AHIP FINAL EXAM 2024 NEWEST EXAM
COMPLETE 200 QUESTIONS WITH
DETAILED VERIFIED ANSWERS (100%
CORRECT) /ALREADY GRADED A+
1. A consumer desires to provide you with an enrollment utility on October 1 earlier than
the beginning of the Annual Election Period because he's leaving on vacation for two
weeks and does now not need to neglect approximately turning it in. What should you
tell him? - ANSWER-You need to tell him you aren't accepted to take the form. If he
sends the form directly to the plan, the plan will method the enrollment at the day
the Annual Election Period starts offevolved.
2. ABC is a Medicare Advantage (MA) plan sponsor. It would really like to apply its
enrollees' data to market non-fitness associated products such as lifestyles insurance
and annuities. Which assertion quality describes ABC's duty to its enrollees concerning
advertising such products? - ANSWER-It should reap a HIPAA compliant
authorization from an enrollee that shows the plan or plan sponsor can also use
their information for advertising and marketing purposes.
3. Agent Daniel Webber has well installation a sales appointment to meet with patron
Edward Young at Agent Webber's office. At the agreed upon appointment time, Mr.
Young arrives along with his elderly neighbor - Clara Burton, who wants to learn about
her Medicare Advantage alternatives. What have to Agent Daniel Webber do? -
ANSWER-After executing a scope of appointment (SOA) with Clara Burton, meet
with Edward Young and Clara Burton to talk about their Medicare Advantage
alternatives.
4. Agent John Miller is assembly with Jerry Smith, a new prospect. Jerry is currently
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
no longer offer drug advantages. How could you endorse Agent John Miller to continue?
- ANSWER-Tell prospect Jerry Smith that he have to do not forget including a
standalone Part D prescription drug insurance policy to his present insurance.
5. Agent Martinez wishes to solicit Medicare Advantage potentialities via email and asks
you for recommendation as to whether this is feasible. What should you tell her? -
ANSWER-Marketing representatives may additionally initiate electronic contact
thru email but an opt-out process ought to be provided.
6. Agent Suma has these days had several customers request his assistance in completing
their paper enrollment shape. What advice would you give him? - ANSWER-In
maximum instances, Agent Suma need to be really indicating his name on their
forms as their advertising consultant.
,7. Another agent working on your corporation claims that due to the fact you aren't
employed by the Medicare Advantage plans which you constitute, you are not situation
to the equal advertising and marketing necessities as the plans themselves. How have to
you reply to such a declaration? - ANSWER-Your coworker isn't accurate. Marketing
on behalf of a plan is considered advertising via the plan and requires that each
one contracted and employed agents observe all Medicare marketing guidelines.
8. Another agent you realize has engaged in misconduct that has been established by
means of the plan she represented. What form of penalty might the plan impose on this
person? - ANSWER-The plan may additionally withhold fee, require retraining,
record the misconduct to a nation department of insurance or terminate the
agreement.
9. Anthony Boniface became 65 in 2023. He become no longer receiving Social Security or
Railroad Retirement Benefits on his 65th birthday. He changed into inquisitive about
acquiring Medicare insurance and is eligible for premium-loose Part A. Before he could
enroll in Medicare, his complete location become impacted by way of a hurricane
causing massive flooding and extreme wind damage. The Federal government declared
this to be a herbal catastrophe which has these days ended. During this period
Anthony's initial enrollment length expired. Anthony asks you ways he can now gain
Medicare insurance. What need to you assert? - ANSWER-Anthony is eligible for a
unique enrollment length (SEP) because he overlooked an enrollment duration
due to the effect of the Federally declared disaster. This SEP will permit Anthony
to sign up for Part B up to six months after the quit of the emergency
announcement. Anthony may additionally join in top class-loose Part A at any
time and his Part A coverage might be retroactive for up to six months.
10.Charles McCarthy is a Medicare beneficiary who suffers from diabetes. Mr. McCarthy is
considering enrollment in a MA-PD plan which you constitute. He asks you whether or
not his insulin charges might be covered. What ought to you are saying? - ANSWER-Mr.
