AHIP 2023 Final Exam Question & Answers
Mr. Olsen is concerned that a Medicare Advantage plan will not cover the same
range of services that would be covered under Original fee-for-service Medicare.
What should you tell him? - AnswerThough their cost-sharing may differ from
Original Medicare's, Medicare Advantage plans are required to cover all services
covered by original Medicare.
Mrs. Sanchez lives in a state located near Canada. She has recently become
eligible for Medicare and is considering enrollment in Part D prescription drug
coverage. One of her friends has told her that she needs to be aware of something
called TrOOP. What should you tell her when she asks you about TrOOP? -
AnswerTrOOP are out-of-pocket costs that count toward the annual out-of-pocket
threshold to move into catastrophic coverage and generally include the annual
deductible(s) and costs for drugs on the plan's formulary purchased at a plan's
participating pharmacy. In some instances, amounts not directly paid by the
enrollee (like manufacturer discounts) count toward TrOOP.
When you market Medicare Advantage and Part D plans, what may you offer as a
gift to induce enrollment in a plan? - Answer You may provide gifts or prizes to all
potential enrollees during an event that does not exceed $15 in retail value.
By contacting plans available in your area, you have learned that the plan you
represent has a significantly lower monthly premium than the others.
Mr. Olsen is concerned that a Medicare Advantage plan will not cover the same
range of services that would be covered under Original fee-for-service Medicare.
What should you tell him? - AnswerThough their cost-sharing may differ from
Original Medicare's, Medicare Advantage plans are required to cover all services
covered by original Medicare.
Mrs. Sanchez lives in a state located near Canada. She has recently become
eligible for Medicare and is considering enrollment in Part D prescription drug
coverage. One of her friends has told her that she needs to be aware of something
called TrOOP. What should you tell her when she asks you about TrOOP? -
AnswerTrOOP are out-of-pocket costs that count toward the annual out-of-pocket
threshold to move into catastrophic coverage and generally include the annual
deductible(s) and costs for drugs on the plan's formulary purchased at a plan's
participating pharmacy. In some instances, amounts not directly paid by the
enrollee (like manufacturer discounts) count toward TrOOP.
When you market Medicare Advantage and Part D plans, what may you offer as a
gift to induce enrollment in a plan? - Answer You may provide gifts or prizes to all
potential enrollees during an event that does not exceed $15 in retail value.
By contacting plans available in your area, you have learned that the plan you
represent has a significantly lower monthly premium than the others.
