AHIP Final Exam Test Questions and Answers (2022/2023) (Verified Answers), Exams of Nursing

Download AHIP Final Exam Test Questions and Answers (2022/2023) (Verified Answers) and more Exams Nursing in PDF only on Docsity!

A+ TEST BANK

AHIP Final Exam

Test Questions and

Answers

(Verified Answers)

TESTED AND EDITED

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 ,answersHe ,may ,sign-up ,for ,Medicare ,at any ,time ,however ,coverage ,usually ,begins ,on ,the ,fourth ,month ,after ,dialysis ,treatments start. Juan ,Perez, ,who ,is ,turning ,age , 65 ,next ,month, ,intends ,to ,work ,for ,several ,more ,years ,at,Smallcap, ,Incorporated. ,Smallcap ,has ,a ,workforce ,of ,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 ,answersJuan ,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. 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 ,answersMedicare Supplemental ,Insurance ,would ,help ,cover ,his ,Part ,A ,and ,Part ,B ,deductibles ,or coinsurance ,in ,Original ,Fee-for- Service ,(FFS) ,Medicare ,as ,well ,as ,possibly ,some services ,that ,Medicare

Mrs. ,Gonzalez ,is ,enrolled ,in ,Original ,Medicare ,and ,has ,a ,Medigap ,policy ,as ,well, ,but ,it provides ,no ,drug ,coverage. ,She ,would ,like ,to ,keep ,the ,coverage ,she ,has ,but ,replace her ,existing ,Medigap ,plan ,with ,one ,that ,provides ,drug ,coverage. ,What ,should ,you ,tell her?correct ,answersMrs. ,Gonzalez ,cannot ,purchase ,a ,Medigap ,plan ,that ,covers ,drugs, but ,she ,could ,keep ,her ,Medigap ,policy ,and ,enroll ,in ,a ,Part ,D ,prescription ,drug ,plan. Mrs. ,West ,wears ,glasses ,and ,dentures ,and ,has ,enjoyed ,considerable ,pain ,relief ,from arthritis ,through ,massage ,therapy. ,She ,is ,concerned ,about ,whether ,or ,not ,Medicare ,will,cover ,these ,items ,and ,services. ,What ,should ,you ,tell ,her?correct ,answersMedicare does ,not ,cover ,massage ,therapy, ,or, ,in ,general, ,glasses ,or ,dentures. 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 ,exposed ,to,under ,Medicare ,if ,he ,were ,to ,require ,hospitalization ,as ,a ,result ,of ,an ,illness. ,In ,general terms, ,what ,could ,you ,tell ,him ,about ,his ,costs ,for ,inpatient ,hospital ,services under ,Original ,Medicare?correct ,answersUnder ,Original ,Medicare, ,there ,is ,a ,single deductible ,amount ,due ,for ,the ,first , 60 ,days ,of ,any ,inpatient ,hospital ,stay, ,after ,which ,it converts ,into ,a ,per-day ,coinsurance ,amount ,through ,day ,90. ,After ,day ,90, ,he ,would ,pay,a ,daily ,amount ,up ,to , 60 ,days ,over ,his ,lifetime, ,after ,which ,he ,would ,be ,responsible ,for all ,costs. 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 ,years ,and ,paying Medicare ,taxes. ,What ,should ,you ,tell ,her?correct ,answersTo ,obtain ,Part ,B ,coverage, she ,must ,pay ,a ,standard ,monthly

,premium, ,though ,it ,is ,higher ,for ,individuals ,with ,higher,incomes. Mr. ,Alonso ,receives ,some ,help ,paying ,for ,his ,two ,generic ,prescription ,drugs ,from ,his employer's ,retiree ,coverage, ,but ,he ,wants ,to ,compare ,it ,to ,a ,Part ,D ,prescription ,drug plan. ,He ,asks ,you ,what ,costs ,he ,would ,generally ,expect ,to ,encounter ,when ,enrolling into ,a ,standard ,MedicarePart ,D ,prescription ,drug ,plan. ,What ,should ,you ,tell ,him?correct answers ,He ,generally ,would ,pay ,a ,monthly ,premium, ,annual ,deductible, ,and ,per- prescription ,cost-sharing. 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 ,concerned ,that ,her ,income will ,make ,it ,impossible ,for ,her ,to ,qualify ,for ,Medicare. ,What ,could ,you ,tell ,her ,to ,address,her ,concern?correct ,answersMedicare ,is ,a ,program ,for ,people ,age , 65 ,or ,older ,and those ,under ,age , 65 ,with ,certain ,disabilities, ,end-stage ,renal ,disease, ,and ,Lou ,Gehrig's disease ,so ,she ,will ,be ,eligible ,for ,Medicare. 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 ,answersBeneficiaries ,under,Original ,Medicare ,have ,no ,cost-sharing ,for ,most ,preventive ,services ,which ,include immunizations ,such ,as ,annual ,flu ,shots.

