2024 AHIP Medicare Module 4 Complete Guide

2024 AHIP Medicare Module 4 Complete Guide Before Discussing Medicare Advantage Options Correct answer: Before discussing Medicare Advantage options with a beneficiary, you should have them sign a scope of appointment form, indicating which products they wish to discuss. Advertising Educational Event Correct answer: Accurate advertising is not the only requirement for putting together an educational event. You should ensure that advertisements indicate it is an educational event and not a sales presentation. Marketing Activities with Current Medicare Advantage Plan Members Correct answer: Plan sponsors cannot market lists of current members without compliant permission, as HIPAA Privacy Rules are applicable, not Dodd-Frank legislation. Planning Educational Event Correct answer: To avoid violating guidelines, you should plan an informative event and not conduct a sales presentation or distribute or accept enrollment forms at the event. Marketing Requirements Correct answer: Marketing on behalf of a plan is considered marketing by the plan and requires that all contracted and employed agents comply with all Medicare marketing rules. Neighborhood Targeting Correct answer: You should not engage in any activity that would be considered discriminatory, such as targeting higher-income areas without making comparable efforts to recruit beneficiaries from lower income areas. Meals During Sales Presentations Correct answer: You may provide light snacks, but a Thanksgiving-style meal would be prohibited, regardless of who provides or pays for the meal. Scope of Appointment Correct answer: Because Mrs. Lu only requested help regarding Medicare Advantage plan selection, that is her scope of appointment. Therefore, your offer to discuss Medigap and/or Part D would go beyond the scope of appointment. Presenting Program at Assisted Living Facility Correct answer: Marketing representatives may schedule an appointment with a beneficiary in a long term care facility only upon their request. Addressing Hospital Administrator Concerns Correct answer: You should tell her that Medicare guidelines allow you to conduct marketing activities in common areas of a provider's facility. MA-OEP Advice Correct answer: During the MA-OEP, Miguel can have one-on-one meetings with beneficiaries who have requested such meetings. Gifts or Prizes Correct answer: If the gift is one large item that would be enjoyed by all attending the event, the total cost must be $15 or less divided by estimated attendance. Representing Medicare Advantage Plan and Part D Plan Correct answer: There are no required events to attend in order to become eligible to retake the test. ABC is a Medicare Advantage (MA) plan sponsor. It would like to use its enrollees' information to market non-health related products such as life insurance and annuities. Which statement best describes ABC's obligation to its enrollees regarding marketing such products? ️It must obtain a HIPAA compliant authorization from an enrollee that indicates the plan or plan sponsor may use their information for marketing purpose Agent Martinez wishes to solicit Medicare Advantage prospects through e-mail and asks you for advice as to whether this is possible. What should you tell her ️Marketing representatives may initiate electronic contact through e-mail but an opt-out process must be provided. Another agent you know has engaged in misconduct that has been verified by the plan she represented. What sort of penalty might the plan impose on this individual? ️The plan may withhold commission, require retraining, report the misconduct to a state department of insurance or terminate the contract. During a sales presentation, your client asks you whether the Medicare agency recommends that she sign up for your plan or stay in Original Medicare. What should you tell her? ️Tell her that the Medicare agency does not endorse or recommend any plan. Agent Jennings makes a presentation on Medicare advertised as an educational event. Agent Jennings distributes materials that are solely educational. However, she gives a brief presentation that mentions plan-specific premiums. Is this a prohibited activity at an event that has been advertised as educational? ️Yes. When an event has been advertised as "educational," discussing plan-specific premiums is impermissible. Agent Armstrong is employed by XYZ Agency, which is under contract with ABC Health Plan, a Medicare Advantage (MA) plan that offers plans in multiple states. XYZ Agency maintains a website marketing the MA plans with which it has contracts. Agent Armstrong follows up with individuals who request more information about ABC MA plans via the website and tries to persuade them to enroll in ABC plans. What statement best describes the marketing and compliance rules that apply to Agent Armstrong?