AHIP 2024/2025 Exam Questions and Answers: Medicare Coverage and Enrollment, Exams of Nursing

Download AHIP 2024/2025 Exam Questions and Answers: Medicare Coverage and Enrollment and more Exams Nursing in PDF only on Docsity! AHIP 2024/2025 Exam Questions and Answers Rated A+ LATEST UPDATE!!! RATED A+ 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. Anita Magri will turn age 65 in August 2020. 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 AHIP 2022/2023 Exam Questions and Answers Rated A+ LATEST UPDATE!!! AHIP 2024/2025 Exam Questions and Answers Rated A+ LATEST UPDATE!!! RATED A+ Medigap Part F plan 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? - correct answer ✅You are sorry to disappoint Anita but a Medigap Part F plan is no longer available 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. 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. Bauer is 49 years old, but eighteen months ago he was declared disabled by the Social Security Administration and has been receiving disability payments. He is wondering whether he can obtain coverage under Medicare. What should you tell him? - correct answer ✅After receiving such disability payments for 24 months, he will be automatically enrolled in Medicare, regardless of age. 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? - AHIP 2022/2023 Exam Questions and Answers Rated A+ LATEST UPDATE!!! AHIP 2024/2025 Exam Questions and Answers Rated A+ LATEST UPDATE!!! RATED A+ 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 adding a standalone Part D prescription drug coverage policy to his present coverage. AHIP 2022/2023 Exam Questions and Answers Rated A+ LATEST UPDATE!!! AHIP 2024/2025 Exam Questions and Answers Rated A+ LATEST UPDATE!!! RATED A+ Mrs. Paterson is concerned about the deductibles and co-payments associated with Original Medicare. What can you tell her about Medigap as an option to address this concern? - correct answer ✅Medigap plans help beneficiaries cover coinsurance, co-payments, and/or deductibles for medically necessary services Mr. Davis is 52 years old and has recently been diagnosed with end-stage renal disease (ESRD) and will soon begin dialysis. He is wondering if he can obtain coverage under Medicare. What should you tell him? - correct answer ✅He may sign-up for Medicare at any time however coverage usually begins on the fourth month after dialysis treatments start. 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 age 65 or over 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. Singh would like drug coverage but does not want to be enrolled in a Medicare Advantage plan. What should you tell him? - correct answer ✅Mr. AHIP 2022/2023 Exam Questions and Answers Rated A+ LATEST UPDATE!!! AHIP 2024/2025 Exam Questions and Answers Rated A+ LATEST UPDATE!!! RATED A+ Singh can enroll in a stand-alone prescription drug plan and continue to be covered for Part A and Part B services through Original Fee-for-Service Medicare. Juan Perez, who is turning age 65 next month, intends to work for several more years at Smallcap, Incorporated. Smallcap has a workforce of 15 employees and offers employer-sponsored healthcare coverage. Juan is a naturalized citizen and has contributed to the Medicare system for over 20 years. Juan asks you if he will be entitled to Medicare and if he enrolls how that will impact his employer- sponsored healthcare coverage. How would you respond? - correct answer ✅Juan is likely to be eligible for Medicare once he turns age 65 and if he enrolls Medicare would become the primary payor of his healthcare claims and Smallcap does not have to continue to offer him coverage comparable to those under age 65 under its employer-sponsored group health plan. Mrs. Radford asks whether there are any special eligibility requirements for Medicare Advantage. What should you tell her? - correct answer ✅Mrs. Radford must be entitled to Part A and enrolled in Part B to enroll in Medicare Advantage. AHIP 2022/2023 Exam Questions and Answers Rated A+ LATEST UPDATE!!! AHIP 2024/2025 Exam Questions and Answers Rated A+ LATEST UPDATE!!! RATED A+ 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 2024/2025 Exam Questions and Answers Rated A+ LATEST UPDATE!!! RATED A+ Ms. Gardner is currently enrolled in an MA-PD plan. However, she wants to disenroll from the MA-PD plan and instead enroll in a Part D only plan and go back to Original Medicare. According to Medicare's enrollment guidelines, when could she do this? - correct answer ✅She may make such a change during the Annual Election Period that runs from Oct. 15 to December 7, or during the MA Open Enrollment Period which takes place from January 1- March 31 of each year. Mr. Jackson just turned 65. He has been seeing the same general practitioner for annual check-ups for the past 15 years, likes these yearly visits, and would like to continue obtaining these services as a Medicare beneficiary. What should you tell him about annual check-ups? - correct answer ✅Medicare will cover an annual wellness visit, even if he has no illnesses or injuries. Ms. Brooks has an aggressive cancer and would like to know if Medicare will cover hospice services in case she needs them. What should you tell her? - correct answer ✅Medicare covers hospice services and they will be available for her. 