AHIP Final Exam Questions and Answers Latest 2022

AHIP Final Exam Questions and Answers Latest 2022. Agent Higgins helps Mrs. O'Malley to enroll in AB Medicare Advantage (MA) plan during the Annual Open Enrollment Period. Mrs. O'Malley's effective enrollment date is January 1st. Subsequently, Mrs. O'Malley disenrolls on February 12th following a move outside the plan's service area. What impact will this have on Agent Higgins compensation? Choose one a. Agent Higgins entire compensation must be recouped because Mrs. O’Malley has answer. disenrolled within 3 months of enrollment. b. AB MA plan must recoup a pro rata amount of Agent Higgins’ compensation if Mrs. O’Malley subsequently enrolls in Original Medicare and Part D c. AB MA plan does not have to recoup Agent Higgins’ compensation because she has moved away from its service area. d. AB MA plan must recoup a pro rata amount of Agent Higgins’ compensation and pay him only for the month of January. 2 Marks: 1 2/18 3 Marks: 1 Mrs. Mulcahy is concerned that she may not qualify for enrollment in a Medicare prescription drug plan because, although she is entitled to Part A, she is not enrolled under Medicare Part B. What should you tell her? Choose one a. Everyone who is entitled to Part A or enrolled under Part B is eligible to enroll in a answer. Medicare prescription drug plan. As long as Mrs. Mulcahy is entitled to Part A, she does not need to enroll under Part B before enrolling in a prescription drug plan. b. To qualify for enrollment into a Medicare prescription drug plan, Mrs. Mulcahy must be entitled to Part A and enrolled under Part B. She should contact her local Social Security office and make arrangements to enroll in Part B prior to selecting a prescription drug plan. c. Like all Medicare beneficiaries, Mrs. Mulcahy will be automatically enrolled in a Medicare prescription drug plan when she turns 65. She will have a six-month window during which she can select a plan other than the one into which she has been automatically enrolled. d. As long as Mrs. Mulcahy is 65, eligibility for a Medicare prescription drug plan is not dependent on entitlement to Part A or enrollment under Part B, so she should not be concerned. 3/18 Alice is enrolled in a MA-PD plan. She makes a permanent move across the country and wonders what her options are for continuing MA-PD coverage. What would you say to her in regard to a special enrollment period (SEP)? Choose one a. She is unlikely to qualify for a SEP but will be automatically covered by Original answer. Medicare and a standalone Part D prescription drug plan. b. She is likely to qualify for a SEP. She can choose an effective date of up to six months after the month in which the enrollment form is received by the new plan, but the effective date may not be earlier than 30 days prior to the date of her move. c. She is unlikely to qualify for a SEP and should remain on her current plan, relying on her current plan’s out-of-network benefits. d. She is likely to qualify for a SEP. She can choose an effective date of up to three months after the month in which the enrollment form is received by the new plan, but the effective date may not be earlier than the date of her permanent move. 4 Marks: 1 Mrs. Walters is entitled to Part A and has medical coverage without drug coverage through an employer retiree plan. She is not enrolled in Part B. Since the employer plan does not cover prescription drugs, she wants to enroll in a Medicare prescription drug plan. Will she be able to? Choose one a. Yes, but Mrs. Walters must drop the employer coverage prior to enrolling in a answer. Medicare prescription drug plan. b. No. Mrs. Walters will have to enroll in Part B in order to qualify for enrollment into the Medicare prescription drug program. c. Yes. Mrs. Walters must be entitled to Part A or enrolled in Part B to be eligible for coverage under the Medicare prescription drug program. d. No. As long as her employer offers coverage that is equivalent to that available through Medicare, Mrs. Walters cannot enroll in a Medicare prescription drug plan. 5 Marks: 1 Ms. Lopez is an independent agent under contract with MarketCo, a third-party marketing organization. MarketCo has a contract with BestCare health plan, a Medicare Advantage (MA) organization, to offer marketing services through its contracted agents and agencies. Ms. Lopez returns calls to individuals who contact MarketCo in response to its mailers promoting BestCare health plan. Which of the following best describes the responsibilities of