AHIP 2024 final exam QUESTIONS AND
ANSWERS
1. A customer wants to come up with an enrollment application on October 1 before the
start of the Annual Election Period because he is leaving on vacation for 2 weeks and
does now not need to forget about approximately turning it in. What need to you inform
him? - ANSWER-You have to inform him you are not authorised to take the shape.
If he sends the form immediately to the plan, the plan will process the enrollment
on the day the Annual Election Period begins.
2. ABC is a Medicare Advantage (MA) plan sponsor. It would really like to apply its
enrollees' facts to marketplace non-health related products inclusive of existence
insurance and annuities. Which declaration fine describes ABC's responsibility to its
enrollees regarding advertising and marketing such merchandise? - ANSWER-b.
It have to gain a HIPAA compliant authorization from an enrollee that suggests the
plan or plan sponsor may also use their data for advertising purposes.
3. Agent Daniel Webber has well set up a sales appointment to meet with consumer
Edward Young at Agent Webber's workplace. At the agreed upon appointment time, Mr.
Young arrives with his aged neighbor - Clara Burton, who desires to learn about her
Medicare Advantage alternatives. What must Agent Daniel Webber do? - ANSWER-
4. Agent John Miller is meeting with Jerry Smith, a new prospect. Jerry is presently enrolled
in Medicare Parts A and B. Jerry has additionally purchased a Medicare Supplement
(Medigap) plan which he has had for several years. However, the plan does now not
provide drug advantages. How would you propose Agent John Miller to continue? -
ANSWER-Tell prospect Jerry Smith that he have to don't forget including a
standalone Part D prescription drug coverage policy to his gift insurance.
5. Agent Martinez desires to solicit Medicare Advantage potentialities thru email and asks
you for recommendation as to whether that is possible. What ought to you tell her? -
ANSWER-Marketing representatives can also provoke digital contact through
e-mail however an opt-out system should be supplied.
6. Edna, Felix, George, and Harriet are Medicare beneficiaries. Edna lives in an area that
has suffered from predominant flooding that has been declared a chief disaster by way
of both the Federal government and her nation. As a result of coping with the flooding
problems and being evacuated from her domestic, Edna neglected her threat to sign up
for MA in the course of her Initial Coverage Election Period. Felix lives in an area with a
Medicare Advantage plan with a four-famous person score that he would like to enroll in.
George dropped his Medigap coverage six months in the past whilst he first enrolled in a
Medicare Advantage plan. He now desires to return to Original Medicare. Harriet has
recently evolved diabetes and would really like to enroll in a Medicare Advantage plan
that focuses on care for those with that disorder. Which, if any, of those people could
qualify for a special election length (SEP)? - ANSWER-Edna could qualify for a SEP
due to the fact government officials have declared a main disaster for her region
, and she did no longer join in MA at some point of her ICEP due to the emergency.
George would qualify for an SEP because he enrolled in Medicare Advantage (MA)
plan for the first time and might now like to go back to Original Medicare inside
the first 12 months of his enrollment. Harriet could additionally qualify for a SEP to
join a C-SNP because she has developed a continual condition. Felix would not
qualify for a SEP in view that he seeks to join a 4-superstar now not a five-famous
person MA plan.
7. Hector Hernandez is an impartial agent. Hector sells plans on behalf of 3 Medicare
Advantage businesses that offer a total of 10 plans however does now not represent all
Medicare Advantage groups imparting plans which can be to be had in his area. Which
of the following statements first-class describes any steps Hector is needed to take? -
ANSWER-During the primary minute of a sales call, Hector must ship an e mail to
the prospect mentioning that "I represent three plans however no longer each
plan available for your location. Please contact Medicare.Gov to get statistics on
all your options.
8. If a beneficiary is enrolled in a stand-alone prescription drug plan and desires to
preserve that plan, what form of Medicare health plan ought to the individual additionally
join in, without being robotically disenrolled from the stand-alone prescription drug plan?
- ANSWER-The beneficiary should sign up in a personal charge-for-service (PFFS)
plan that does not include prescription drug insurance; a price plan; or a Medicare
Medical Savings Account (MSA) plan.
9. Juan Hernandez is turning 65 subsequent month, Juan legally entered the United States
over 20 years ago but isn't always a citizen. Since his entry into the country, Juan has
labored at Smallcap Incorporated and contributed to the Medicare system. Juan suffers
from diabetes. He will soon retire and asks you if he can sign up in a Medicare
Advantage plan which you represent. How would you reply? - ANSWER-Juan is
eligible to enroll in a Medicare Advantage as long as he is entitled to Part A and
enrolled in Part B. Juan have to go to the Social Security website to sign up for
Medicare Part A and B if he has not carried out so already. Once he is enrolled, he
can pick out a Medicare Advantage plan.
10.Madeline Martinez changed into widowed numerous years in the past. Her husband
worked for many years and contributed into the Medicare device. He also left a
widespread property which affords Madeline with an annual income of approximately
$one hundred thirty,000. Madeline, who has best labored part-time for the last 3 years,
will soon flip age 65 and hopes to sign up for Original Medicare. She involves you for
advice. What must you inform her? - ANSWER-You must inform Madeline that she
might be able to join in Medicare Part A without paying monthly rates because of
her husband's long paintings file and participation within the Medicare machine.
You should additionally tell Madeline that she will be able to pay Part B premiums
at extra than the usual lowest fee however less than the very best charge due her
sizable profits.
11.Mildred Savage enrolled in Allcare Medicare Advantage plan numerous years in the
past. Mildred recently found out that she is stricken by inoperable most cancers and has
only a few months to live. She would love to spend those final months in hospice care.
