Alignment Health Care Certification
UPDATED ACTUAL Exam Questions and
CORRECT Answers
If a beneficiary enrolled in an HMO tells you that she wants to see a specialist, you should tell
her: - CORRECT ANSWER You will likely need a referral from your primary care
physician (PCP) to see a specialist. If you see your specialist without this referral, the plan may
not pay for your visit
Mrs. Doe will turn 65 at the end of March and signed up for an MA plan in January during her
Initial Coverage Election Period (ICEP) When will her coverage begin? - CORRECT
ANSWER On March 1
Which of the following periods provide an opportunity for a beneficiary to make a one-time
switch from an MA plan Medicare to another MA plan? - CORRECT ANSWER January 1
- March 31
Mrs. Doe has decided to file a grievance because she fells that she was treated with disrespect
while communicating with the plan's customer service representative (CSR) What is the first step
Mrs. Doe should take to file a grievance? - CORRECT ANSWER Contact the plan in
writing or by telephone to file a grievance
Which of the following is NOT considered a plan sales agent? - CORRECT ANSWER A
member of the plan who speaks highly of the plan
Mr. Smith, an agent with ACME Health Plan, is giving a sales presentation and wants to provide
some food for his guests. What can Mr. Smith provide? - CORRECT ANSWER Snacks,
such as cheese and crackers
In which of the following settings is a Scope of Appointment (SOA) form NOT required to be
collected? - CORRECT ANSWER A formal marketing event that a beneficiary did not
pre-register to attend
UPDATED ACTUAL Exam Questions and
CORRECT Answers
If a beneficiary enrolled in an HMO tells you that she wants to see a specialist, you should tell
her: - CORRECT ANSWER You will likely need a referral from your primary care
physician (PCP) to see a specialist. If you see your specialist without this referral, the plan may
not pay for your visit
Mrs. Doe will turn 65 at the end of March and signed up for an MA plan in January during her
Initial Coverage Election Period (ICEP) When will her coverage begin? - CORRECT
ANSWER On March 1
Which of the following periods provide an opportunity for a beneficiary to make a one-time
switch from an MA plan Medicare to another MA plan? - CORRECT ANSWER January 1
- March 31
Mrs. Doe has decided to file a grievance because she fells that she was treated with disrespect
while communicating with the plan's customer service representative (CSR) What is the first step
Mrs. Doe should take to file a grievance? - CORRECT ANSWER Contact the plan in
writing or by telephone to file a grievance
Which of the following is NOT considered a plan sales agent? - CORRECT ANSWER A
member of the plan who speaks highly of the plan
Mr. Smith, an agent with ACME Health Plan, is giving a sales presentation and wants to provide
some food for his guests. What can Mr. Smith provide? - CORRECT ANSWER Snacks,
such as cheese and crackers
In which of the following settings is a Scope of Appointment (SOA) form NOT required to be
collected? - CORRECT ANSWER A formal marketing event that a beneficiary did not
pre-register to attend
