2022 AHIP Test Review Questions and With All Correct Answers (Graded A+)

2022 AHIP Test Review Questions and With All Correct Answers (Graded A+) Question 10 A client wants to give you an enrollment application on October 1 before the beginning of the Annual Election Period because he is leaving on vacation for two weeks and does not want to forget about turning it in. What should you tell him? a.You must tell him you are not permitted to take the form. If he sends the form directly to the plan, the plan will process the enrollment on the day the Annual Election Period begins. b.You must tell him you are not permitted to take the form and if he sends it to the plan, the application will be rejected and he will need to fill out another form and submit it after the Annual Election Period begins. c.You must send it to the plan for immediate processing, although the enrollment will not become effective until January 1. d.You must accept the application, but hold it until the annual election period begins, after which you must send it to the plan for processing. Source: Part 5, Slide -Enrollment Periods: Annual Election Period, Timeframe for Submitting Enrollment Forms Question 11 Mr. White has Medicare Parts A and B with a Part D plan. Last year, he received a notice that his plan sponsor identified him as a “potential at-risk” beneficiary. This month, he started receiving assistance from Medicaid. He wants to find a different Part D plan that’s more suitable to his current prescription drug needs. He believes he’s entitled to a SEP since he is now a dual eligible. Is he able to change to a different Part D plan during a SEP for dual eligible individuals? a.No. Individuals identified by the plan sponsor as “potential at-risk” must wait 2 years to switch plans, after which time the designation is lifted. b.Yes. “Potential at-risk” designations are just a warning. Only “at-risk” beneficiaries are prohibited from using this SEP while the designation is in place. c.Yes. The “potential at-risk” designation only impacts the services he may receive from the Part D plan he enrolls, but it doesn’t affect his ability to change plans during this SEP. Incorrect.: Once an individual is identified by the plan sponsor as a “potential at-risk” or “at-risk” beneficiary and the plan sponsor has sent written notice to the individual, he or she cannot use this SEP to change plans while this designation is in place. d.No. Once he is identified by the plan sponsor as a “potential at-risk” beneficiary, he cannot use the dual eligible SEP to change plans while this designation is in place. Source: Part 5, Slide – Typical SEPs – Beneficiaries who are dual eligible or who have LIS eligibility; and Slide – Typical SEPs – Beneficiaries who are dual eligible or who have LIS eligibility, limitations for at-risk and potential at-risk beneficiaries Question 12 You are meeting with Ms. Berlin and she has completed an enrollment form for a MA-PD plan you represent. You notice that her handwriting is illegible and as a result, the spelling of her street looks incorrect. She asks you to fill in the corrected street name. What should you do? a.You may correct this information as long as you add your initials and date next to the correction. b.You may correct the information since it was a simple mistake. You do not need to do anything further to the application form. c.Under no circumstances may you make corrections to information a beneficiary has provided. Review of enrollment forms is the sole responsibility of the plan sponsor. d.You may correct the information, but she will need to write a brief statement indicating she authorized you to make the change. Source: Part 5, Slide – Who May Complete the Enrollment Form? Marketing Representative Participation. Mr. Chen is enrolled in his employer’s group health plan and will be retiring soon. He would like to know his options since he has decided to drop his retiree coverage and is eligible for Medicare. What should you tell him? a.Mr. Chen can disenroll from his employer-sponsored coverage to elect a Medicare Advantage or Part D plan, but he must wait until the next Annual Election Period. b.Mr. Chen must convert his current coverage to employer-sponsored retiree coverage and wait one year before enrolling in a MA or Part D plan. c.Mr. Chen can disenroll from his employer-sponsored coverage to elect a Medicare Advantage or Part D plan within 2 months of his disenrollment. d.Mr. Chen can disenroll from the employer-sponsored plan and his only option is to choose a Medigap plan. Source: Part 5, Slide Other Common SEPs. Question 14 Mr. Garrett has just entered his MA Initial Coverage Election Period (ICEP). What action could you help him take during this time? a.He will have one opportunity to