AHIP Final Exam Test Questions and Answers (2022/2023)

AHIP Final Exam Test Questions and Answers (2022/2023) Mrs. Paterson is concerned about the deductibles and co-payments associated with Original MedicareWhat can you tell her about Medigap as an option to address this concern? a. Medigap plans are not sold by private companies and are a government insurance product. b. All costs not covered by Medicare are covered by some Medigap plans. c. If Mrs. Paterson applies during the Medigap open enrollment period, she will have to undergo a medical review to determine if she has a pre-existing condition that would increase the premium for a Medigap policy. d. Medigap plans help beneficiaries cover coinsurance, co-payments, and/or deductibles for medically necessary services. 2. Mr Valesquez asked if the Private Fee-for-Service plan you have discussed is like Original Medicare or a Medigap supplement plan. What should you say about a Private Fee-for-Service (PFFS) plan to explain it to Mr. Valesquez? a. It is a type of Medicare Advantage plan that allows you to go to any doctor anywhere. c. It is the same as Original Medicare, but offered by a private company. d. It is not Original Medicare and it works differently than a Medicare supplement plan. 3. Which of the following statements about Medicare Part D are correct? I. Part D plans must enroll any eligible beneficiary who applies regardless of health status except in limited circumstances. II. Private fee-for-service (PFFS) plans are not required to use a pharmacy network but may choose to have one. III. Beneficiaries enrolled in a MA-Medical Savings Account (MSA) plan may only obtain Part D benefits through a standalone PDP. IV.Beneficiaries enrolled in a MA-PPO may obtain Part D benefits through a standalone PDP or through their plan. a. I and II only b. I only c. I, II, and III only 4. You are completing a PFFS plan sale to Mr. West who is new to Medicare and prefers to be contacted AHIP Final Exam Test Questions and Answers (2022/2023) by telephone. As you are finishing up, what should you tell him about next steps in the enrollment process? a. You need to ask Mr. West a few final questions to ensure he understands the nature of the plan and really wants to enroll. You also should tell Mr. Schmidt that after you leave, he should not answer any questions about his enrollment in the plan because it could result in a disenrollment. b. You need to get Mr. West’s phone number and include it on the enrollment form because the PFFS plan will contact him once the organization receives the enrollment form and will ask about the quality of your service. You should not discuss the phone call with Mr. West to avoid influencing his answers. c. You need to get Mr. West’s phone number and include it on the enrollment form because the plan must call him after you leave to ensure that he understood the nature of the PFFS plan he selected and to verify his intent to enroll. d. You should not include Mr. West’s phone number on the enrollment form in case he is on the “Do Not Call” registry. 5. What impact, if any, will the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) have upon Medigap plans? a. The Part A deductible will no longer be covered for individuals newly eligible for Medicare starting January 1, 2020. b. The Part B deductible will no longer be covered for individuals newly eligible for Medicare starting January 1, 2020. c. The Part A deductible is no longer covered under Medigap plans for all enrollees staring January 1, 2020. d. MACRA provides funding to help individuals age 59 and above enroll in Medigap plans. 6. Able, Baker, and Charles are engaged in the marketing to and enrollment of beneficiaries into Medicare health plans. Mr. Able is an independent agent paid directly by a health plan. Ms. Baker is an independent agent paid through a field marketing organization (FMO). Mr. Charles is an independent agent paid for his work by a third-party marketing organization (TMO). How do the CMS compensation rules apply to these three agents? a. All three are treated as independent agents under CMS compensation rules. b. Baker and Charles are subject to CMS compensation rules because they are paid by third parties. Able is not bec he is paid directly by a health plan. c. Able is subject to CMS compensation rules because he is paid directly by a health plan. Agents Baker and Charle not because they are paid by third parties. d. Charles is subject to CMS compliance rules because he works for a TMO and CMS applies an extra layer of scru such organizations. Able and Baker are not. 7. 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? a. You should sign the form for Mrs. Nunez yourself, since she informed you, as the plan’s representative, that she w to enroll. AHIP Final Exam Test Questions and Answers (2022/2023)