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 AHIP 2022/2023 Exam Questions and Answers Rated A+ LATEST UPDATE!!! AHIP 2024/2025 Exam Questions and Answers Rated A+ LATEST UPDATE!!! RATED A+ 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 and items he thought would be fully covered. He called you to ask what he could do? What could you tell him? - correct answer ✅You can offer to review the plans appeal process to help him ask the plan to review the coverage decision. Mr. Lee was intending to enroll in MaxCare's Medicare Advantage plan this year. However, due to his current medical condition, his daughter Debbie has been appointed as his legal representative over both health and financial matters. Debbie would like to ensure that her father is still able to enroll in MaxCare's plan, but she is unsure what her role is to help with his enrollment request. What advice can you give her? - correct answer ✅Debbie can submit an electronic enrollment request on Mr. Lee's behalf as long as she attests that she has the legal authority to do so. (not sure) 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. AHIP 2022/2023 Exam Questions and Answers Rated A+ LATEST UPDATE!!! AHIP 2024/2025 Exam Questions and Answers Rated A+ LATEST UPDATE!!! RATED A+ 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 and items he thought would be fully covered. He called you to ask what he could do? What could you tell him? - correct answer ✅You can offer to review the plans appeal process to help him ask the plan to review the coverage decision. AHIP 2022/2023 Exam Questions and Answers Rated A+ LATEST UPDATE!!! AHIP 2024/2025 Exam Questions and Answers Rated A+ LATEST UPDATE!!! RATED A+ Mr. Gomez notes that a Private Fee-for-Service (PFFS) plan available in his area has an attractive premium. 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 answer ✅He 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. Mr. Wells is trying to understand the difference between Original Medicare and Medicare Advantage. What would be the correct description? - correct answer ✅Medicare Advantage is a way of covering all the Original Medicare benefits through private health insurance companies. Mrs. Ramos is considering a Medicare Advantage PPO and has questions about which providers she can go to for her health care. What should you tell her? - correct answer ✅Mrs. Ramos can obtain care from any provider who participates in Original Medicare, but generally will have a higher cost-sharing amount if she sees a provider who/that is not a part of the PPO network. 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? - correct answer ✅Dr. Brennan AHIP 2022/2023 Exam Questions and Answers Rated A+ LATEST UPDATE!!! AHIP 2024/2025 Exam Questions and Answers Rated A+ LATEST UPDATE!!! RATED A+ can charge Mary Rogers no more than the 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. Mrs. Davenport enrolled in the ABC Medicare Advantage (MA) plan several years ago. In mid-February of 2021, her doctor confirms a diagnosis of end-stage renal disease (ESRD). What options will Mrs. Davenport have regarding her MA plan during the next open enrollment season? - correct answer ✅She may remain in her ABC MA plan, enroll in another MA plan in her service area, or enroll in a Special Needs Plan (SNP) for individuals suffering from ESRD if one is available in her area. Mrs. Lyons is in good health, uses a single prescription, and lives independently in her own home. She is attracted by the idea of maintaining control over a Medical Savings Account (MSA) but is not sure if the plan associated with the account will fit her needs. What specific piece of information about a Medicare MSA plan would it be important for her to know, prior to enrolling in such a plan? - correct answer ✅All MSAs cover Part A and Part B benefits, but not Part D prescription drug benefits, which could be obtained by also enrolling in a separate prescription drug plan. AHIP 2022/2023 Exam Questions and Answers Rated A+ LATEST UPDATE!!! AHIP 2024/2025 Exam Questions and Answers Rated A+ LATEST UPDATE!!! RATED A+ 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- the-counter medications for colds and allergies, vitamins, and drugs from an Internet-based Canadian pharmacy to promote hair growth and reduce joint swelling. His neighbor recently told him about a concept called TrOOP and he asks you if any of his other medications could count toward TrOOP should he ever reach the Part D catastrophic limit. What should you say? - correct answer ✅None of the costs of AHIP 2022/2023 Exam Questions and Answers Rated A+ LATEST UPDATE!!! AHIP 2024/2025 Exam Questions and Answers Rated A+ LATEST UPDATE!!! RATED A+ Mr. Wingate's other medications would currently count toward TrOOP but he may wish to ask his plan for an exception to cover the