AHIP FINAL EXAM TEST QUESTIONS
AND CORRECT DETAILED ANSWERS.
Mrs. |West |wears |glasses |and |dentures |and |has |enjoyed |considerable |pain |relief |from |arthritis |
through |acupuncture. |She |is |concerned |about |whether |or |not |Medicare |will |cover |these |items
|and |services. |What |should |you |tell |her? |- |ANS |-Medicare |does |not |cover |acupuncture, |or, |in |
general, |glasses |or |dentures.
Mr. |Bickford |did |not |quite |qualify |for |the |extra |help |low-income |subsidy |under |the |Medicare |
Part |D |Prescription |Drug |program |and |he |is |wondering |if |there |is |any |other |option |he |has |for |
obtaining |help |with |his |considerable |drug |costs. |What |should |you |tell |him? |- |ANS |-He |could |
check |with |the |manufacturers |of |his |medications |to |see |if |they |offer |an |assistance |program |to |
help |people |with |limited |means |obtain |the |medications |they |need. |Alternatively, |he |could |
check |to |see |whether |his |state |has |a |pharmacy |assistance |program |to |help |him |with |his |
expenses.
Mr. |Lombardi |is |interested |in |a |Medicare |Advantage |(MA) |PPO |plan |that |you |represent. |It |is |
one |of |three |plans |operated |by |the |same |organization |in |Mr. |Lombardi's |area. |The |MA |PPO |
plan |does |not |include |drug |coverage, |but |the |other |two |plans |do. |Mr. |Lombardi |likes |the |PPO |
plan |that |does |not |include |drug |coverage |and |intends |to |obtain |his |drug |coverage |through |a |
stand-alone |Medicare |prescription |drug |plan. |What |should |you |tell |him |about |this |situation? |- |
ANS |-He |could |enroll |in |one |of |the |MA |plans |that |include |prescription |drug |coverage |or |a |
Medigap |plan |and |a |stand-alone |prescription |drug |plan, |but |he |cannot |enroll |in |the |MA-only |
PPO |plan |and |a |stand-alone |prescription |drug |plan.
Mr. |Torres |has |a |small |savings |account. |He |would |like |to |pay |for |his |monthly |Part |D |premiums |
with |an |automatic |monthly |withdrawal |from |his |savings |account |until |it |is |exhausted, |and |then
|have |his |premiums |withheld |from |his |Social |Security |check. |What |should |you |tell |him? |- |ANS |-
, In |general, |he |must |select |a |single |Part |D |premium |payment |mechanism |that |will |be |used |
throughout |the |year.
Agent |Jennings |makes |a |presentation |on |Medicare |advertised |as |an |educational |event. |Agent |
Jennings |distributes |materials |that |are |solely |educational |in |nature. |However, |she |gives |a |brief |
presentation |that |mentions |plan-specific |premiums. |Is |this |a |prohibited |activity |at |an |event |
that |has |been |advertised |as |educational? |- |ANS |-Yes. |When |an |event |has |been |advertised |as
|"educational," |discussing |plan-specific |premiums |is |impermissible.
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? |- |ANS |-Everyone |who |is |entitled |to |Part |A |or |enrolled |under |Part
|B |is |eligible |to |enroll |in |a |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.
Mr. |Jacob |understands |that |there |is |a |standard |Medicare |Part |D |prescription |drug |benefit, |but |
when |he |looks |at |information |on |various |plans |available |in |his |area, |he |sees |a |wide |range |in |
what |they |charge |for |deductibles, |premiums |and |cost |sharing. |How |can |you |explain |this |to |
him? |- |ANS |-Medicare |Part |D |drug |plans |may |have |different |benefit |structures, |but |on |
average, |they |must |all |be |at |least |as |good |as |the |standard |model |established |by |the |
government.
Ms. |Moore |plans |to |retire |when |she |turns |65 |in |a |few |months. |She |is |in |excellent |health |and |
will |have |considerable |income |when |she |retires. |She |is |concerned |that |her |income |will |make |it
|impossible |for |her |to |qualify |for |Medicare. |What |could |you |tell |her |to |address |her |concern? |- |
ANS |-Medicare |is |a |program |for |people |age |65 |or |older |and |those |under |age |65 |with |certain |
disabilities, |end |stage |renal |disease |or |Lou |Gehrig's |disease, |so |she |will |be |eligible |for |
Medicare.
Agent |Armstrong |is |employed |by |XYZ |Agency, |which |is |under |contract |with |ABC |Health |Plan, |a |
Medicare |Advantage |(MA) |plan |that |offers |plans |in |multiple |states. |XYZ |Agency |maintains |a |
website |marketing |the |MA |plans |with |which |it |has |contracts. |Agent |Armstrong |follows |up |with
AND CORRECT DETAILED ANSWERS.