McCarthy's insulin charges for a one-month deliver cannot be extra than $35 in
any insurance section underneath the prescription drug plan beginning in 2023.
11.Daniel is a center-earnings Medicare beneficiary. He has persistent bronchitis, setting
him at extreme chance for pneumonia. Otherwise, he has no problems functioning.
Which sort of SNP is probable to be maximum appropriate for him? - ANSWER-C-SNP
12.Dr. Elizabeth Brennan does no longer agreement with the ABC PFFS plan but accepts
the plan's phrases and conditions for fee. Mary Rodgers sees Dr. Brennan for remedy.
How lots might also Dr. Brennan charge? - ANSWER-Dr. Brennan can rate Mary
Rogers no greater than the price sharing precise in the PFFS plan's phrases and
situation of charge which may encompass balance billing as much as 15p.Cof the
Medicare rate.
13.Edna, Felix, George, and Harriet are Medicare beneficiaries. Edna lives in a place that
has suffered from foremost flooding that has been declared a chief catastrophe by each
the Federal authorities and her state. As a end result of handling the flooding troubles
and being evacuated from her home, Edna missed her threat to enroll in MA for the
duration of her Initial Coverage Election Period. Felix lives in a place with a Medicare
Advantage plan with a 4-celebrity rating that he would really like to sign up for. George
, dropped his Medigap coverage six months ago while he first enrolled in a Medicare
Advantage plan. He now desires to go back to Original Medicare. Harriet has currently
developed diabetes and would like to sign up for a Medicare Advantage plan that makes
a speciality of care for people with that disease. Which, if any, of these individuals would
qualify for a unique election length (SEP)? - ANSWER-Edna might qualify for a SEP
because government officials have declared a prime disaster for her location and
she did now not enroll in MA at some stage in her ICEP due to the emergency.
George might qualify for an SEP due to the fact he enrolled in Medicare Advantage
(MA) plan for the primary time and could now like to return to Original Medicare
inside the first 12 months of his enrollment. Harriet would additionally qualify for a
SEP to join a C-SNP because she has evolved a persistent condition. Felix could
not qualify for a SEP when you consider that he seeks to join a four-big name now
not a five-megastar MA plan.
14.Edward IP suffered from critical kidney disease. As a end result. Edward became eligible
for Medicare insurance due to cease-stage renal disease (ESRD). A close relative
donated their kidney and Edward efficaciously underwent transplant surgical operation
one year in the past. Edward is now age 50 and asks you if his Medicare coverage will
retain, what have to you say? - ANSWER-Individuals eligible for Medicare based
totally on ESRD commonly lose eligibility 36 months after the month in which the
person receives a kidney transplant until they may be eligible for Medicare on
every other foundation which includes age or incapacity. Edward can also,
however, remain enrolled in Part B however entirely for coverage of
immunosuppressive capsules if he has no other fitness care insurance that might
cowl the drugs.
15.Evan Marsh is a newly appointed agent. Evan intends to conduct an academic
consultation on Medicare at a senior citizens middle near his home. He has advertised
the consultation as an academic event. Evan asks you what is permissible at such an
event. What ought to you are saying? - ANSWER-Evan may additionally provide a
meal as long as its value is $15 or less in line with attendee and he may also make
available business reply playing cards (BRCs).
16.Hector Hernandez is an impartial agent. Hector sells plans on behalf of three Medicare
Advantage businesses that offer a complete of 10 plans but does not constitute all
Medicare Advantage corporations imparting plans which might be to be had in his area.
Which of the subsequent statements first-rate describes any steps Hector is needed to
take? - ANSWER-During the primary minute of a sales name, Hector have to use a
disclaimer that says "I do no longer constitute each plan available in your
location. I represent 3 agencies that offer 10 plans to your location. Please touch
Medicare.Gov, 1-800-MEDICARE, or your neighborhood State Health Insurance
Program to get facts on all your alternatives."