enroll in a Medicare Advantage plan. b.He will have a nine month period during which he may enroll in as many Medicare Advantage plans as he chooses, with the last enrollment being the effective one. c.If he has a disability, he must enroll in Original Fee-for-Service Medicare during the MA Initial Coverage Election Period. d.He may change or drop MA plans, but may not drop drug coverage. Source: Module 5, Slide - Enrollment Periods: MA Initial Coverage Election Period (ICEP) and Slide – Enrollment Periods MAICEP, continued Question 15 Mr. Roberts is enrolled in an MA plan. He recently suffered complications following hip replacement surgery. As a result, he has spent the last three months in Resthaven, a skilled nursing facility. Mr. Roberts is about to be discharged. What advice would you give him regarding his health coverage options? a.Mr. Roberts must return to Original Medicare within two months of discharge, but he may continue to enroll and disenroll in Part D for 12 months following discharge. Incorrect. An institutionalized individual, such as Mr. Roberts, does not have to return to Original Medicare within two months of discharge. He may make a Medicare Advantage enrollment request or at his option return to Original Medicare and enroll in Part D. b.His open enrollment period as an institutionalized individual will continue for two months after the month he moves out of the facility. c.His open enrollment period as an institutionalized individual will continue for 12 months following his date of discharge. d.Mr. Roberts has two months following his discharge to continue under his current MA plan before he must return to Original Medicare for the remainder to the calendar year. Source: Part 5, MA Open Enrollment Period for Institutionalized (OEPI) Individuals Part D SEP for Institutionalized Individuals. Question 16 Mr. Johannsen is entitled to Medicare Part A and Part B. He gains the Part D low-income subsidy. How does that affect his ability to enroll or disenroll in a Part D plan? a.He can enroll in a different plan or disenroll from his current plan during the next Annual Election Period. b.He qualifies for a special election period and can enroll in or disenroll from a Part D plan once during that period. c.He can apply the subsidy amount to his existing plan immediately, but he cannot enroll in a different plan. d.He can only enroll in or disenroll from an MA-PD plan. Incorrect. He is not restricted only to enrolling in or disenrolling from a MA-PD plan. He is also eligible to enroll in or disenroll from a Part D plan. Source: Part 5, Slide -Typical SEPs – Beneficiaries who are dual eligible or who have LIS eligibility, and Slide - Typical SEPs - Change in Medicaid or LIS Status. Question 17 Mrs. Kumar would like her daughter, who lives in another state, to meet with you during the Annual Election Period to help her complete her enrollment in a Part D plan. She asked you when she should have her daughter plan to visit. What could you tell her? a.She should wait for at least six months into the plan year to be sure that she really wants to make the change. If she still wants to do so, she can make any sort of change she likes at that point. b.Her daughter should come in November. c.Her daughter should come during the three month period that begins on the first day of her birthday month and runs for three full months. d.Her daughter should come sometime between January 1 and March 31. Source: Part 5, Slide -Enrollment Periods: Annual Election Period. Question 18 You have come to Mrs. Midler’s home for a sales presentation. At the beginning of the presentation, Mrs. Midler tells you that she has a copy of her medical records available because she thinks this will help you understand her needs. She suggests that you will know which questions to ask her about her health status in order to best assist her in selecting a plan. What should you do? a.If she brings up the topic of her health, you can ask Mrs. Midler as many questions as she is willing to answer, so you can determine which plan is most suitable for her health needs. b.You can initiate a detailed discussion of all of Mrs. Midler’s health conditions only to better understand her situation and to advise her to choose a different plan if she is experiencing significant health problems. c. You cannot, under any circumstances, ask Mrs. Midler any health-related questions. Incorrect. Marketing representatives may ask health screening questions during the completion of an enrollment request if they are necessary to determine eligibility to enroll in a SNP. d.You can only ask Mrs. Midler questions about conditions that affect eligibility, specifically, whether she has one of the conditions that would qualify her for a special needs plan.