prescription not on its formulary. Mrs. Roswell is a new Medicare beneficiary who has just retired from retail work. She is interested in selecting a Medicare Part D prescription drug plan. She takes a number of medications and is concerned that she has not been able to identify a plan that covers all of her medications. She does not want to make an abrupt change to new drugs that would be covered and asks what she should do. What should you tell her? - correct answer ✅Every Part D drug plan is required to cover a single one-month fill of her existing medications sometime during a 90-day transition period. Mrs. Lopez is enrolled in a cost plan for her Medicare benefits. She has recently lost creditable coverage previously available through her husband's employer. She is interested in enrolling in a Medicare Part D prescription drug plan (PDP). What should you tell her? - correct answer ✅If a Part D benefit is offered through her plan she may choose to enroll in that plan or a standalone PDP. 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 AHIP 2022/2023 Exam Questions and Answers Rated A+ LATEST UPDATE!!! AHIP 2024/2025 Exam Questions and Answers Rated A+ LATEST UPDATE!!! RATED A+ 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. Mr. Zachow has a condition for which three drugs are available. He has tried two but had an allergic reaction to them. Only the third drug works for him and it is not on his Part D plan's formulary. What could you tell him to do? - correct answer ✅Mr. Zachow has a right to request a formulary exception to obtain coverage for his Part D drug. He or his physician could obtain the standardized request form on the plan's website, fill it out, and submit it to his plan. Mrs. Quinn has just turned 65, is in excellent health and has a relatively high income. She uses no medications and sees no reason to spend money on a Medicare prescription drug plan if she does not need the coverage. She 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. AHIP 2022/2023 Exam Questions and Answers Rated A+ LATEST UPDATE!!! AHIP 2024/2025 Exam Questions and Answers Rated A+ LATEST UPDATE!!! RATED A+ 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 coverage. It is now a year later and Mr. Shultz has lost his employer group coverage within the last two weeks. How would you advise him? - correct answer ✅Mr. Schultz should enroll in a Part D plan before he has a 63-day break in coverage in order to avoid a premium penalty. AHIP 2022/2023 Exam Questions and Answers Rated A+ LATEST UPDATE!!! AHIP 2024/2025 Exam Questions and Answers Rated A+ LATEST UPDATE!!! RATED A+ 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 to 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. Mr. Jacob understands that there is a standard Medicare Part D prescription drug benefit, but when he looks at information on various plans available in his area, he sees a wide range in what they charge for deductibles, premiums, and cost sharing. How can you explain this to him? - correct answer ✅Medicare Part D drug plans may have different benefit structures, but on average, they must all be at least as good as the standard model established by the government. Mr. Hutchinson has drug coverage through his former employer's retiree plan. He is concerned about the Part D premium penalty if he does not enroll in a Medicare prescription drug plan, but does not want to purchase extra coverage that he will not need. What should you tell him? - correct answer ✅If the drug coverage he has is not expected to pay, on average, at least as much as Medicare's standard Part D coverage expects to pay, then he will need to enroll AHIP 2022/2023 Exam Questions and Answers Rated A+ LATEST UPDATE!!! AHIP 2024/2025 Exam Questions and Answers Rated A+ LATEST UPDATE!!! RATED A+ in Medicare Part D during his initial eligibility period to avoid the late enrollment penalty. Mrs. Lu is turning 65 in November and called to ask for your help deciding on a Medicare Advantage plan. She agreed to sign a scope of appointment form and meet with you on October 15. During the appointment, what are you permitted to do? - correct answer ✅You may provide her with the required enrollment materials and take her completed enrollment application. 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? - correct answer ✅You must have her sign a scope of appointment form, indicating which products she wishes to discuss. You may then proceed with the discussion. 