Mrs. |West |wears |glasses |and |dentures |and |has |enjoyed |considerable |pain |relief |from |arthritis |
through |acupuncture. |She |is |concerned |about |whether |or |not |Medicare |will |cover |these |items
|and |services. |What |should |you |tell |her? |- |ANS |-Medicare |does |not |cover |acupuncture, |or, |in |
general, |glasses |or |dentures.
Mr. |Bickford |did |not |quite |qualify |for |the |extra |help |low-income |subsidy |under |the |Medicare |
Part |D |Prescription |Drug |program |and |he |is |wondering |if |there |is |any |other |option |he |has |for |
obtaining |help |with |his |considerable |drug |costs. |What |should |you |tell |him? |- |ANS |-He |could |
check |with |the |manufacturers |of |his |medications |to |see |if |they |offer |an |assistance |program |to |
help |people |with |limited |means |obtain |the |medications |they |need. |Alternatively, |he |could |
check |to |see |whether |his |state |has |a |pharmacy |assistance |program |to |help |him |with |his |
expenses.
Mr. |Lombardi |is |interested |in |a |Medicare |Advantage |(MA) |PPO |plan |that |you |represent. |It |is |
one |of |three |plans |operated |by |the |same |organization |in |Mr. |Lombardi's |area. |The |MA |PPO |
plan |does |not |include |drug |coverage, |but |the |other |two |plans |do. |Mr. |Lombardi |likes |the |PPO |
plan |that |does |not |include |drug |coverage |and |intends |to |obtain |his |drug |coverage |through |a |
stand-alone |Medicare |prescription |drug |plan. |What |should |you |tell |him |about |this |situation? |- |
ANS |-He |could |enroll |in |one |of |the |MA |plans |that |include |prescription |drug |coverage |or |a |
Medigap |plan |and |a |stand-alone |prescription |drug |plan, |but |he |cannot |enroll |in |the |MA-only |
PPO |plan |and |a |stand-alone |prescription |drug |plan.
Mr. |Torres |has |a |small |savings |account. |He |would |like |to |pay |for |his |monthly |Part |D |premiums |
with |an |automatic |monthly |withdrawal |from |his |savings |account |until |it |is |exhausted, |and |then
|have |his |premiums |withheld |from |his |Social |Security |check. |What |should |you |tell |him? |- |ANS |-
, In |general, |he |must |select |a |single |Part |D |premium |payment |mechanism |that |will |be |used |
throughout |the |year.
Agent |Jennings |makes |a |presentation |on |Medicare |advertised |as |an |educational |event. |Agent |
Jennings |distributes |materials |that |are |solely |educational |in |nature. |However, |she |gives |a |brief |
presentation |that |mentions |plan-specific |premiums. |Is |this |a |prohibited |activity |at |an |event |
that |has |been |advertised |as |educational? |- |ANS |-Yes. |When |an |event |has |been |advertised |as
|"educational," |discussing |plan-specific |premiums |is |impermissible.
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? |- |ANS |-Everyone |who |is |entitled |to |Part |A |or |enrolled |under |Part
|B |is |eligible |to |enroll |in |a |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.
Mr. |Jacob |understands |that |there |is |a |standard |Medicare |Part |D |prescription |drug |benefit, |but |
when |he |looks |at |information |on |various |plans |available |in |his |area, |he |sees |a |wide |range |in |
what |they |charge |for |deductibles, |premiums |and |cost |sharing. |How |can |you |explain |this |to |
him? |- |ANS |-Medicare |Part |D |drug |plans |may |have |different |benefit |structures, |but |on |
average, |they |must |all |be |at |least |as |good |as |the |standard |model |established |by |the |
government.
Ms. |Moore |plans |to |retire |when |she |turns |65 |in |a |few |months. |She |is |in |excellent |health |and |
will |have |considerable |income |when |she |retires. |She |is |concerned |that |her |income |will |make |it
|impossible |for |her |to |qualify |for |Medicare. |What |could |you |tell |her |to |address |her |concern? |- |
ANS |-Medicare |is |a |program |for |people |age |65 |or |older |and |those |under |age |65 |with |certain |
disabilities, |end |stage |renal |disease |or |Lou |Gehrig's |disease, |so |she |will |be |eligible |for |
Medicare.
Agent |Armstrong |is |employed |by |XYZ |Agency, |which |is |under |contract |with |ABC |Health |Plan, |a |
Medicare |Advantage |(MA) |plan |that |offers |plans |in |multiple |states. |XYZ |Agency |maintains |a |
website |marketing |the |MA |plans |with |which |it |has |contracts. |Agent |Armstrong |follows |up |with
