AHIP Actual Exam Questions with Accurate
Verified Detailed Solutions latest updated
version A+ Graded
ABC is a Medicare Advantage (MA) plan sponsor. It would like to use
its enrollees' protected health information to market non-health
related products such as life insurance and annuities. To do so it must
obtain authorization from the enrollees. Which statement best
describes the authorization process? --- correct precise answer ---
Authorization may be obtained by directing a beneficiary to a website
to provide consent
Mrs. Henderson believes that she will qualify for Medicare coverage
when she turns 65, without paying any premiums, because she has
been working for 40 years and paying Medicare taxes. What should
you tell her? --- correct precise answer ---In order to obtain Part B
coverage, she must pay a standard monthly premium, though it is
higher for individuals with higher incomes.
Mr. Buck has several family members who died from different
cancers. He wants to know if Medicare covers cancer screening. What
should you tell him? --- correct precise answer ---Medicare covers
periodic performance of a range of screening tests that are meant to
,provide early detection of disease. Mr. Buck will need to check specific
tests before obtaining them to see if they will be covered.
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 oculd you tell her to address her concern. -
-- correct precise answer ---Medicare is a program for people age 65
or older and those under age 65 with certain disabilities, end-stage
renal disease, and Lou Gehrig's disease so she will be eligible for
Medicare.
Mr. Wells is trying to understand the difference between Original
Medicare and Medicare Advantage. What would be a correct
description? --- correct precise answer ---Medicare Advantage is a
way of covering all the Original Medicare benefits through private
health insurance companies.
Which of the following steps may a Part D sponsor adopt for
beneficiaries who are at risk of misusing or abusing frequently abused
drugs?
I. Identifying at risk individuals by using criteria that includes the
number of opioid prescriptions the beneficiary has and the number of
prescribers who have written those prescriptions.
,II. Locking an at-risk beneficiary into one pharmacy.
III. Locking an at-risk beneficiary into one prescriber.
IV. Increasing deductibles and copays for at-risk beneficiaries. ---
correct precise answer ---I, II, and III only
Ms. Hernandez has marketed several different types of insurance
products in her home state and has typically sough approval of her
materials from her State Department of Insurance.. What would you
advise her regarding seeking such approval for materials she uses to
market Medicare Advantage plans? --- correct precise answer ---
Materials for marketing Medicare health plans to individuals are
subject to Medicare's uniform national requirements. They do not
need to be reviewed by the state, but the company she represents
must obtain approval from the Medicare agency (CMS) for any
materials she uses.
Ms. Gibson recently lost her employer group health and drug coverage
and now she wants to enroll in a PPO that does not include drug
coverage. What should you tell her about obtaining drug coverage? ---
correct precise answer ---She can enroll in the PPO, but she will not
be able to purchase a stand-alone Medicare Part D prescription drug
plan.
, Mrs. Quinn has recently turned 66 and decided after many years of
work to begin receiving Social Security benefits. Shortly thereafter
Mrs. Quinn and 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 precise
answer ---Part B primarily covers physician services. She will be
paying a monthly premium and, with the exception of many
preventive and screening tests, generally will have 20% co-payments
for these services, in addition to an annual deductible.
Mr. Xi will soon turn age 65 and has come to you for advice as to what
services are provided under Original Medicare. What should you tell
Mr. Zi that best describes the health coverage provided to Medicare
beneficiaries? --- correct precise answer ---Beneficiaries under
Original Medicare have no cost0sharing for most preventative
services which include immunization such as annual flu shots.
Your friend's mother just moved to an assisted living facility and he
asked if you could present a program for the residents about the MA-
PD plans you market. What could you tell him? --- correct precise
answer ---You appreciate the opportunity and would be happy to
schedule an appointment with anyone at their request.
Verified Detailed Solutions latest updated
version A+ Graded
ABC is a Medicare Advantage (MA) plan sponsor. It would like to use
its enrollees' protected health information to market non-health
related products such as life insurance and annuities. To do so it must
obtain authorization from the enrollees. Which statement best
describes the authorization process? --- correct precise answer ---
Authorization may be obtained by directing a beneficiary to a website
to provide consent
Mrs. Henderson believes that she will qualify for Medicare coverage
when she turns 65, without paying any premiums, because she has
been working for 40 years and paying Medicare taxes. What should
you tell her? --- correct precise answer ---In order to obtain Part B
coverage, she must pay a standard monthly premium, though it is
higher for individuals with higher incomes.
Mr. Buck has several family members who died from different
cancers. He wants to know if Medicare covers cancer screening. What
should you tell him? --- correct precise answer ---Medicare covers
periodic performance of a range of screening tests that are meant to
,provide early detection of disease. Mr. Buck will need to check specific
tests before obtaining them to see if they will be covered.
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 oculd you tell her to address her concern. -
-- correct precise answer ---Medicare is a program for people age 65
or older and those under age 65 with certain disabilities, end-stage
renal disease, and Lou Gehrig's disease so she will be eligible for
Medicare.
Mr. Wells is trying to understand the difference between Original
Medicare and Medicare Advantage. What would be a correct
description? --- correct precise answer ---Medicare Advantage is a
way of covering all the Original Medicare benefits through private
health insurance companies.
Which of the following steps may a Part D sponsor adopt for
beneficiaries who are at risk of misusing or abusing frequently abused
drugs?
I. Identifying at risk individuals by using criteria that includes the
number of opioid prescriptions the beneficiary has and the number of
prescribers who have written those prescriptions.
,II. Locking an at-risk beneficiary into one pharmacy.
III. Locking an at-risk beneficiary into one prescriber.
IV. Increasing deductibles and copays for at-risk beneficiaries. ---
correct precise answer ---I, II, and III only
Ms. Hernandez has marketed several different types of insurance
products in her home state and has typically sough approval of her
materials from her State Department of Insurance.. What would you
advise her regarding seeking such approval for materials she uses to
market Medicare Advantage plans? --- correct precise answer ---
Materials for marketing Medicare health plans to individuals are
subject to Medicare's uniform national requirements. They do not
need to be reviewed by the state, but the company she represents
must obtain approval from the Medicare agency (CMS) for any
materials she uses.
Ms. Gibson recently lost her employer group health and drug coverage
and now she wants to enroll in a PPO that does not include drug
coverage. What should you tell her about obtaining drug coverage? ---
correct precise answer ---She can enroll in the PPO, but she will not
be able to purchase a stand-alone Medicare Part D prescription drug
plan.
, Mrs. Quinn has recently turned 66 and decided after many years of
work to begin receiving Social Security benefits. Shortly thereafter
Mrs. Quinn and 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 precise
answer ---Part B primarily covers physician services. She will be
paying a monthly premium and, with the exception of many
preventive and screening tests, generally will have 20% co-payments
for these services, in addition to an annual deductible.
Mr. Xi will soon turn age 65 and has come to you for advice as to what
services are provided under Original Medicare. What should you tell
Mr. Zi that best describes the health coverage provided to Medicare
beneficiaries? --- correct precise answer ---Beneficiaries under
Original Medicare have no cost0sharing for most preventative
services which include immunization such as annual flu shots.
Your friend's mother just moved to an assisted living facility and he
asked if you could present a program for the residents about the MA-
PD plans you market. What could you tell him? --- correct precise
answer ---You appreciate the opportunity and would be happy to
schedule an appointment with anyone at their request.
