AHIP Studienführer, Klassennotizen & Zusammenfassungen

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 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 ne...

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. 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. Singh can enroll in a stand-alone prescription drug plan and...

AHIP Exam | Questions & 100% Correct Answers (Verified) | Latest Update | Grade 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 prem...

Mr. Prentice has many clients who are Medicare beneficiaries. He should review the Centers for Medicare & Medicaid Services' Marketing Guidelines to ensure he is compliant for which type of products? Correct Answer: Medicare Advantage (MA) and Prescription Drug (PDP) plans Correct 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 requirements as the plans themselves. How ...

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 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 ...

Medicare plan means Correct Answer: A MA plan, MA-PD plan or PDP Subcontractor means Correct Answer: **An individual or entity that provides services on behalf of a Medicare plan sponsor. This includes individuals and organizations with DIRECT relationship with the plan sponsor or individuals or organizations with INDIRECT relationship, such as an agent who has a contract with an agency or filed marketing organization that contract with a Medicare plan. FWA Training: A compliance prog...

What impact, if any, have recent regulatory changes had upon Medigap plans? A. The Part A deductible is no longer covered under Medigap plans for all enrollees starting January 1, 2020. B. The Part A deductible is no longer covered for individuals newly eligible for Medicare starting January 1, 2020. C. The Part B deductible is no longer covered for individuals newly eligible for Medicare starting January 1, 2020. D. The Part B deductible is now covered for some newly eligible individu...

Ms. Jensen has heard about "Original Fee-for-Service Medicare" and "Private Fee-forService" plans. She wants to know what the difference is if any. What should you tell her? Correct Answer: PFFS plans are a type of Medicare Advantage plan offered by private companies. This year you decide to focus your efforts on marketing to employer and union groups. Which of the following statements best describes what you can and cannot do in order to stay in compliance? Correct Answer: You a...

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? a. Eligibility for Medicare is based on whether or not a person has ever been employed by the federal government. If she or her husband were ever employed by the federal government, she can enroll in Medicare. ...

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. Mr. Polanski likes ...