AHIP EXAM MODULE 1-5 ACTUAL COMPLETE REAL EXAM
QUESTIONS WITH CORRECT ANSWERS (VERIFIED ANSWERS)
/A+ GRADE ASSURED
Mrs. Lyons is in good health, uses a single prescription, and lives
independently in her own home. She is attracted by the idea of
maintaining control over a Medical Savings Account (MSA) but is
not sure if the plan associated with the account will fit her needs.
What specific piece of information about a Medicare MSA plan
would it be important for her to know, prior to enrolling in such a
plan? - ANSWER -All MSAs cover Part A and Part B benefits, but
not Part D prescription drug benefits, which could be obtained by
also enrolling in a separate prescription drug plan.
When Myra first became eligible for Medicare, she enrolled in
Original Medicare (Parts A and B). She is now 67 and will turn 68
on July 1. She would now like to enroll in a Medicare Advantage
(MA) plan and approaches you about her options. What advice
would you give her? - ANSWER -She should remain in Original
Medicare until the annual election period running from October 15
to December 7, during which she can select an MA plan.
,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? -
ANSWER -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.
Mr. Johannsen is entitled to Medicare Part A and Part B. He gains
the Part D lowincome subsidy. How does that affect his ability to
enroll or disenroll in a Part D plan? - ANSWER -He qualifies for a
special election period and can enroll in or disenroll from a Part D
plan once during that period.
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? -
ANSWER -Mr. Tully's daughter can do so only, if she is authorized
under state law as a court-appointed legal guardian, has a
,durable power of attorney for health care decisions, or is
authorized under state surrogate consent laws to make health
decisions.
Torie Jones is a new marketing representative. Torie asks you for
advice as to what topics must be discussed with a Medicare
beneficiary prior to enrollment in a Medicare Advantage (MA-PD)
plan. What should you say? - ANSWER -Torie, there are many
required questions and topics regarding beneficiary needs to be
discussed prior to enrollment in an MA plan. These include
information regarding primary care providers and specialists
whether they are in the plan network, whether or not a
beneficiary's current prescriptions are covered as well as
premiums, benefits, and costs of health care services.
Mrs. Parker likes to handle most of her business matters through
telephone calls.
She currently is enrolled in Original Medicare Parts A and B but
has heard about a
Medicare Advantage plan offered by Senior Health from a
neighbor. Mrs. Parker asks you whether she can enroll in Senior
Health's MA plan over the telephone. What can you tell her? -
ANSWER -Telephone enrollment request calls must be recorded.
Telephonic enrollments must include all required elements
necessary to complete an enrollment.
, You are doing a sales presentation for Mrs. Pearson. You know
that Medicare marketing guidelines prohibit certain types of
statements. Apply those guidelines to the following statements
and identify which would be prohibited. - ANSWER -"If you're not
in very good health, you will probably do better with a different
product."
Mrs. Margolis contacts you in August because she will become
eligible for Medicare for the first time in November. She would like
to meet and discuss plan choices with you. What advice should
you give her? - ANSWER -Tell her to wait until October to discuss
plan choices with you so that you can share plan benefits for the
current year as well as any changes for the following year that
may impact her choice.
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? - ANSWER -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.
QUESTIONS WITH CORRECT ANSWERS (VERIFIED ANSWERS)
/A+ GRADE ASSURED
Mrs. Lyons is in good health, uses a single prescription, and lives
independently in her own home. She is attracted by the idea of
maintaining control over a Medical Savings Account (MSA) but is
not sure if the plan associated with the account will fit her needs.
What specific piece of information about a Medicare MSA plan
would it be important for her to know, prior to enrolling in such a
plan? - ANSWER -All MSAs cover Part A and Part B benefits, but
not Part D prescription drug benefits, which could be obtained by
also enrolling in a separate prescription drug plan.
When Myra first became eligible for Medicare, she enrolled in
Original Medicare (Parts A and B). She is now 67 and will turn 68
on July 1. She would now like to enroll in a Medicare Advantage
(MA) plan and approaches you about her options. What advice
would you give her? - ANSWER -She should remain in Original
Medicare until the annual election period running from October 15
to December 7, during which she can select an MA plan.
,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? -
ANSWER -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.
Mr. Johannsen is entitled to Medicare Part A and Part B. He gains
the Part D lowincome subsidy. How does that affect his ability to
enroll or disenroll in a Part D plan? - ANSWER -He qualifies for a
special election period and can enroll in or disenroll from a Part D
plan once during that period.
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? -
ANSWER -Mr. Tully's daughter can do so only, if she is authorized
under state law as a court-appointed legal guardian, has a
,durable power of attorney for health care decisions, or is
authorized under state surrogate consent laws to make health
decisions.
Torie Jones is a new marketing representative. Torie asks you for
advice as to what topics must be discussed with a Medicare
beneficiary prior to enrollment in a Medicare Advantage (MA-PD)
plan. What should you say? - ANSWER -Torie, there are many
required questions and topics regarding beneficiary needs to be
discussed prior to enrollment in an MA plan. These include
information regarding primary care providers and specialists
whether they are in the plan network, whether or not a
beneficiary's current prescriptions are covered as well as
premiums, benefits, and costs of health care services.
Mrs. Parker likes to handle most of her business matters through
telephone calls.
She currently is enrolled in Original Medicare Parts A and B but
has heard about a
Medicare Advantage plan offered by Senior Health from a
neighbor. Mrs. Parker asks you whether she can enroll in Senior
Health's MA plan over the telephone. What can you tell her? -
ANSWER -Telephone enrollment request calls must be recorded.
Telephonic enrollments must include all required elements
necessary to complete an enrollment.
, You are doing a sales presentation for Mrs. Pearson. You know
that Medicare marketing guidelines prohibit certain types of
statements. Apply those guidelines to the following statements
and identify which would be prohibited. - ANSWER -"If you're not
in very good health, you will probably do better with a different
product."
Mrs. Margolis contacts you in August because she will become
eligible for Medicare for the first time in November. She would like
to meet and discuss plan choices with you. What advice should
you give her? - ANSWER -Tell her to wait until October to discuss
plan choices with you so that you can share plan benefits for the
current year as well as any changes for the following year that
may impact her choice.
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? - ANSWER -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.