,tell ,him?correct ,answersPart,A, ,which ,covers ,hospital, ,skilled ,nursing ,facility, ,hospice, ,and ,home ,health ,services ,and,Part ,B, ,which ,covers ,professional ,services ,such ,as ,those ,provided ,by ,a ,doctor ,are covered ,under ,Original ,Medicare. 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 ,answersTell prospect ,Jerry ,Smith ,that ,he ,should ,consider ,adding ,a ,standalone ,Part ,D ,prescription drug ,coverage ,policy ,to ,his ,present ,coverage. 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 ,answersAfter ,receiving ,such ,disability ,payments ,for , 24 ,months, ,he ,will ,be,automatically ,enrolled ,in ,Medicare, ,regardless ,of ,age. 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?correct ,answersMedicare ,covers ,the ,periodic ,performance ,of,a ,range ,of ,screening ,tests ,that ,are ,meant ,to ,provide ,early ,detection ,of ,disease. ,Mr. Buck ,will ,need ,to ,check ,specific ,tests ,before ,obtaining ,them ,to ,see ,if ,they ,will ,be,covered. Which ,of ,the ,following ,statement ,is/are ,correct ,about ,a ,Medicare ,Savings ,Account,(MSA) ,Plans? I. MSAs ,may ,have ,either ,a ,partial ,network, ,full ,network, ,or ,no ,network ,of ,providers. II. MSA ,plans ,cover ,Part ,A ,and ,Part ,B ,benefits ,but ,not ,Part ,D ,prescription ,drug ,benefits.,III. ,An ,individual ,who ,is ,enrolled ,in ,an ,MSA ,plan ,is ,responsible ,for ,a ,minimal ,deductible of ,$500 ,indexed ,for ,inflation. IV. ,Non-network ,providers ,must ,accept ,the ,same ,amount ,that ,Original ,Medicare ,would,pay ,them ,as ,payment ,in ,full. ,correct ,answers ,I, ,II, ,and ,IV ,only Mr. ,Lombardi ,is ,interested ,in ,a ,Medicare ,Advantage ,(MA) ,PPO ,plan ,that ,you ,represent. It ,is ,one ,of ,three ,plans ,operated ,by ,the ,same ,organization ,in ,Mr. ,Lombardi's ,area. ,The MA ,PPO ,plan ,does ,not ,include ,drug ,coverage, ,but ,the ,other ,two ,plans ,do. ,Mr. ,Lombardi,likes ,the ,PPO ,plan ,that ,does ,not ,include ,drug ,coverage ,and ,intends ,to ,obtain ,his ,drug coverage ,through ,a ,stand-alone ,Medicare ,prescription ,drug ,plan. ,What ,should ,you ,tell him ,about ,this ,situation?correct ,answersHe ,could ,enroll ,either ,in ,one ,of ,the ,MA ,plans that ,include ,prescription ,drug ,coverage ,or ,Original ,Medicare ,with ,a ,Medigap ,plan ,and standalone ,Part ,D ,prescription ,drug ,coverage, ,but ,he ,cannot ,enroll ,in ,the ,MA-only ,PPO plan ,and ,a ,stand-alone ,prescription

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 ,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. Mr. ,Wells ,is ,trying ,to ,understand ,the ,difference ,between ,Original ,Medicare ,and Medicare ,Advantage. ,What ,would ,be ,the ,correct ,description?correct ,answersMedicare Advantage ,is ,a ,way ,of ,covering ,all ,the ,Original ,Medicare ,benefits ,through ,private ,health,insurance ,companies. Mrs. ,Chi ,is ,age , 75 ,and ,enjoys ,a ,comfortable ,but ,not ,extremely ,high- income ,level. ,She wishes ,to ,enroll ,in ,a ,MA ,MSA ,plan ,that ,she ,heard ,about ,from ,her ,neighbor. ,She ,also wants ,to ,have ,prescription ,drug ,coverage ,since ,her ,doctor ,recently ,prescribed ,several expensive ,medications. ,Currently, ,she ,is ,enrolled ,in ,Original ,Medicare ,and ,a ,standalone,Part ,D ,plan. ,How ,would ,you ,advise ,Mrs. ,Chi?correct ,answersMrs. ,Chi ,may ,enroll ,in ,a MA ,MSA ,plan ,and ,remain ,in ,her ,current ,standalone ,Part ,D ,prescription ,drug ,plan. 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 ,answers. C-SNP

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 ,answersShe could ,file ,a ,grievance ,with ,her ,plan ,to ,complain ,about ,the ,lack ,of ,timeliness ,in ,getting ,an,appointment. 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 ,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 answersSNPs ,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. ,Radford ,asks ,whether ,there ,are ,any ,special ,eligibility ,requirements ,for ,Medicare Advantage. ,What ,should ,you ,tell ,her?correct ,answersMrs. ,Radford ,must ,be ,entitled ,to,Part ,A ,and ,enrolled ,in ,Part ,B ,to ,enroll ,in ,Medicare ,Advantage. Mrs. ,Andrews ,asked ,how ,a ,Private ,Fee-for-Service ,(PFFS) ,plan ,might ,affect ,her ,access,to ,services ,since ,she ,receives ,some ,assistance ,for ,her ,health ,care ,costs ,from ,the ,State.

