AHIP (AHIP)

Mr. Bauer is 49 years old, but eighteen months ago he was declared disabled by the Social Security Administration and has been receiving disability payments. He is wondering whether he can obtain coverage under Medicare. What should you tell him? - After receiving such disability payments for 24 months, he will be automatically enrolled in Medicare, regardless of age Mrs. Geisler's neighbor told her she should look at her Part D options during the annual Medicare enrollment period because...

Mr. Zachow has a condition for which three drugs are available. He has tried two but had an allergic reaction to them. Only the third drug works for him and it is not on his Part D plan's formulary. What could you tell him to do? - Mr. Zachow has a right to request a formulary exception to obtain coverage for his Part D drug. He or his physician could obtain the standardized request form on the plan's website, fill it out, and submit it to his plan. Mr. Polanski likes the cost of an HMO ...

Mrs. Quinn recently turned 66 and decided after many years of work to begin receiving Social Security benefits. Shortly thereafter Mrs. Quinn received a letter informing her that she has been automatically enrolled in Medicare Part B. She wants to understand what this means. What should you tell Mrs. Quinn? - Part B primarily covers physician services. She will be paying a monthly premium and, with the exception of many preventive and screening tests, generally will have 20% coinsurance for...

ABC is a Medicare Advantage (MA) plan sponsor. It would like to use its enrollees' protected health information to market non-health related products such as life insurance and annuities. To do so it must obtain authorization from the enrollees. Which statement best describes the authorization process? - Authorization may be obtained by directing a beneficiary to a website to provide consent. During a sales presentation to Ms. Daley for a Medicare Advantage plan that has a 5- star rating ...

A Medicare beneficiary has walked into your office and requested that you sit down with her and discuss her options under the Medicare Advantage program. Before engaging in such a discussion, what should you do? - You must have her sign a scope of appointment form, indicating which products she wishes to discuss. You may then proceed with the discussion. You will be holding a sales event in the near future, at which you would like to offer door prizes to attendees. Under guidelines from th...

A Medicare beneficiary has walked into your office and requested that you sit down with her and discuss her options under the Medicare Advantage program. Before engaging in such a discussion, what should you do? - c. You must have her sign a scope of appointment form, indicating which products she wishes to discuss. You may then proceed with the discussion. Next week you will be participating in your first "educational event" for prospective enrollees. In order to be sure that you do not...

Mr. Sinclair has diabetes and heart trouble and is generally satisfied with the care he has received under Original Medicare, but he would like to know more about Medicare Advantage Special Needs Plans (SNPs). What could you tell him? - a. SNPs have special programs for enrollees with chronic conditions, like Mr. Sinclair, and they provide prescription drug coverage that could be very helpful as well. Ms. Gibson recently lost her employer group health and drug coverage and now she wants to...

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? - Medicare is a program for people age 65 or older and those under age 65 with certain disabilities, end stage renal disease and Lou Gehrig's disease, so she will be eligible for Medicare. Mr. Schmidt would like to ...

ABC is a Medicare Advantage (MA) plan sponsor. It would like to use its enrollees' protected health information to market non-health related products such as life insurance and annuities. To do so it must obtain authorization from the enrollees. Which statement best describes the authorization process? - Authorization may be obtained by directing a beneficiary to a website to provide consent. During a sales presentation to Ms. Daley for a Medicare Advantage plan that has a 5- star rating ...