign up at a later date, her premium will be permanently increased by 1% of the national average premium for every month that she was not covered. Ms. Edwards is enrolled in a Medicare Advantage plan that includes prescription drug plan (PDP) coverage. She is traveling and wishes to fill two of the prescriptions that she has lost. How would you advise her? - correct answer ✅She may fill prescriptions for covered drugs at non-network pharmacies, but likely at a higher cost than paid at an in-network pharmacy. One of your clients, Lauren Nichols, has heard about a Medicare concept from one of her neighbors called TrOOP. She asks you to explain it. What do you say? - correct answer ✅TrOOP stands for true out-of-pocket expenses that count toward the Medicare Part D catastrophic limit and include not only expenses paid by a beneficiary but also in some instances drug manufacturer discounts. Mr. and Mrs. Vaughn both take a specialized multivitamin prescription each day. Mr. Vaughn takes a prescription for helping to regrow his hair. They are anxious AHIP 2022/2023 Exam Questions and Answers Rated A+ LATEST UPDATE!!! AHIP 2022/2023 Exam Questions and Answers Rated A+ LATEST UPDATE!!! to have their Medicare prescription drug plan cover these drug needs. What should you tell them? - correct 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 Vaughn's could look into that possibility. Mrs. Allen has a rare condition for which two different brand name drugs are the only available treatment. She is concerned that since no generic prescription drug is available and these drugs are very high cost, she will not be able to find a Medicare Part D prescription drug plan that covers either one of them. What should you tell her? - correct answer ✅Medicare prescription drug plans are required to cover drugs in each therapeutic category. She should be able to enroll in a Medicare prescription drug plan that covers the medications she needs. Mrs. Mulcahy is concerned that she may not qualify for enrollment in a Medicare prescription drug plan because, although she is entitled to Part A, she is not enrolled under Medicare Part B. What should you tell her? - correct answer ✅An individual who is entitled to Part A or enrolled under Part B is eligible to enroll in a Medicare prescription drug plan. As long as Mrs. Mulcahy is entitled to Part A, she does not need to enroll under Part B before enrolling in a prescription drug plan. AHIP 2022/2023 Exam Questions and Answers Rated A+ LATEST UPDATE!!! AHIP 2022/2023 Exam Questions and Answers Rated A+ LATEST UPDATE!!! Which of the following statements about Medicare Part D are correct? I. Part D plans must enroll any eligible beneficiary who applies regardless of health status except in limited circumstances. II. Private fee-for-service (PFFS) plans are not required to use a pharmacy network but may choose to have one. III. Beneficiaries enrolled in a MA-Medical Savings Account (MSA) plan may only obtain Part D benefits through a standalone PDP. IV. Beneficiaries enrolled in a MA-PPO may obtain Part D benefits through a standalone PDP or through their plan. - correct answer ✅I, II, and III only Mr. Shapiro gets by on a very small amount of fixed income. He has heard there may be extra help paying for Part D prescription drugs for Medicare beneficiaries with limited income. He wants to know whether he might qualify. What should you tell him? - correct answer ✅The extra help is available to beneficiaries whose income and assets do not exceed annual limits specified by the government. Mr. Shultz was still working when he first qualified for Medicare. At that time, he had employer group coverage that was creditable. During his initial Part D eligibility period, he decided not to enroll because he was satisfied with his drug AHIP 2022/2023 Exam Questions and Answers Rated A+ LATEST UPDATE!!! AHIP 2022/2023 Exam Questions and Answers Rated A+ LATEST UPDATE!!! 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 (MA- OEP). What advice should you give Miguel? - correct answer ✅During the MA- OEP, Miguel can have one-on-one meetings with beneficiaries who have requested such meetings. One of your colleagues argues that it is better to focus your time and energy exclusively in neighborhoods with single-family homes. He further argues that their older owners are more likely to have higher incomes and purchase the Medicare Advantage products you represent compared to those living in apartment complexes. How should you respond? - correct answer ✅This could be considered discriminatory activity and a prohibited practice. Melissa Meadows is a marketing representative for Best Care which