Ahip module 5 | Ahip module 5, Exams of Psychology

Ahip module 5 | Ahip module 5 | Ahip module 5

Typology: Exams

2023/2024

Available from 08/02/2024

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Ahip module 5
1. Mrs. Walters is entitled to Part A and has med-
ical coverage without drug coverage through an
employer retiree plan. She is not enrolled in Part
B. Since the employer plan does not cover pre-
scription drugs, she wants to enroll in a Medicare
prescription drug plan. Will she be able to?
d. Yes. Mrs. Walters
must be entitled to Part
A or enrolled in Part B to
be eligible for coverage
under the Medicare pre-
scription drug program.
Correct
2. 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 Advantage plan, what will he have
to do?
b. He will have to enroll
in Part B. Correct
3. 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?
c. You would need to ask
Mr. Kelly if he is enrolled
in Part A and Part B and
if he lives in the PFFS
plan's service area. Cor-
rect
4. 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?
c. He will have to en-
roll in Part B prior to en-
rolling in the PFFS plan.
Correct
5. Mrs. Berkowitz wants to enroll in a Medicare Ad-
vantage plan that does not include drug cover-
age and also enroll in a stand-alone Medicare
prescription drug plan. Under what circum-
stances can she do this?
b. If the Medicare Ad-
vantage plan is a Private
Fee-for-Service (PFFS)
plan that does not offer
drug coverage or a Med-
ical Savings Account,
Mrs. Berkowitz can do
this. Correct
6. 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
c. A Medicare Advan-
tage Prescription Drug
(MA-PD) PFFS plan
that combines medical
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Ahip module 5

  1. Mrs. Walters is entitled to Part A and has med- ical coverage without drug coverage through an employer retiree plan. She is not enrolled in Part B. Since the employer plan does not cover pre- scription drugs, she wants to enroll in a Medicare prescription drug plan. Will she be able to? d. Yes. Mrs. Walters must be entitled to Part A or enrolled in Part B to be eligible for coverage under the Medicare pre- scription drug program. Correct
  2. 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 Advantage plan, what will he have to do? b. He will have to enroll in Part B. Correct
  3. 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? c. You would need to ask Mr. Kelly if he is enrolled in Part A and Part B and if he lives in the PFFS plan's service area. Cor- rect
  4. 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? c. He will have to en- roll in Part B prior to en- rolling in the PFFS plan. Correct
  5. Mrs. Berkowitz wants to enroll in a Medicare Ad- vantage plan that does not include drug cover- age and also enroll in a stand-alone Medicare prescription drug plan. Under what circum- stances can she do this? b. If the Medicare Ad- vantage plan is a Private Fee-for-Service (PFFS) plan that does not offer drug coverage or a Med- ical Savings Account, Mrs. Berkowitz can do this. Correct
  6. 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 c. A Medicare Advan- tage Prescription Drug (MA-PD) PFFS plan that combines medical

area. Which options could Mrs. Roberts consider before selecting a PFFS plan? benefits and Part D prescription drug cov- erage, a PFFS plan offering only medical benefits, or a PFFS plan in combination with a stand-alone prescrip- tion drug plan. Correct

  1. Which of the following individuals is most likely to be eligible to enroll in a Medicare Advantage or Part D Plan? d. Jose, a grandfather who was granted asy- lum and has worked in the United States for many years. Correct
  2. 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 presentation, Mrs. Nunez feels tired and tells you that her husband can finish things up. She goes to bed. At the end of your discussion, Mr. Nunez says that he wants to enroll both himself and his wife. What should you do? a. As long as she is able to do so, only Mrs. Nunez can sign her enrollment form. Mrs. Nunez will have to wake up to sign her form or do so at another time. Cor- rect
  3. 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 enroll- ment form and sign it for him? d. Mr. Tully's daughter can do so only, if she is authorized under state law as a court-appoint- ed legal guardian, has durable power of attor- ney for health care de- cisions, or is authorized under state surrogate consent laws to make health decisions. Cor- rect
  4. You are meeting with Ms. Berlin and she has completed an enrollment form for a MA-PD plan you represent. You notice that her handwriting c. You may correct this information as long as you add your initials and

Apply those guidelines to the following state- ments and identify which would be prohibited. different product." Cor- rect

  1. You have come to Mrs. Midler's home for a sales presentation. At the beginning of the presenta- tion, Mrs. Midler tells you that she has a copy of her medical record available because she thinks this will help you understand her needs. She suggests that you will know which questions to ask her about her health status in order to best assist her in selecting a plan. What should you do? b. You can only ask Mrs. Midler questions about conditions that af- fect eligibility, specifical- ly, whether she has end stage renal disease or one of the conditions that would qualify her for a special needs plan. Correct
  2. Willard works as a representative focused on the senior marketplace. What would be considered prohibited activity by Willard? d. Implying that only seniors can enroll in a Medicare Advantage plan when meeting with Mr. Hernandez, who is 58 but qualifies for Medicare because she is disabled. Correct
  3. Mr. Garrett has just entered his MA Initial Cov- erage Election Period (ICEP). What action could you help him take during this time? When Myra first became eligible for Medicare, she enrolled in Original Medicare (Parts A and B). She is now 67 and will turn 68 on July 1. She would now like to enroll in a Medicare Ad- vantage (MA) plan and approaches you about her options. What ad- vice would you give her?
  4. Mrs. Kendrick 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? c. She may enroll in an MA plan beginning three months immediately be- fore her first entitlement