17.If a beneficiary is enrolled in a stand-by myself prescription drug plan and wants to keep
that plan, what kind of Medicare health plan ought to the person additionally join in, with
out being robotically disenrolled from the stand-on my own prescription drug plan? -
ANSWER-The beneficiary ought to join in a personal price-for-carrier (PFFS) plan
COMPLETE 200 QUESTIONS WITH
DETAILED VERIFIED ANSWERS (100%
CORRECT) /ALREADY GRADED A+
1. A consumer desires to provide you with an enrollment utility on October 1 earlier than
the beginning of the Annual Election Period because he's leaving on vacation for two
weeks and does now not need to neglect approximately turning it in. What should you
tell him? - ANSWER-You need to tell him you aren't accepted to take the form. If he
sends the form directly to the plan, the plan will method the enrollment at the day
the Annual Election Period starts offevolved.
2. ABC is a Medicare Advantage (MA) plan sponsor. It would really like to apply its
enrollees' data to market non-fitness associated products such as lifestyles insurance
and annuities. Which assertion quality describes ABC's duty to its enrollees concerning
advertising such products? - ANSWER-It should reap a HIPAA compliant
authorization from an enrollee that shows the plan or plan sponsor can also use
their information for advertising and marketing purposes.
3. Agent Daniel Webber has well installation a sales appointment to meet with patron
Edward Young at Agent Webber's office. At the agreed upon appointment time, Mr.
Young arrives along with his elderly neighbor - Clara Burton, who wants to learn about
her Medicare Advantage alternatives. What have to Agent Daniel Webber do? -
ANSWER-After executing a scope of appointment (SOA) with Clara Burton, meet
with Edward Young and Clara Burton to talk about their Medicare Advantage
alternatives.
4. Agent John Miller is assembly with Jerry Smith, a new prospect. Jerry is currently
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
no longer offer drug advantages. How could you endorse Agent John Miller to continue?
- ANSWER-Tell prospect Jerry Smith that he have to do not forget including a
standalone Part D prescription drug insurance policy to his present insurance.
5. Agent Martinez wishes to solicit Medicare Advantage potentialities via email and asks
you for recommendation as to whether this is feasible. What should you tell her? -
ANSWER-Marketing representatives may additionally initiate electronic contact
thru email but an opt-out process ought to be provided.
6. Agent Suma has these days had several customers request his assistance in completing
their paper enrollment shape. What advice would you give him? - ANSWER-In
maximum instances, Agent Suma need to be really indicating his name on their
forms as their advertising consultant.
,7. Another agent working on your corporation claims that due to the fact you aren't
employed by the Medicare Advantage plans which you constitute, you are not situation
to the equal advertising and marketing necessities as the plans themselves. How have to
you reply to such a declaration? - ANSWER-Your coworker isn't accurate. Marketing
on behalf of a plan is considered advertising via the plan and requires that each
one contracted and employed agents observe all Medicare marketing guidelines.
8. Another agent you realize has engaged in misconduct that has been established by
means of the plan she represented. What form of penalty might the plan impose on this
person? - ANSWER-The plan may additionally withhold fee, require retraining,
record the misconduct to a nation department of insurance or terminate the
agreement.
9. Anthony Boniface became 65 in 2023. He become no longer receiving Social Security or
Railroad Retirement Benefits on his 65th birthday. He changed into inquisitive about
acquiring Medicare insurance and is eligible for premium-loose Part A. Before he could
enroll in Medicare, his complete location become impacted by way of a hurricane
causing massive flooding and extreme wind damage. The Federal government declared
this to be a herbal catastrophe which has these days ended. During this period
Anthony's initial enrollment length expired. Anthony asks you ways he can now gain
Medicare insurance. What need to you assert? - ANSWER-Anthony is eligible for a
unique enrollment length (SEP) because he overlooked an enrollment duration
due to the effect of the Federally declared disaster. This SEP will permit Anthony
to sign up for Part B up to six months after the quit of the emergency
announcement. Anthony may additionally join in top class-loose Part A at any
time and his Part A coverage might be retroactive for up to six months.
10.Charles McCarthy is a Medicare beneficiary who suffers from diabetes. Mr. McCarthy is
considering enrollment in a MA-PD plan which you constitute. He asks you whether or
not his insulin charges might be covered. What ought to you are saying? - ANSWER-Mr.
McCarthy's insulin charges for a one-month deliver cannot be extra than $35 in
any insurance section underneath the prescription drug plan beginning in 2023.