has recently introduced a Medicare Advantage plan offering comprehensive dental benefits for $15 per month. Best Care has not submitted any potential posts to CMS for approval. Melissa would like to use the power of social media to reach potential prospects. What advice would you give her? - correct answer ✅If permitted under the terms of her contract, Agent Meadows could post a tweet stating that "Best Care offers an array of Medicare Advantage benefit packages. One might be right for you. Call me to find out more!" AHIP 2022/2023 Exam Questions and Answers Rated A+ LATEST UPDATE!!! AHIP 2022/2023 Exam Questions and Answers Rated A+ LATEST UPDATE!!! You have sought permission from a hospital to place brochures for your product in their gift shop and cafeteria. The hospital administration expresses some hesitation about allowing marketing in a health care facility. What should you tell them? - correct answer ✅Marketing in health care facilities is an acceptable practice, as long as it takes place in common areas where patients are not receiving health care services. You would like to market a MA plan at a neighborhood pharmacy. What should you keep in mind to comply with the marketing requirements for MA plans? - correct answer ✅You must set up your table, make marketing presentations, and accept enrollment applications only in common areas outside of where the patient waits for services from the pharmacist. You will be holding a sales event in the near future, at which you would like to offer door prizes to attendees. Under guidelines from the Medicare agency, what types of gifts or prizes would not be allowed in this situation? - correct answer ✅Gift cards or gift certificates of $15 or less that can be readily converted to cash. AHIP 2022/2023 Exam Questions and Answers Rated A+ LATEST UPDATE!!! AHIP 2022/2023 Exam Questions and Answers Rated A+ LATEST UPDATE!!! During a sales presentation, your client asks you whether the Medicare agency recommends that she sign up for your plan or stay in Original Medicare. What should you tell her? - correct answer ✅Tell her that the Medicare agency does not endorse or recommend any plan. You are working with a number of plans and community organizations to sponsor an educational event. When putting together advertisements for this event, what should you do? - correct answer ✅You must ensure that the advertisements indicate it is an educational event, otherwise it will be considered a marketing event. Agent Lopez helps Ralph to enroll in Top Choice Medicare Advantage plan during the Annual Open Enrollment Period. Ralph's effective enrollment date is January 1st. Ralph disenrolls on February 12th because he discovers that the plan does not cover services furnished by several of his longtime providers. Which of the following statements best describes the impact of Ralph's action upon Agent Lopez's compensation? - correct answer ✅Agent Lopez's entire compensation must be recouped because Ralph disenrolled within 3 months of enrollment. AHIP 2022/2023 Exam Questions and Answers Rated A+ LATEST UPDATE!!! AHIP 2022/2023 Exam Questions and Answers Rated A+ LATEST UPDATE!!! You work for a company that has marketed Medigap products for many years. The company has added Medicare Advantage and Part D plans and you will begin marketing those plans this fall. You are planning what materials to use to easily show the differences in benefits, premiums and cost sharing for each of the products. What do you need to do with your materials before using them for marketing purposes? - correct answer ✅You must submit your materials to the plan you represent, so CMS can review and approve the materials to ensure they are accurate. You are seeking to represent an individual Medicare Advantage plan and an individual Part D plan 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? - correct answer ✅You will not be able to represent any Medicare Advantage or Part D plan until you complete the training and achieve an 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. Agent Martinez wishes to solicit Medicare Advantage prospects through e-mail and asks you for advice as to whether this is possible. What should you tell her? AHIP 2022/2023 Exam Questions and Answers Rated A+ LATEST UPDATE!!! AHIP 2022/2023 Exam Questions and Answers Rated A+ LATEST UPDATE!!! - correct answer ✅Marketing representatives may initiate electronic contact through e-mail but an opt-out process must be provided. Mr. Ford enrolled in an MA-only plan in mid-November during the Annual Election Period (AEP). On December 1, he calls you up and says that he has changed his mind and would like to enroll into a MA-PD plan. What enrollment rules would apply in this case? - correct answer ✅He can make as many enrollment changes as he likes during the Annual Election Period and the last choice made prior to the end of the period will be the effective one as of January 1. 