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AHIP Certification Test Study Guide
She could enroll in a PFFS plan and a stand-alone Medicare prescription
drug plan.
Mrs. Chou likes a PFFS plan available in her area that does not offer drug
coverage. She wants to enroll in the plan and enroll in a stand-alone
prescription drug plan. What should you tell her?
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.
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?
A meal cannot be provided, but light snacks would be permitted.
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
Smith tell Mr. Moreno about the kinds of food that can be provided to
potential enrollees who attend the sales presentation?
Medicare will cover a total of 190 days of inpatient psychiatric care during
Mr. Rainey's entire lifetime.
Mr. Rainey is experiencing paranoid delusions and his physician feels that
he should be hospitalized. What should you tell Mr. Rainey (or his
representative) about the length of an inpatient psychiatric hospital stay
that Medicare will cover?
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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. Alternately, he could check to see whether his state
has a pharmacy assistance program to help him with expenses.
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?
Due to his participation in the workforce he will not have to pay a premium
for Part A but he will pay higher premiums for Part B and Part D due to the
amount of his income.
Mr. Wong is a single individual. He has a successful business career and is
now able to retire with a comfortable income. Mr. Wong's taxable income is
in excess of $80,000. Mr. Wong has health coverage through his employer
but will sign-up for Medicare Part A, Part B and Part D when he leaves the
workforce. How would you advise him as he budgets for Medicare
premiums?
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.
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?
You may make comparisons between plans if you can support them by
studies or statistical data and such comparisons are factually based.
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