AHIP Medicare
A Medicare beneficiary has walked into your office and requested which you take a seat down
along with her and discuss her options beneath the Medicare Advantage program. Before
engaging in this sort of dialogue, what should you do? - ANS-You need to have her sign a scope
of appointment shape, indicating which merchandise she wishes to talk about, and note at the
shape that she is a "stroll in. " You may then proceed with the discussion.
ABC is a Medicare Advantage (MA) plan sponsor. It would like to apply its enrollees' statistics to
marketplace non-fitness related merchandise together with lifestyles coverage and annuities. To
do so it must attain authorization from the enrollees. Which announcement satisfactory
describes the authorization process? - ANS-Authorization may be acquired by means of
directing a beneficiary to a website to provide consent so long as the website includes a
mechanism for an digital signature this is valid beneath relevant law.
Agent Armstrong is hired by way of XYZ Agency, that is underneath agreement with ABC Health
Plan, a Medicare Advantage (MA) plan that offers plans in multiple states. XYZ Agency
maintains a internet site advertising and marketing the MA plans with which it has contracts.
Agent Armstrong follows up with folks who request greater records about ABC MA plans via the
internet site and attempts to persuade them to enroll in ABC plans. What assertion pleasant
describes the marketing and compliance rules that apply to Agent Armstrong? - ANS-Agent
Armstrong desires to be certified and appointed in every state in which beneficiaries to whom he
markets ABC MA plans are placed.
Agent Jennings makes a presentation on Medicare advertised as an educational event. Agent
Jennings distributes substances which are totally academic in nature. However, she offers a
short presentation that mentions plan-specific premiums. Is this a prohibited interest at an event
that has been marketed as academic? - ANS-Yes. When an event has been advertised as
"academic," discussing plan-particular premiums is impermissible.
Agent John Miller is meeting with Jerry Smith, a brand new prospect. Jerry is currently enrolled
in Medicare Parts A and B. Jerry has also bought a Medicare Supplement (Medigap) plan which
he has had for numerous years. However, the plan does now not provide drug advantages. How
would you endorse Agent John Miller to continue? - ANS--Tell prospect Jerry Smith that he must
recall adding a standalone Part D prescription drug insurance coverage to his present
insurance.
Agent Lopez enables Ralph to sign up for Top Choice Medicare Advantage plan at some stage
in the Annual Open Enrollment Period. Ralph's powerful enrollment date is January 1st. Ralph
disenrolls on February twelfth because he discovers that the plan does not cover services
supplied by using several of his longtime vendors. Which of the following statements fine
, describes the effect of Ralph's movement upon Agent Lopez's compensation? - ANS-Agent
Lopez's entire repayment must be recouped because Ralph disenrolled inside 3 months of
enrollment.
Agent Martinez desires to solicit Medicare Advantage prospects through e mail and asks you for
recommendation as to whether that is possible. What need to you tell her? - ANS-Marketing
representatives can also initiate digital touch thru e-mail however an decide-out manner ought
to be provided
All plans need to cover at the least the usual Part D insurance or its actuarial equivalent. Which
of the subsequent statements excellent describes some of the expenses a beneficiary would
incur for prescribed drugs below the standard coverage? - ANS--Standard Part D coverage
would require fee of an annual deductible, and as soon as beyond the catastrophic insurance
threshold, the beneficiary pays whichever is extra of both the co-pays for ordinary and brand call
pills or coinsurance of 5%.
Anita Magri will turn age sixty five in August 2020. Anita intends to enroll in Original Medicare
Part A and Part B. She could also like to sign up for a Medicare Supplement (Medigap) plan.
Anita's older neighbor Mel has told her approximately the Medigap Part F plan in which he's
enrolled. It no longer handiest provides foreign journey emergency blessings but also covers his
Medicare Part B deductible. Anita comes to you for advice. What ought to you tell her? -
ANS--You are sorry to disappoint Anita but a Medigap Part F plan is now not available to folks
who flip age 65 after January 1,2020. Anita might as an alternative don't forget other Medigap
plans that provide foreign journey advantages however do not cowl the Part B deductible.
Daniel is a middle-income Medicare beneficiary. He has persistent bronchitis, putting him at
severe risk for pneumonia. Otherwise, he has no troubles functioning. Which type of SNP is in
all likelihood to be most suitable for him? - ANS--C-SNP
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 can
also Dr. Brennan rate? - ANS--Dr. Brennan can price Mary Rogers no extra than the value
sharing distinct within the PFFS plan's terms and situation of price which may additionally
encompass balance billing as much as 15%of the Medicare fee.
During a income presentation, your consumer asks you whether the Medicare organization
recommends that she sign up for your plan or stay in Original Medicare. What have to you
inform her? - ANS-Tell her that the Medicare corporation does no longer recommend or advise
any plan.