,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 ,some ,services ,and ,items ,he ,thought would ,be ,fully ,covered. ,He ,called ,you ,to ,ask ,what ,he ,could ,do? ,What ,could ,you ,tell him?correct ,answersYou ,can ,offer ,to ,review ,the ,plans ,appeal ,process ,to ,help ,him ,ask the ,plan ,to ,review ,the ,coverage ,decision. 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 ,answersSNPs,have ,special ,programs ,for ,enrollees ,with ,chronic ,conditions, ,like ,Mr. ,Sinclair, ,and ,they provide ,prescription ,drug ,coverage ,that ,could ,be ,very ,helpful ,as ,well. 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 ,answersThey ,are ,Medicare ,health ,plans ,such ,as,HMOs, ,PPOs, ,PFFS, ,and ,MSAs. Mr. ,Sanchez ,has ,just ,turned , 65 ,and ,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 Advantage ,plan, ,what ,will ,he ,have ,to ,do?correct ,answersHe ,will ,have ,to ,enroll ,in ,Part ,B.

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 ,answersMr. ,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. 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 ,answersHe ,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. ,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 ,to ,have their ,Medicare ,prescription ,drug ,plan ,cover ,these ,drug ,needs. ,What ,should ,you ,tell them?correct ,answersMedicare ,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. Mr. ,Wingate ,is ,a ,newly ,enrolled ,Medicare ,Part ,D ,beneficiary ,and ,one ,of

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 ,answersMedicare ,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. ,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 ,answersIf ,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. 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 ,answersMr. ,Schultz ,should ,enroll ,in ,a ,Part ,D,plan ,before ,he ,has ,a , 63 - day ,break ,in ,coverage ,in ,order ,to ,avoid ,a ,premium ,penalty.

Mrs. ,Mulcahy, ,age ,65, ,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 ,answersAn ,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. What ,types ,of ,tools ,can ,Medicare ,Part ,D ,prescription ,drug ,plans ,use ,that ,affect ,the ,way,their ,enrollees ,can ,access ,medications?correct ,answersPart ,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 co-payments ,and ,prior ,authorization. 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 ,answersStandard ,Part,D ,coverage ,would ,require ,payment ,of ,an ,annual ,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%.

period ,to ,avoid ,the ,late ,enrollment ,penalty. Mrs. ,McIntire ,is ,enrolled ,in ,her ,state's ,Medicaid ,plan ,and ,has ,just ,become ,eligible ,for Medicare ,as ,well. ,What ,can ,she ,expect ,will ,happen ,to ,her ,drug ,coverage?correct answersUnless ,she ,chooses ,a ,Medicare ,Part ,D ,prescription ,drug ,plan ,on ,her ,own, ,she,will ,be ,automatically ,enrolled ,in ,one ,available ,in ,her ,area. Mrs. ,Berkowitz ,wants ,to ,enroll ,in ,a ,Medicare ,Advantage ,plan ,that ,does ,not ,include ,drug,coverage ,and ,also ,enroll ,in ,a ,stand-alone ,Medicare ,prescription ,drug ,plan. ,Under ,what circumstances ,can ,she ,do ,this?correct ,answersIf ,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. 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 ,answersI, ,II, ,and ,III ,only 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 ,answersIn ,general, ,he ,must ,select ,a ,single ,Part ,D ,premium,payment ,mechanism ,that ,will ,be ,used ,throughout ,the ,year. You ,will ,be ,holding ,a ,sales ,event ,soon, ,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 ,answersGift ,cards ,or ,gift ,certificates ,of $15 ,or ,less ,that ,can ,be ,readily ,converted ,to ,cash. Another ,agent ,working ,for ,your ,agency ,claims ,that ,because ,you ,are ,not ,employed ,by the ,Medicare ,Advantage ,plans ,that ,you ,represent, ,you ,are ,not ,subject ,to ,the ,same marketing ,requirements ,as ,the ,plans ,themselves. ,How ,should ,you ,respond ,to ,such ,a statement?correct ,answersYour ,coworker ,is ,not ,correct. ,Marketing ,on ,behalf ,of ,a ,plan ,is,considered ,marketing ,by ,the ,plan ,and ,requires ,that ,all ,contracted ,and ,employed ,agents comply ,with ,all ,Medicare ,marketing ,rules. 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,answersYou ,may ,provide