11.Daniel is a center-earnings Medicare beneficiary. He has persistent bronchitis, setting
him at extreme chance for pneumonia. Otherwise, he has no problems functioning.
Which sort of SNP is probable to be maximum appropriate for him? - ANSWER-C-SNP
12.Dr. Elizabeth Brennan does no longer agreement with the ABC PFFS plan but accepts
the plan's phrases and conditions for fee. Mary Rodgers sees Dr. Brennan for remedy.
How lots might also Dr. Brennan charge? - ANSWER-Dr. Brennan can rate Mary
Rogers no greater than the price sharing precise in the PFFS plan's phrases and
situation of charge which may encompass balance billing as much as 15p.Cof the
Medicare rate.
13.Edna, Felix, George, and Harriet are Medicare beneficiaries. Edna lives in a place that
has suffered from foremost flooding that has been declared a chief catastrophe by each
the Federal authorities and her state. As a end result of handling the flooding troubles
and being evacuated from her home, Edna missed her threat to enroll in MA for the
duration of her Initial Coverage Election Period. Felix lives in a place with a Medicare
Advantage plan with a 4-celebrity rating that he would really like to sign up for. George
, dropped his Medigap coverage six months ago while he first enrolled in a Medicare
Advantage plan. He now desires to go back to Original Medicare. Harriet has currently
developed diabetes and would like to sign up for a Medicare Advantage plan that makes
a speciality of care for people with that disease. Which, if any, of these individuals would
qualify for a unique election length (SEP)? - ANSWER-Edna might qualify for a SEP
because government officials have declared a prime disaster for her location and
she did now not enroll in MA at some stage in her ICEP due to the emergency.
George might qualify for an SEP due to the fact he enrolled in Medicare Advantage
(MA) plan for the primary time and could now like to return to Original Medicare
inside the first 12 months of his enrollment. Harriet would additionally qualify for a
SEP to join a C-SNP because she has evolved a persistent condition. Felix could
not qualify for a SEP when you consider that he seeks to join a four-big name now
not a five-megastar MA plan.
14.Edward IP suffered from critical kidney disease. As a end result. Edward became eligible
for Medicare insurance due to cease-stage renal disease (ESRD). A close relative
donated their kidney and Edward efficaciously underwent transplant surgical operation
one year in the past. Edward is now age 50 and asks you if his Medicare coverage will
retain, what have to you say? - ANSWER-Individuals eligible for Medicare based
totally on ESRD commonly lose eligibility 36 months after the month in which the
person receives a kidney transplant until they may be eligible for Medicare on
every other foundation which includes age or incapacity. Edward can also,
however, remain enrolled in Part B however entirely for coverage of
immunosuppressive capsules if he has no other fitness care insurance that might
cowl the drugs.
15.Evan Marsh is a newly appointed agent. Evan intends to conduct an academic
consultation on Medicare at a senior citizens middle near his home. He has advertised
the consultation as an academic event. Evan asks you what is permissible at such an
event. What ought to you are saying? - ANSWER-Evan may additionally provide a
meal as long as its value is $15 or less in line with attendee and he may also make
available business reply playing cards (BRCs).
16.Hector Hernandez is an impartial agent. Hector sells plans on behalf of three Medicare
Advantage businesses that offer a complete of 10 plans but does not constitute all
Medicare Advantage corporations imparting plans which might be to be had in his area.
Which of the subsequent statements first-rate describes any steps Hector is needed to
take? - ANSWER-During the primary minute of a sales name, Hector have to use a
disclaimer that says "I do no longer constitute each plan available in your
location. I represent 3 agencies that offer 10 plans to your location. Please touch
Medicare.Gov, 1-800-MEDICARE, or your neighborhood State Health Insurance
Program to get facts on all your alternatives."
17.If a beneficiary is enrolled in a stand-by myself prescription drug plan and wants to keep
that plan, what kind of Medicare health plan ought to the person additionally join in, with
out being robotically disenrolled from the stand-on my own prescription drug plan? -
ANSWER-The beneficiary ought to join in a personal price-for-carrier (PFFS) plan