to both Medicare Part A and Part B. Correct

  1. Mr. Ziegler is turning 65 next month and has asked you what he can do, and when he must do it, with respect to enrolling in Part D. What could you tell him? c. He is currently in the Part D Initial En- rollment Period (IEP) and, during this time, he may make one Part D enrollment choice, in- cluding enrollment in a stand-alone Part D plan or an MA-PD plan. Cor- rect
  2. Ms. Claggett is sixty-six (66) years old. She has been covered under both Parts A and B of Orig- inal Medicare for the last six years due to her disability, 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 Peri- od" and has concluded that, since she has never enrolled in such a plan before, she should be eli- gible to enroll under this period. What should you tell her about how the Part D Initial Enrollment Period applies to her situation? c. It occurs three months before and three months after the month when a benefi- ciary meets the eligibili- ty requirements for Part B, so she will not be able to use it as a justification for enrolling in a Part D plan now. Correct
  3. When Myra first became eligible for Medicare, she enrolled in Original Medicare (Parts A and B). She is now 67 and will turn 68 on July 1. She would now like to enroll in a Medicare Advantage (MA) plan and approaches you about her options. What advice would you give her? b. She should remain in Original Medicare until the annual election pe- riod running from Oc- tober 15 to December 7, during which she can select an MA plan. Cor- rect
  4. Mr. Ford enrolled in an MA-only plan in mid-No- vember during the Annual Election Period. On December 1, he calls you up and says that he has changed his mind and would like to enroll into an b. He can make as many enrollment changes as he likes during the An- nual Election Period and

ing with Agent Neil Adams in the selection of a Medicare Advantage (MA) plan. It is mid-Septem- ber, and Mrs. Young is going on vacation. Agent Adams is considering suggesting that he and Mrs. Young complete the application together be- fore she leaves. He will then submit the paper ap- plication prior the start of the annual enrollment period (AEP). What would you say If you were advising Agent Adams? prohibited from solicit- ing or accepting an en- rollment form prior to the start of the AEP. Correct

  1. Ms. Gonzales decided to remain in Original Medicare (Parts A and B) and Part D during the Annual Enrollment Period (AEP). At the begin- ning of January, her neighbor told her about the Medicare Advantage (MA) plan he selected. He also told her there was an open enrollment pe- riod that she might be able to use to enroll in a MA plan. Ms. Gonzales comes to you for ad- vice shortly after speaking to her neighbor. What should you tell her? d. There is a MA Open Enrollment Period (OEP) that takes place between January 1 and March 31, but Ms. Gon- zales cannot use it be- cause eligibility to use the OEP is available only to MA enrollees. Correct
  2. Mrs. Schmidt is moving and a friend told her she might qualify for a "Special Election Period" to enroll in a new Medicare Advantage plan. She contacted you to ask what a Special Election Period is. What could you tell her? d. It is a time period, outside of the Annual Election Period, when a Medicare beneficiary can select a new or dif- ferent Medicare Advan- tage and/or Part D pre- scription drug plan. Typ- ically the Special Elec- tion Period is benefi- ciary specific and re- sults from events, such as when the beneficia- ry moves outside of the service area. Correct
  3. Mr. Garcia was told he qualifies for a Special Election Period (SEP), but he lost the paper that b. If the SEP is for MA coverage, he will gener-

explains what he could do during the SEP. What can you tell him? ally have one opportuni- ty to change his MA cov- erage. Correct

