AHIP Practice Exam
1. ABC is a Medicare Advantage (MA) plan sponsor. It would really like to apply its
enrollees' included health records to market non-health related products which includes
existence coverage and annuities. To accomplish that it should obtain authorization from
the enrollees. Which statement first-rate describes the authorization process? -
ANS-Authorization can be obtained via directing a beneficiary to a internet site to provide
consent
2. Agent Harriet Walker has recently started advertising and marketing Medicare
Advantage and related products geared toward assembly the desires of senior citizens.
Client Mildred Jones has expressed hobby in a Medicare Advantage plan. It is now the
start of September. If you had been in Agent Walker's role, what could you do? -
ANS-Inquire whether the purchaser qualifies for a unique enrollment period, and if now
not, solicit an enrollment application as soon as the once a year open enrollment
election period starts on October 15th.
3. Alice is a marketing consultant hired with the aid of a fitness plan. Betty is a captive
agent of a fitness plan who markets to more than one plans and sponsors. Carl is a
captive agent who markets to most effective one plan/sponsor. Denise is an independent
agent who markets to exceptional types of groups. Edward is an independent agent who
markets handiest to employer and union businesses. CMS advertising representative
repayment guidelines commonly practice to: - ANS-Betty and Denise, however not Alice
(the employee) or Carl or Edward (to whom exceptions follow).
4. Another agent running to your agency claims that because you aren't hired by means of
the Medicare Advantage plans that you represent, you aren't situation to the equal
necessities because the plans themselves. How must you reply to any such assertion? -
ANS-Your coworker is not accurate. Marketing on behalf of a plan is considered
advertising and marketing with the aid of the plan and required that every one shriveled
and hired marketers observe all Medicare marketing regulations.
5. During a income presentation to Ms Daley for a Medicare Advantage plan that has a
5-megastar rating in customer support and care coordination, and obtained an average
plan overall performance of a 4-superstar, which of the subsequent would be the suitable
declaration to mention to her? - ANS-The Medicare Advantage plan obtained a
five-celebrity rating in customer service and care coordination with an common overall
performance rating of 4-stars
6. Last 12 months Agent Melanie Meyers advertised and enrolled several clients in
Medicare Advantage (MA) health plans. This year she has determined to consciousness
on non-MA products. What recommendation might you Melanie if she needs to keep to
get hold of renewal costs? - ANS-Melanie must continue to be educated, tested,
licensed, and appointed, no matter whether or not she is actively selling MA
merchandise.
, 7. Monica is an agent targeted on serving seniors eligible for Medicare. As she evaluations
her statistics, she is trying to decide which of the following gadgets are taken into
consideration repayment. What do you tell her?
8. I. Commissions
9. II. Bonuses
10. III. Mileage repayment
11. IV. Referral prices - ANS-I, II, and IV only
12. Mr. Bickford did now not quite qualify for the greater assist low-profits subsidy
underneath the Medicare Part D Prescription Drug program and he's questioning if
there's any other alternative he has for acquiring assist with his widespread drug
expenses. What must you inform him? - ANS-He may want to take a look at with the
producers of his medicinal drugs to peer if they provide an help program to help human
beings with limited way achieve the medications they need. Alternatively, he may want to
take a look at to see whether his country has a pharmacy assistance software to help
him along with his costs.
13. Mr. Buck has numerous circle of relatives individuals who died from exclusive cancers.
He desires to understand if Medicare covers most cancers screening. What have to you
tell him? - ANS-Medicare covers periodic overall performance of a variety of screening
checks that are intended to provide early detection of disease. Mr. Buck will want to
check specific exams earlier than acquiring them to see if they may be blanketed.
14. Mr. Carlini has heard that Medicare prescription drug plans are simplest provided thru
non-public businesses below a application called Medicare Advantage (MA), no longer
by means of the government. He likes Original Medicare and does now not need to join
an MA product, but he also wishes prescription drug insurance. What have to you inform
him? - ANS-Mr. Carlini can live with Original Medicare and also join in a Medicare
prescription drug plan thru a private agency that has reduced in size with the
government to provide simplest such drug coverage to eligible Medicare beneficiaries.
15. Mr. Chen has heard approximately a Medical Savings Account (MSA), however wants to
understand if it's miles just about saving money, or if he'll get insurance insurance for his
fitness care expenditures as properly. What need to you inform him? - ANS-Under the
Medicare Advantage application, a MSA plan includes the mixture of a excessive
deductible health plan and a savings account for fitness expenses. Medicare will make
contributions to this financial savings account to help him pay his fitness care costs even
as inside the deductible.
16. Mr. Cole has been a Medicaid beneficiary for sometime, and lately certified for Medicare
as nicely. He is worried approximately modifications in his price-sharing. What ought to
you inform him? - ANS-He need to understand that Medicaid can pay cost0sharing only
for services furnished by Medicaid collaborating vendors.
17. Mr. Davis is fifty two years vintage and has recently been diagnosed with cease-degree
renal sickness (ESRD) and will quickly begin dialysis. He is questioning if he can acquire
coverage underneath Medicare. What should you tell him? - ANS-He can also signal-up
for Medicare at any time however insurance typically starts offevolved on the fourth
month after dialysis treatment starts offevolved.