Juan Perez, who's turning age 65 subsequent month, intends to paintings for numerous extra
years at Smallcap, Incorporated. Smallcap has a workforce of 15 personnel and gives
company-sponsored healthcare coverage. Juan is a naturalized citizen and has contributed to
the Medicare machine for over 20 years. Juan asks you if he can be entitled to Medicare and if
A Medicare beneficiary has walked into your office and requested which you take a seat down
along with her and discuss her options beneath the Medicare Advantage program. Before
engaging in this sort of dialogue, what should you do? - ANS-You need to have her sign a scope
of appointment shape, indicating which merchandise she wishes to talk about, and note at the
shape that she is a "stroll in. " You may then proceed with the discussion.
ABC is a Medicare Advantage (MA) plan sponsor. It would like to apply its enrollees' statistics to
marketplace non-fitness related merchandise together with lifestyles coverage and annuities. To
do so it must attain authorization from the enrollees. Which announcement satisfactory
describes the authorization process? - ANS-Authorization may be acquired by means of
directing a beneficiary to a website to provide consent so long as the website includes a
mechanism for an digital signature this is valid beneath relevant law.
Agent Armstrong is hired by way of XYZ Agency, that is underneath agreement with ABC Health
Plan, a Medicare Advantage (MA) plan that offers plans in multiple states. XYZ Agency
maintains a internet site advertising and marketing the MA plans with which it has contracts.
Agent Armstrong follows up with folks who request greater records about ABC MA plans via the
internet site and attempts to persuade them to enroll in ABC plans. What assertion pleasant
describes the marketing and compliance rules that apply to Agent Armstrong? - ANS-Agent
Armstrong desires to be certified and appointed in every state in which beneficiaries to whom he
markets ABC MA plans are placed.
Agent Jennings makes a presentation on Medicare advertised as an educational event. Agent
Jennings distributes substances which are totally academic in nature. However, she offers a
short presentation that mentions plan-specific premiums. Is this a prohibited interest at an event
that has been marketed as academic? - ANS-Yes. When an event has been advertised as
"academic," discussing plan-particular premiums is impermissible.
Agent John Miller is meeting with Jerry Smith, a brand new prospect. Jerry is currently enrolled
in Medicare Parts A and B. Jerry has also bought a Medicare Supplement (Medigap) plan which
he has had for numerous years. However, the plan does now not provide drug advantages. How
would you endorse Agent John Miller to continue? - ANS--Tell prospect Jerry Smith that he must
recall adding a standalone Part D prescription drug insurance coverage to his present
insurance.
Agent Lopez enables Ralph to sign up for Top Choice Medicare Advantage plan at some stage
in the Annual Open Enrollment Period. Ralph's powerful enrollment date is January 1st. Ralph
disenrolls on February twelfth because he discovers that the plan does not cover services
supplied by using several of his longtime vendors. Which of the following statements fine
, describes the effect of Ralph's movement upon Agent Lopez's compensation? - ANS-Agent
Lopez's entire repayment must be recouped because Ralph disenrolled inside 3 months of
enrollment.
Agent Martinez desires to solicit Medicare Advantage prospects through e mail and asks you for
recommendation as to whether that is possible. What need to you tell her? - ANS-Marketing
representatives can also initiate digital touch thru e-mail however an decide-out manner ought
to be provided
All plans need to cover at the least the usual Part D insurance or its actuarial equivalent. Which
of the subsequent statements excellent describes some of the expenses a beneficiary would
incur for prescribed drugs below the standard coverage? - ANS--Standard Part D coverage
would require fee of an annual deductible, and as soon as beyond the catastrophic insurance
threshold, the beneficiary pays whichever is extra of both the co-pays for ordinary and brand call
pills or coinsurance of 5%.
Anita Magri will turn age sixty five in August 2020. Anita intends to enroll in Original Medicare
Part A and Part B. She could also like to sign up for a Medicare Supplement (Medigap) plan.
Anita's older neighbor Mel has told her approximately the Medigap Part F plan in which he's
enrolled. It no longer handiest provides foreign journey emergency blessings but also covers his
Medicare Part B deductible. Anita comes to you for advice. What ought to you tell her? -
ANS--You are sorry to disappoint Anita but a Medigap Part F plan is now not available to folks
who flip age 65 after January 1,2020. Anita might as an alternative don't forget other Medigap
plans that provide foreign journey advantages however do not cowl the Part B deductible.
Daniel is a middle-income Medicare beneficiary. He has persistent bronchitis, putting him at
severe risk for pneumonia. Otherwise, he has no troubles functioning. Which type of SNP is in
all likelihood to be most suitable for him? - ANS--C-SNP
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 can
also Dr. Brennan rate? - ANS--Dr. Brennan can price Mary Rogers no extra than the value
sharing distinct within the PFFS plan's terms and situation of price which may additionally
encompass balance billing as much as 15%of the Medicare fee.
During a income presentation, your consumer asks you whether the Medicare organization
recommends that she sign up for your plan or stay in Original Medicare. What have to you
inform her? - ANS-Tell her that the Medicare corporation does no longer recommend or advise
any plan.
Juan Perez, who's turning age 65 subsequent month, intends to paintings for numerous extra
years at Smallcap, Incorporated. Smallcap has a workforce of 15 personnel and gives
company-sponsored healthcare coverage. Juan is a naturalized citizen and has contributed to
the Medicare machine for over 20 years. Juan asks you if he can be entitled to Medicare and if