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 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 answer ✅She 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. Mary Samuels recently suffered a stroke while visiting her daughter and grandchildren. As a result, Mary has been admitted to a rehabilitation hospital AHIP 2022/2023 Exam Questions and Answers Rated A+ LATEST UPDATE!!! AHIP 2022/2023 Exam Questions and Answers Rated A+ LATEST UPDATE!!! 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 answer ✅Mary may make an unlimited number of MA enrollment requests and may disenroll from her current MA plan. Which of the following individuals are likely to qualify for a special enrollment period (SEP) for either a MA and/or 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 to a new state providing him with new MA and Part D options. - correct answer ✅II, III, and IV only Mr. Garcia was told he qualifies for a Special Enrollment Period (SEP), but he lost the paper that explains what he could do during the SEP. What can you tell him? AHIP 2022/2023 Exam Questions and Answers Rated A+ LATEST UPDATE!!! AHIP 2022/2023 Exam Questions and Answers Rated A+ LATEST UPDATE!!! 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. Since the employer plan does not cover prescription drugs, she wants to enroll in a Medicare prescription drug plan. Will she be able to? - correct answer ✅Yes. Mrs. Walters must be entitled to Part A or enrolled in Part B to be eligible for coverage under the Medicare prescription drug program. Ms. Gonzales decided to remain in Original Medicare (Parts A and B) and Part D during the Annual Enrollment Period (AEP). At the beginning of January, her neighbor told her about the Medicare Advantage (MA) plan he selected. He also told her there was an open enrollment period that she might be able to use to enroll in a MA plan. Ms. Gonzales comes to you for advice shortly after speaking to her neighbor. What should you tell her? - correct answer ✅There is a MA Open Enrollment Period (OEP) that takes place between January 1 and March 31, but Ms. Gonzales cannot use it because eligibility to use the OEP is available only to MA enrollees. 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 January 1 next year. He is currently enrolled in Original AHIP 2022/2023 Exam Questions and Answers Rated A+ LATEST UPDATE!!! AHIP 2022/2023 Exam Questions and Answers Rated A+ LATEST UPDATE!!! Medicare. What should you do? - correct answer ✅Tell Mr. Anderson that you cannot accept any enrollment forms until the annual election period begins. Ms. Claggett is sixty-six (66) years old. She has been covered under Original Medicare for the last six years due to her disability and has never been enrolled in a Medicare Advantage or a Part D plan before. She wants to enroll in a Part D plan. She knows that there is such a thing as the "Part D Initial Enrollment Period" (IEP) and has concluded that, since she has never enrolled in such a plan before, she should be eligible to enroll under this period. What should you tell her about how the Part D Initial Enrollment Period applies to her situation? - correct answer ✅It occurs three months before and three months after the month when a beneficiary meets the eligibility requirements for Part B, so she will not be able to use it as a justification for enrolling in a Part D plan now. 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? AHIP 2022/2023 Exam Questions and Answers Rated A+ LATEST UPDATE!!! AHIP 2022/2023 Exam Questions and Answers Rated A+ LATEST UPDATE!!! 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 mechanism must advise each individual at the beginning of the process that he or she is completing an actual enrollment request. IV. The mechanism must capture an accurate time and date stamp at the time the applicant enters the online site. - correct answer ✅II and III only Mrs. Goodman enrolled in an MA-PD plan during the Annual Election Period. In mid-January of the following year, she wants to switch back to Original Medicare and enroll in a stand-alone prescription drug plan. What should you tell her? - correct answer ✅During the MA Open Enrollment Period, from January 1 - March 31, she may disenroll from the MA-PD plan into Original Medicare and also may add a stand-alone prescription drug plan. AHIP 2022/2023 Exam Questions and Answers Rated A+ LATEST UPDATE!!!