Ms. Lopez? Choose one a. Ms. Lopez is considered a marketing representative of BestCare and thus is answer. obligated to comply with CMS marketing requirements, including those regarding using only approved call scripts. b. Ms. Lopez no longer needs to be concerned about state licensure since she is marketing an MA product subject to federal rules. c. Ms. Lopez is considered a marketing representative of BestCare but is exempt from the marketing rules regarding approved call scripts because she works directly for MarketCo. d. Ms. Lopez needs to maintain state licensure, but because she is working for a thirdparty marketing organization she is exempt from CMS training requirements that apply to BestCare captive agents. 4/18 6 Marks: 1 Last year Agent Melanie Meyers marketed and enrolled several clients in Medicare Advantage (MA) health plans. This year she has decided to focus on non-MA products. What advice would you give Melanie if she wishes to continue to receive renewal fees? Choose one a. All that she needs to do is meet state licensure requirements moving forward. answer. b. Melanie will need to do nothing to continue receiving renewal fees since the initial sale was made when she met all requirements. c. All that she needs to do is avoid being terminated for cause. d. Melanie must remain trained, tested, licensed, and appointed, regardless of whether she is actively selling MA products. 7 Marks: 1 Mr. Kelly has substantial financial means. He enrolled in Original Medicare and purchased a Medigap policy many years ago that offered prescription drug coverage. The prescription drug coverage has not been comparable to that offered by Medicare Part D for several years and despite notification, Mr. Kelly took no action. Which of the following statements best describes what will occur if Mr. Kelly now decides to enroll in Medicare Part D? Choose one a. He will avoid any financial penalty or late enrollment fee under the grandfathering answer. provisions of Medicare Part D. b. He will incur a late enrollment penalty. c. He will incur a one-time financial penalty equal to 30 percent of the annual Part D premium. d. He will not be able to enroll in Part D unless he decides to also enroll in a Medicare Advantage plan. 8 Marks: 1 This year you decide to focus your efforts on marketing to employer and union groups. Which of the following statements best describes what you can and cannot do in order to stay in compliance? Choose one a. You can make unsolicited contacts but you cannot cross-sell other products. answer. b. You are not required to submit communication and marketing materials specific only to those employer plans to CMS at the time of use, but CMS may request and review copies if employee complaints occur. c. You do not need to take an annual test, but you must not provide potential enrollees with more than light snacks at presentations. d. You do not need to complete a scope of appointment, but CMS can ask you to reconstruct one if there is a subsequent employee complaint. 5/18 9 Marks: 1 For which of the following individuals would a Cost Plan be most appropriate? Choose one a. Mr. Charles who is enrolled in Medicare Part A but does not want to enroll in Part B. answer. b. Ms. Darwin who is enrolled in Medicare Parts A and B who also is enrolled in a Medicare Supplement (Medigap) and is unwilling to pay any additional plan premiums. c. Ms. Baker who is enrolled in Medicare Part B and is willing to continue paying Part B premiums plus any plan premiums. d. Mr. Able who has retiree health insurance but relatively modest prescription drug benefits. 10 Marks: 1 You have set up an appointment for an in-home sales presentation with Mrs. Fernandez, who expressed interest in the Medicare plans you represent. In preparation for the sales presentation, what must you do? Choose one a. Prior to conducting the presentation, obtain, and document having obtained her answer. permission to visit, along with her interest in the specific products you will present. b. Seven days prior to the appointment, you must notify the company(s) you represent regarding which products you will be presenting, so they can report the nature of your meeting to the Medicare agency. c. At the time you arrive for the appointment, let her know which products you will be going over. d. Prior to arriving at her home, request approval from CMS to use special materials that you developed to explain the plan benefits instead of the plan’s materials, which you think are confusing. 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