ANSWERS
1. A customer wants to come up with an enrollment application on October 1 before the
start of the Annual Election Period because he is leaving on vacation for 2 weeks and
does now not need to forget about approximately turning it in. What need to you inform
him? - ANSWER-You have to inform him you are not authorised to take the shape.
If he sends the form immediately to the plan, the plan will process the enrollment
on the day the Annual Election Period begins.
2. ABC is a Medicare Advantage (MA) plan sponsor. It would really like to apply its
enrollees' facts to marketplace non-health related products inclusive of existence
insurance and annuities. Which declaration fine describes ABC's responsibility to its
enrollees regarding advertising and marketing such merchandise? - ANSWER-b.
It have to gain a HIPAA compliant authorization from an enrollee that suggests the
plan or plan sponsor may also use their data for advertising purposes.
3. Agent Daniel Webber has well set up a sales appointment to meet with consumer
Edward Young at Agent Webber's workplace. At the agreed upon appointment time, Mr.
Young arrives with his aged neighbor - Clara Burton, who desires to learn about her
Medicare Advantage alternatives. What must Agent Daniel Webber do? - ANSWER-
4. Agent John Miller is meeting with Jerry Smith, a new prospect. Jerry is presently enrolled
in Medicare Parts A and B. Jerry has additionally purchased a Medicare Supplement
(Medigap) plan which he has had for several years. However, the plan does now not
provide drug advantages. How would you propose Agent John Miller to continue? -
ANSWER-Tell prospect Jerry Smith that he have to don't forget including a
standalone Part D prescription drug coverage policy to his gift insurance.
5. Agent Martinez desires to solicit Medicare Advantage potentialities thru email and asks
you for recommendation as to whether that is possible. What ought to you tell her? -
ANSWER-Marketing representatives can also provoke digital contact through
e-mail however an opt-out system should be supplied.
6. Edna, Felix, George, and Harriet are Medicare beneficiaries. Edna lives in an area that
has suffered from predominant flooding that has been declared a chief disaster by way
of both the Federal government and her nation. As a result of coping with the flooding
problems and being evacuated from her domestic, Edna neglected her threat to sign up
for MA in the course of her Initial Coverage Election Period. Felix lives in an area with a
Medicare Advantage plan with a four-famous person score that he would like to enroll in.
George dropped his Medigap coverage six months in the past whilst he first enrolled in a
Medicare Advantage plan. He now desires to return to Original Medicare. Harriet has
recently evolved diabetes and would really like to enroll in a Medicare Advantage plan
that focuses on care for those with that disorder. Which, if any, of those people could
qualify for a special election length (SEP)? - ANSWER-Edna could qualify for a SEP
due to the fact government officials have declared a main disaster for her region
, and she did no longer join in MA at some point of her ICEP due to the emergency.
George would qualify for an SEP because he enrolled in Medicare Advantage (MA)
plan for the first time and might now like to go back to Original Medicare inside
the first 12 months of his enrollment. Harriet could additionally qualify for a SEP to
join a C-SNP because she has developed a continual condition. Felix would not
qualify for a SEP in view that he seeks to join a 4-superstar now not a five-famous
person MA plan.
7. Hector Hernandez is an impartial agent. Hector sells plans on behalf of 3 Medicare
Advantage businesses that offer a total of 10 plans however does now not represent all
Medicare Advantage groups imparting plans which can be to be had in his area. Which
of the following statements first-class describes any steps Hector is needed to take? -
ANSWER-During the primary minute of a sales call, Hector must ship an e mail to
the prospect mentioning that "I represent three plans however no longer each
plan available for your location. Please contact Medicare.Gov to get statistics on
all your options.
8. If a beneficiary is enrolled in a stand-alone prescription drug plan and desires to
preserve that plan, what form of Medicare health plan ought to the individual additionally
join in, without being robotically disenrolled from the stand-alone prescription drug plan?
- ANSWER-The beneficiary should sign up in a personal charge-for-service (PFFS)
plan that does not include prescription drug insurance; a price plan; or a Medicare
Medical Savings Account (MSA) plan.
9. Juan Hernandez is turning 65 subsequent month, Juan legally entered the United States
over 20 years ago but isn't always a citizen. Since his entry into the country, Juan has
labored at Smallcap Incorporated and contributed to the Medicare system. Juan suffers
from diabetes. He will soon retire and asks you if he can sign up in a Medicare
Advantage plan which you represent. How would you reply? - ANSWER-Juan is
eligible to enroll in a Medicare Advantage as long as he is entitled to Part A and
enrolled in Part B. Juan have to go to the Social Security website to sign up for
Medicare Part A and B if he has not carried out so already. Once he is enrolled, he
can pick out a Medicare Advantage plan.
10.Madeline Martinez changed into widowed numerous years in the past. Her husband
worked for many years and contributed into the Medicare device. He also left a
widespread property which affords Madeline with an annual income of approximately
$one hundred thirty,000. Madeline, who has best labored part-time for the last 3 years,
will soon flip age 65 and hopes to sign up for Original Medicare. She involves you for
advice. What must you inform her? - ANSWER-You must inform Madeline that she
might be able to join in Medicare Part A without paying monthly rates because of
her husband's long paintings file and participation within the Medicare machine.
You should additionally tell Madeline that she will be able to pay Part B premiums
at extra than the usual lowest fee however less than the very best charge due her
sizable profits.
11.Mildred Savage enrolled in Allcare Medicare Advantage plan numerous years in the
past. Mildred recently found out that she is stricken by inoperable most cancers and has
only a few months to live. She would love to spend those final months in hospice care.