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. AHIP 2022/2023 Exam Questions and Answers Rated A+ LATEST UPDATE!!! AHIP 2024/2025 Exam Questions and Answers Rated A+ LATEST UPDATE!!! RATED A+ 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. Agent Jennings makes a presentation on Medicare advertised as an educational event. Agent Jennings distributes materials that are solely educational in nature. However, she gives a brief presentation that mentions plan-specific premiums. Is this a prohibited activity at an event that has been advertised as educational? - correct answer ✅Yes. When an event has been advertised as "educational," discussing plan-specific premiums is impermissible. AHIP 2022/2023 Exam Questions and Answers Rated A+ LATEST UPDATE!!! AHIP 2024/2025 Exam Questions and Answers Rated A+ LATEST UPDATE!!! RATED A+ Agent Armstrong is employed by XYZ Agency, which is under contract with ABC Health Plan, a Medicare Advantage (MA) plan that offers plans in multiple states. XYZ Agency maintains a website marketing the MA plans with which it has contracts. Agent Armstrong follows up with individuals who request more information about ABC MA plans via the website and tries to persuade them to enroll in ABC plans. What statement best describes the marketing and compliance rules that apply to Agent Armstrong? - correct answer ✅Agent Armstrong needs to be licensed and appointed in every state in which beneficiaries to whom he markets ABC MA plans are located. ABC is a Medicare Advantage (MA) plan sponsor. It would like to use its enrollees' information to market nonhealth related products such as life insurance and annuities. To do so it must obtain authorization from the enrollees. Which statement best describes the authorization process? - correct answer ✅Authorization may be obtained by directing a beneficiary to a website to provide consent as long as the website includes a mechanism for an electronic signature that is valid under applicable law. You have been providing a pre-Thanksgiving meal during sales presentations in November for many years and your clients look forward to attending this annual event. When marketing Medicare Advantage and Part D plans, what are you AHIP 2022/2023 Exam Questions and Answers Rated A+ LATEST UPDATE!!! AHIP 2024/2025 Exam Questions and Answers Rated A+ LATEST UPDATE!!! RATED A+ permitted to do with respect to meals? - correct answer ✅You may provide light snacks, but a Thanksgiving style meal would be prohibited, regardless of who provides or pays for the meal. Mr. Prentice has many clients who are Medicare beneficiaries. He should review the Centers for Medicare & Medicaid Services' (CMS) Communication and Marketing Guidelines to ensure he is compliant for which type of products? - correct answer ✅Medicare Advantage (MA) and Prescription Drug (PDP) plans. Next week you will be participating in your first "educational event" for prospective enrollees. In order to be sure that you do not violate any of the applicable guidelines, in what activities should you plan to engage? - correct answer ✅You should plan to ensure that the educational event is an informative event and must not conduct a sales presentation or distribute or accept enrollment forms at the event. 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 AHIP 2022/2023 Exam Questions and Answers Rated A+ LATEST UPDATE!!! AHIP 2024/2025 Exam Questions and Answers Rated A+ LATEST UPDATE!!! RATED A+ 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? - correct answer ✅If the SEP is for MA coverage, he will generally have one opportunity to change his MA coverage. Which of the following individuals is most likely to be eligible to enroll in a Medicare Advantage (MA) or Part D Plan? - correct answer ✅Jose, a grandfather who was granted asylum and has worked in the United States for many years. AHIP 2022/2023 Exam Questions and Answers Rated A+ LATEST UPDATE!!! AHIP 2024/2025 Exam Questions and Answers Rated A+ LATEST UPDATE!!! RATED A+ 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 and she is considered a dual eligible. Will gaining eligibility for this program affect her ability to enroll in a Medicare Advantage or Medicare Prescription Drug plan? - correct answer ✅Yes. 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. 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 answer ✅"If you're not in very good health, you will probably do better with a different product." Mrs. Berkowitz wants to enroll in a Medicare Advantage plan that does not include drug coverage and also enroll in a stand-alone Medicare prescrip - correct answer ✅If the Medicare Advantage plan is a Private Fee-for-Service (PFFS) plan that does not offer drug coverage or a Medical Savings Account plan, Mrs. Berkowitz can do this. AHIP 2022/2023 Exam Questions and Answers Rated A+ LATEST UPDATE!!! AHIP 2024/2025 Exam Questions and Answers Rated A+ LATEST UPDATE!!! RATED A+ 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 answer ✅Mr. 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 health care decisions, or is authorized under state surrogate consent laws to make health decisions. 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 plan available in her new residence until the Annual Election Period. What should you tell her? - correct answer ✅She is eligible for a Special Election Period that begins either the month before her permanent move, if the plan is notified in advance, or the month she provides notice of the move, and this period typically lasts an additional two months. 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. AHIP 2022/2023 Exam Questions and Answers Rated A+ LATEST UPDATE!!!