AHIP Module 5
2022/2023
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>>>> 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. Correct
2. Mr. Sanchez is entitled to Part A, but has not enrolled in Part B
because he has coverage through an employer plan. If he wants to enroll
in a Medicare Advantage plan, what will he have to do>>>> c. He will
have to enroll in Part B. Correct
3. Mr. Kelly wants to know whether he is eligible to sign up for a Private
fee-for-service (PFFS) plan. What questions would you need to ask to
deter- mine his eligibility>>>> a. You would need to ask Mr. Kelly if
he is enrolled in Part A and Part B and if he lives in the PFFS plan's
service area. Correct
4. Mr. Gonzalez is entitled to Part A, but has not yet enrolled in Part B. If
he wants to enroll in a Private Fee-for-Service (PFFS) plan, what will he
have to do>>>> d. He will have to enroll in Part B prior to enrolling in
the PFFS plan. Correct
5. Mrs. Berkowitz wants to enroll in a Medicare Advantage plan that
does not include drug coverage and also enroll in a stand-alone
Medicare
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,prescription drug plan. Under what circumstances can she do this>>>>
c. If the Medicare Advantage plan is a Private Fee-for-Service (PFFS)
plan that does not offer drug coverage or a Medical Savings Account,
Mrs. Berkowitz can do this. Correct
6. Mrs. Roberts has Original Medicare and would like to enroll in a Private
Fee-for-Service (PFFS) plan. All types of PFFS plans are available in her
area. Which options could Mrs. Roberts consider before selecting a PFFS
plan>>>> d. A Medicare Advantage Prescription Drug (MA-PD) PFFS plan
that combines medical benefits and Part D prescription drug coverage,
a PFFS plan offering only medical benefits, or a PFFS plan in
combination with a stand-alone prescription drug plan. Correct
7. Which of the following individuals is most likely to be eligible to enroll
in a Medicare Advantage or Part D Plan>>>> d. Jose, a grandfather who
was granted asylum and has worked in the United States for many years.
Correct
8. Mr. and Mrs. Nunez attended one of your sales presentations. They've
asked you to come to their home to clear up a few questions. During the
presentation, Mrs. Nunez feels tired and tells you that her husband can
finish things up. She goes to bed. At the end of your discussion, Mr.
Nunez says that he wants to enroll both himself and his wife. What should
you do>>>> d. As
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, long as she is able to do so, only Mrs. Nunez can sign her enrollment
form. Mrs. Nunez will have to wake up to sign her form or do so at
another time. Correct
9. You are visiting with Mr. Tully and his daughter at her request. He has
advanced Alzheimer's and is incapable of understanding the implications
of choosing a Medicare Advantage or prescription drug plan. Can his
daughter fill out the enrollment form and sign it for him>>>> c. Mr.
Tully's daughter can do so only, if she is authorized under state law as a
court-appointed legal guardian, has durable power of attorney for
health care decisions, or is authorized under state surrogate consent
laws to make health decisions. Correct
10. 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>>>> c.
You may correct this information as long as you add your initials and
date next to the correction Correct
11. Phiona works in the IT Department of BestCare Health Plan. Phiona is
placed in charge of BestCare's efforts to facilitate electronic enrollment
in its Medicare Advantage plans. In setting up the enrollment site, which
of the following must Phiona consider?
I. If a legal representative is completing an electronic enrollment request,
he or she must first upload proof of his or her authority.
II. All data elements required to complete an enrollment request must
be captured.
III. The process must include a clear and distinct step that requires
the applicant to activate an "Enroll Now" or "I Agree" type of button
or tool.
IV. The mechanism must capture an accurate time and date stamp at the
time the applicant enters the online site.: b. II and III only Correct
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2022/2023
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>>>> 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. Correct
2. Mr. Sanchez is entitled to Part A, but has not enrolled in Part B
because he has coverage through an employer plan. If he wants to enroll
in a Medicare Advantage plan, what will he have to do>>>> c. He will
have to enroll in Part B. Correct
3. Mr. Kelly wants to know whether he is eligible to sign up for a Private
fee-for-service (PFFS) plan. What questions would you need to ask to
deter- mine his eligibility>>>> a. You would need to ask Mr. Kelly if
he is enrolled in Part A and Part B and if he lives in the PFFS plan's
service area. Correct
4. Mr. Gonzalez is entitled to Part A, but has not yet enrolled in Part B. If
he wants to enroll in a Private Fee-for-Service (PFFS) plan, what will he
have to do>>>> d. He will have to enroll in Part B prior to enrolling in
the PFFS plan. Correct
5. Mrs. Berkowitz wants to enroll in a Medicare Advantage plan that
does not include drug coverage and also enroll in a stand-alone
Medicare
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,prescription drug plan. Under what circumstances can she do this>>>>
c. If the Medicare Advantage plan is a Private Fee-for-Service (PFFS)
plan that does not offer drug coverage or a Medical Savings Account,
Mrs. Berkowitz can do this. Correct
6. Mrs. Roberts has Original Medicare and would like to enroll in a Private
Fee-for-Service (PFFS) plan. All types of PFFS plans are available in her
area. Which options could Mrs. Roberts consider before selecting a PFFS
plan>>>> d. A Medicare Advantage Prescription Drug (MA-PD) PFFS plan
that combines medical benefits and Part D prescription drug coverage,
a PFFS plan offering only medical benefits, or a PFFS plan in
combination with a stand-alone prescription drug plan. Correct
7. Which of the following individuals is most likely to be eligible to enroll
in a Medicare Advantage or Part D Plan>>>> d. Jose, a grandfather who
was granted asylum and has worked in the United States for many years.
Correct
8. Mr. and Mrs. Nunez attended one of your sales presentations. They've
asked you to come to their home to clear up a few questions. During the
presentation, Mrs. Nunez feels tired and tells you that her husband can
finish things up. She goes to bed. At the end of your discussion, Mr.
Nunez says that he wants to enroll both himself and his wife. What should
you do>>>> d. As
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, long as she is able to do so, only Mrs. Nunez can sign her enrollment
form. Mrs. Nunez will have to wake up to sign her form or do so at
another time. Correct
9. You are visiting with Mr. Tully and his daughter at her request. He has
advanced Alzheimer's and is incapable of understanding the implications
of choosing a Medicare Advantage or prescription drug plan. Can his
daughter fill out the enrollment form and sign it for him>>>> c. Mr.
Tully's daughter can do so only, if she is authorized under state law as a
court-appointed legal guardian, has durable power of attorney for
health care decisions, or is authorized under state surrogate consent
laws to make health decisions. Correct
10. 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>>>> c.
You may correct this information as long as you add your initials and
date next to the correction Correct
11. Phiona works in the IT Department of BestCare Health Plan. Phiona is
placed in charge of BestCare's efforts to facilitate electronic enrollment
in its Medicare Advantage plans. In setting up the enrollment site, which
of the following must Phiona consider?
I. If a legal representative is completing an electronic enrollment request,
he or she must first upload proof of his or her authority.
II. All data elements required to complete an enrollment request must
be captured.
III. The process must include a clear and distinct step that requires
the applicant to activate an "Enroll Now" or "I Agree" type of button
or tool.
IV. The mechanism must capture an accurate time and date stamp at the
time the applicant enters the online site.: b. II and III only Correct
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