AHIP FINAL EXAM WITH COMPLETE SOLUTIONS
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? - ANSWER He may sign-up for Medicare at any time
however coverage usually begins on the fourth month after dialysis treatments start.
Mr. Johannsen is entitled to Medicare Part A and Part B. He gains the Part D low-income
subsidy. How does that affect his ability to enroll or disenroll in a Part D plan? - ANSWER He
qualifies for a special election period and can enroll in or disenroll from a Part D plan once
during that period.
Mr. Lopez, who is fairly well-off financially, would like to enroll in a Medicare prescription
drug plan you represent and simply give you a check to cover his premiums for the entire
year. What should you tell him? - ANSWER Enrollees should pay using automatic
withdrawal from a bank account or credit or debit card, direct monthly billing from the
plan, or deductions from their Social Security check.
, You have approached a hospital administrator about marketing in her facility. The
administrator is uncomfortable with the suggestion. How could you address her concerns? -
ANSWER Tell her that Medicare guidelines allow you to conduct marketing activities in
common areas of a provider's facility.
You have come to Mrs. Midler's home for a sales presentation. At the beginning of the
presentation, 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? - ANSWER You can only ask Mrs. Midler questions about
conditions that affect eligibility, specifically, whether she has end stage renal disease or one
of the conditions that would qualify her for a special needs plan.
Mrs. Reeves is newly eligible to enroll in a Medicare Advantage plan and her MA Initial
Coverage Election Period (ICEP) has just begun. Which of the following can she not do
during the ICEP? - ANSWER She can enroll in a Medigap plan to supplement the benefits of
the MA plan that she's also enrolling in.
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? - ANSWER Mrs. Chi may enroll in a MS MSA plan and
remain in her current standalone Part D prescription drug plan.
Alice is enrolled in a MA-PD plan. She makes a permanent move across the country and
wonders what her options are for continuing MA-PD coverage. What would you say to her
in regard to a special enrollment period (SEP)? - ANSWER She is likely to qualify for a SEP.
She can choose an effective date of up to three months after the month in which the
enrollment form is received by the new plan, but the effective date may not be earlier than
the date of her permanent move.
Which of the following individuals is most likely to be eligible to enroll in a part d plan? -
ANSWER Jose, a grandfather who was granted asylum and has worked in the United States
for many years.
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? - ANSWER He may sign-up for Medicare at any time
however coverage usually begins on the fourth month after dialysis treatments start.
Mr. Johannsen is entitled to Medicare Part A and Part B. He gains the Part D low-income
subsidy. How does that affect his ability to enroll or disenroll in a Part D plan? - ANSWER He
qualifies for a special election period and can enroll in or disenroll from a Part D plan once
during that period.
Mr. Lopez, who is fairly well-off financially, would like to enroll in a Medicare prescription
drug plan you represent and simply give you a check to cover his premiums for the entire
year. What should you tell him? - ANSWER Enrollees should pay using automatic
withdrawal from a bank account or credit or debit card, direct monthly billing from the
plan, or deductions from their Social Security check.
, You have approached a hospital administrator about marketing in her facility. The
administrator is uncomfortable with the suggestion. How could you address her concerns? -
ANSWER Tell her that Medicare guidelines allow you to conduct marketing activities in
common areas of a provider's facility.
You have come to Mrs. Midler's home for a sales presentation. At the beginning of the
presentation, 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? - ANSWER You can only ask Mrs. Midler questions about
conditions that affect eligibility, specifically, whether she has end stage renal disease or one
of the conditions that would qualify her for a special needs plan.
Mrs. Reeves is newly eligible to enroll in a Medicare Advantage plan and her MA Initial
Coverage Election Period (ICEP) has just begun. Which of the following can she not do
during the ICEP? - ANSWER She can enroll in a Medigap plan to supplement the benefits of
the MA plan that she's also enrolling in.
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? - ANSWER Mrs. Chi may enroll in a MS MSA plan and
remain in her current standalone Part D prescription drug plan.
Alice is enrolled in a MA-PD plan. She makes a permanent move across the country and
wonders what her options are for continuing MA-PD coverage. What would you say to her
in regard to a special enrollment period (SEP)? - ANSWER She is likely to qualify for a SEP.
She can choose an effective date of up to three months after the month in which the
enrollment form is received by the new plan, but the effective date may not be earlier than
the date of her permanent move.
Which of the following individuals is most likely to be eligible to enroll in a part d plan? -
ANSWER Jose, a grandfather who was granted asylum and has worked in the United States
for many years.