  1. Mr. Wendt suffers from diabetes which has got- ten progressively worse during the last year. He is currently enrolled in Original Medicare (Parts A and B) and a Part D prescription drug plan and did not enroll in a Medicare Advantage (MA) plan during the last annual open enrollment period (AEP) which has just closed. Mr. Wendt has heard that there are certain MA plans that might pro- vide him with more specialized coverage for his diabetes and wants to know if he must wait until the next annual open enrollment period (AEP) before enrolling in such a plan. What should you tell him? c. If there is a special needs plan (SNP) in Mr. Wendt's area that spe- cializes in caring for in- dividuals with diabetes, he may enroll in the SNP at any time under a special enrollment pe- riod (SEP). Correct
  2. Which of the following individuals are likely to qualify for a special enrollment period (SEP) for both MA and Part D due to a change of resi- dence? 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 providing him with new MA and Part D options. d. II, III, and IV only Cor- rect
  3. 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 d. Mr. Rockwell is el- igible for a SEP due to his involuntary loss
  1. If Mr. Johannsen gains the Part D low-income subsidy, how does that affect his ability to enroll or disenroll in a Part D plan? b. He can enroll in or disenroll from a Part D plan at any time and the subsidy will apply to the plan he chooses. Cor- rect
  2. Mrs. Ridgeway enrolled in Original Medicare and Medigap coverage following her retirements sev- eral years ago. Four months ago, Mrs. Ridge- way 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? c. She qualifies for a special enrollment peri- od (SEP) that will allow her to make a one-time election to return to Original Medicare and she also has a guaran- teed eligibility period to rejoin her Medigap plan. Correct
  3. 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 coverage and is eligible for Medicare. What should you tell him? b. Mr. Chen can disenroll from his employer-spon- sored coverage to elect a Medicare Advantage or Part D plan within 2 months of his disen- rollment, but he should revaluate if he really wants to drop his em- ployer coverage. Cor- rect
  4. Mary Samuels recently suffered a stroke while visiting her daughter and grandchildren. As a result, Mary has been admitted to a rehabilita- tion hospital 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? d. Mary may make an unlimited number of MA enrollment requests and may disenroll from her current MA plan. Correct
  1. Mr. Roberts is enrolled in an MA plan. He re- cently suffered complications following hip re- placement surgery. As a result, he has spent the last three months in Resthaven, a skilled nursing facility. Mr. Roberts is about to be discharged. What advice would you give him regarding his health coverage options? a. His open enrollment period as an institu- tionalized individual will continue for two months after the month he moves out of the facility. Correct
  2. Mrs. Lenard is enrolled in a Medicare Cost plan. Recently the cost plan announced its intention to end its cost contract and transition to a Medicare Advantage (MA) Mrs. Lenard received a letter indicating that unless she chooses another plan or opts out she will be automatically enrolled in the new Medicare Advantage plan operated by an organization affiliated with her cost plan. What does this mean? c. If Mrs. Lenard wants to enroll in a Medicare Advantage plan affiliat- ed with her cost plan ef- fective January 1, she should do nothing and she will be automatically enrolled. If she does not want to enroll in that MA plan, she should choose another plan or other- wise opt out of the au- tomatic enrollment. Cor- rect
  3. You are completing a PFFS plan sale to Mr. West who is new to Medicare and prefers to be con- tacted by telephone. As you are finishing up, what should you tell him about next steps in the enrollment process? d. You need to get Mr. West's phone number and include it on the en- rollment form because the plan must call him after you leave to ensure that he understood the nature of the PFFS plan he selected and to verify his intent to enroll. Cor- rect
  4. Mrs. Johnson calls to tell you she has not re- ceived her new plan ID card yet, but she needs to see a doctor. What can she expect to receive b. Evidence of plan membership, informa- tion on how to obtain services, and the effec-

Mrs. Disraeli is enrolled in Original Medicare (Parts A and B) and a standalone Part D pre- scription drug plan. She has recently developed diabetes and has suffered from heart disease for several years. She has also recently learned that her area is served by a SNP for individuals suffer- ing from such a combination of chronic diseases (C-SNP). Mrs. Disraeli is concerned however, that she will have few rights or protections if she enrolls in a C-SNP. How would you respond? b. Enrollees in SNPs must have access to provider networks that include enough doctors, specialists, and hospi- tals to provide all cov- ered services neces- sary to meet enrollee needs within reason- able travel time. Correct

  1. Ms. O'Donnell learned about a new MA-PD plan that her neighbor suggested and that you repre- sent. She plans to switch from her old MA HMO plan to the new MA-PD plan during the Annu- al Election Period. However, she wants to make sure she does not end up paying premiums for two plans. What can you tell her? b. She only needs to en- roll in the new MA-PD plan and she will auto- matically be disenrolled from her old MA plan. Correct
  2. Mr. Fitzgerald is selling his home to permanently move into a retirement facility near his daugh- ter in a neighboring state. He has a stand-alone prescription drug plan, and has learned it is not available where he is moving. He doesn't know what he should do. What can you tell him? b. Because he is mov- ing outside of the ser- vice area, the plan must automatically disenroll him. He will have a spe- cial election period to select a new plan. Cor- rect
  3. 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 needs it the most. He is certain his plan will disenroll him because that is what happened to a friend of his in a similar type of plan. What can you tell Mr. Robinson about his situation? c. Plan sponsors have the option to disenroll members who do not pay their premiums, but they must first provide each member with a grace period of not less than 2 months. Correct
  4. 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 b. Mrs. Valentino can submit a written request to Medicare to be dis-

election period (AEP). What would you say to Mrs. Valentino regarding her options? enrolled from the Cost plan and enroll in Origi- nal Medicare. Correct

  1. 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 web- site marketing the MA plans with which it has contracts. Agent Armstrong follows up with in- dividuals who request more information about ABC MA plans via the website and tries to per- suade them to enroll in ABC plans. What state- ment best describes the marketing and compli- ance rules that apply to Agent Armstrong? c. Agent Armstrong needs to be licensed and appointed in every state in which beneficia- ries to whom he markets ABC MA plans are locat- ed. Correct