1. ABC is a Medicare Advantage (MA) plan sponsor. It would really like to apply its
enrollees' included health records to market non-health related products which includes
existence coverage and annuities. To accomplish that it should obtain authorization from
the enrollees. Which statement first-rate describes the authorization process? -
ANS-Authorization can be obtained via directing a beneficiary to a internet site to provide
consent
2. Agent Harriet Walker has recently started advertising and marketing Medicare
Advantage and related products geared toward assembly the desires of senior citizens.
Client Mildred Jones has expressed hobby in a Medicare Advantage plan. It is now the
start of September. If you had been in Agent Walker's role, what could you do? -
ANS-Inquire whether the purchaser qualifies for a unique enrollment period, and if now
not, solicit an enrollment application as soon as the once a year open enrollment
election period starts on October 15th.
3. Alice is a marketing consultant hired with the aid of a fitness plan. Betty is a captive
agent of a fitness plan who markets to more than one plans and sponsors. Carl is a
captive agent who markets to most effective one plan/sponsor. Denise is an independent
agent who markets to exceptional types of groups. Edward is an independent agent who
markets handiest to employer and union businesses. CMS advertising representative
repayment guidelines commonly practice to: - ANS-Betty and Denise, however not Alice
(the employee) or Carl or Edward (to whom exceptions follow).
4. Another agent running to your agency claims that because you aren't hired by means of
the Medicare Advantage plans that you represent, you aren't situation to the equal
necessities because the plans themselves. How must you reply to any such assertion? -
ANS-Your coworker is not accurate. Marketing on behalf of a plan is considered
advertising and marketing with the aid of the plan and required that every one shriveled
and hired marketers observe all Medicare marketing regulations.
5. During a income presentation to Ms Daley for a Medicare Advantage plan that has a
5-megastar rating in customer support and care coordination, and obtained an average
plan overall performance of a 4-superstar, which of the subsequent would be the suitable
declaration to mention to her? - ANS-The Medicare Advantage plan obtained a
five-celebrity rating in customer service and care coordination with an common overall
performance rating of 4-stars
6. Last 12 months Agent Melanie Meyers advertised and enrolled several clients in
Medicare Advantage (MA) health plans. This year she has determined to consciousness
on non-MA products. What recommendation might you Melanie if she needs to keep to
get hold of renewal costs? - ANS-Melanie must continue to be educated, tested,
licensed, and appointed, no matter whether or not she is actively selling MA
merchandise.
, 7. Monica is an agent targeted on serving seniors eligible for Medicare. As she evaluations
her statistics, she is trying to decide which of the following gadgets are taken into
consideration repayment. What do you tell her?
8. I. Commissions
9. II. Bonuses
10. III. Mileage repayment
11. IV. Referral prices - ANS-I, II, and IV only
12. Mr. Bickford did now not quite qualify for the greater assist low-profits subsidy
underneath the Medicare Part D Prescription Drug program and he's questioning if
there's any other alternative he has for acquiring assist with his widespread drug
expenses. What must you inform him? - ANS-He may want to take a look at with the
producers of his medicinal drugs to peer if they provide an help program to help human
beings with limited way achieve the medications they need. Alternatively, he may want to
take a look at to see whether his country has a pharmacy assistance software to help
him along with his costs.
13. Mr. Buck has numerous circle of relatives individuals who died from exclusive cancers.
He desires to understand if Medicare covers most cancers screening. What have to you
tell him? - ANS-Medicare covers periodic overall performance of a variety of screening
checks that are intended to provide early detection of disease. Mr. Buck will want to
check specific exams earlier than acquiring them to see if they may be blanketed.
14. Mr. Carlini has heard that Medicare prescription drug plans are simplest provided thru
non-public businesses below a application called Medicare Advantage (MA), no longer
by means of the government. He likes Original Medicare and does now not need to join
an MA product, but he also wishes prescription drug insurance. What have to you inform
him? - ANS-Mr. Carlini can live with Original Medicare and also join in a Medicare
prescription drug plan thru a private agency that has reduced in size with the
government to provide simplest such drug coverage to eligible Medicare beneficiaries.
15. Mr. Chen has heard approximately a Medical Savings Account (MSA), however wants to
understand if it's miles just about saving money, or if he'll get insurance insurance for his
fitness care expenditures as properly. What need to you inform him? - ANS-Under the
Medicare Advantage application, a MSA plan includes the mixture of a excessive
deductible health plan and a savings account for fitness expenses. Medicare will make
contributions to this financial savings account to help him pay his fitness care costs even
as inside the deductible.
16. Mr. Cole has been a Medicaid beneficiary for sometime, and lately certified for Medicare
as nicely. He is worried approximately modifications in his price-sharing. What ought to
you inform him? - ANS-He need to understand that Medicaid can pay cost0sharing only
for services furnished by Medicaid collaborating vendors.
17. Mr. Davis is fifty two years vintage and has recently been diagnosed with cease-degree
renal sickness (ESRD) and will quickly begin dialysis. He is questioning if he can acquire
coverage underneath Medicare. What should you tell him? - ANS-He can also signal-up
for Medicare at any time however insurance typically starts offevolved on the fourth
month after dialysis treatment starts offevolved.
