AHIP FINAL EXAM (Latest
Updates) Questions & Answers 100%
Correct {Grade A}
Ms. Levi is considering enrollment in a Medicare Advantage HMO plan offered in her
area. Ms. Levi often travels to visit relatives and is concerned that she may need
emergency care outside of her plan's service area. What should you tell her about
coverage of emergency care? - correct answer Plans are required to cover out-of
network emergency care.
Which of the following individuals are likely to qualify for a special enrollment period
(SEP) for both MA and Part D due to a change of residence?
I. Edward (enrolled in MA and Part D) moves to a new home within the same
neighborhood in his existing plan's service area.
II. Fiona (enrolled in MA and Part D) moves cross-country to an area outside her
existing plan's service area.
III. Gilbert moves into a plan service area where there is now a Part D plan available to
him from a service area where no Part D plan was available.
,IV. Henry makes a permanent move providing him with new MA and Part D options. -
correct answer II, III, and IV only
Mr. Lynn, an agent for Acme Insurance, Inc. thinks that, since state laws are
preempted with regard to the marketing of Medicare health plans, he doesn't have
much to worry about. What might you, as his colleague, advise him concerning the type
of scrutiny he will be under? - correct answer Organizations sponsoring Medicare
health plans are responsible for the behavior of their contracted representatives and
will be conducting
monitoring activities to ensure compliance with all applicable Federal
law and guidance and plan policies.
Furthermore, state agent licensure laws are not preempted and he must abide by their
requirements.
Mrs. Wellington is enrolled in Parts A and B of Original Medicare. A friend recently told
her that there is an excellent Medicare Advantage (MA) plan with a five-star rating
serving her area. On January 15 she comes to you for advice as to what options, if any,
, she has. What should you say regarding special enrollment periods (SEPs)? - correct
answer Mrs. Wellington is eligible for a SEP
that may be used once until November 30 to enroll in the fivestar plan.
Mrs. Berkowitz wants to enroll in a Medicare Advantage plan that does not include
drug coverage and also enroll in a stand-alone Medicare prescription drug plan. Under
what circumstances can she do this? - correct answer If the Medicare Advantage plan
is a
Private Fee-for-Service (PFFS) plan
that does not offer drug coverage or a
Medical Savings Account, Mrs. Berkowitz can do this.
Mr. Romero is 64, retiring soon, and considering enrollment in his employer-
sponsored retiree group health plan that includes drug coverage with nominal copays.
He heard about a neighbor's MA-PD plan that you represent and because he takes
numerous prescription drugs, he is considering signing up for it. What should you tell
him? - correct answer Beneficiaries should check with their employer or union group
Updates) Questions & Answers 100%
Correct {Grade A}
Ms. Levi is considering enrollment in a Medicare Advantage HMO plan offered in her
area. Ms. Levi often travels to visit relatives and is concerned that she may need
emergency care outside of her plan's service area. What should you tell her about
coverage of emergency care? - correct answer Plans are required to cover out-of
network emergency care.
Which of the following individuals are likely to qualify for a special enrollment period
(SEP) for both MA and Part D due to a change of residence?
I. Edward (enrolled in MA and Part D) moves to a new home within the same
neighborhood in his existing plan's service area.
II. Fiona (enrolled in MA and Part D) moves cross-country to an area outside her
existing plan's service area.
III. Gilbert moves into a plan service area where there is now a Part D plan available to
him from a service area where no Part D plan was available.
,IV. Henry makes a permanent move providing him with new MA and Part D options. -
correct answer II, III, and IV only
Mr. Lynn, an agent for Acme Insurance, Inc. thinks that, since state laws are
preempted with regard to the marketing of Medicare health plans, he doesn't have
much to worry about. What might you, as his colleague, advise him concerning the type
of scrutiny he will be under? - correct answer Organizations sponsoring Medicare
health plans are responsible for the behavior of their contracted representatives and
will be conducting
monitoring activities to ensure compliance with all applicable Federal
law and guidance and plan policies.
Furthermore, state agent licensure laws are not preempted and he must abide by their
requirements.
Mrs. Wellington is enrolled in Parts A and B of Original Medicare. A friend recently told
her that there is an excellent Medicare Advantage (MA) plan with a five-star rating
serving her area. On January 15 she comes to you for advice as to what options, if any,
, she has. What should you say regarding special enrollment periods (SEPs)? - correct
answer Mrs. Wellington is eligible for a SEP
that may be used once until November 30 to enroll in the fivestar plan.
Mrs. Berkowitz wants to enroll in a Medicare Advantage plan that does not include
drug coverage and also enroll in a stand-alone Medicare prescription drug plan. Under
what circumstances can she do this? - correct answer If the Medicare Advantage plan
is a
Private Fee-for-Service (PFFS) plan
that does not offer drug coverage or a
Medical Savings Account, Mrs. Berkowitz can do this.
Mr. Romero is 64, retiring soon, and considering enrollment in his employer-
sponsored retiree group health plan that includes drug coverage with nominal copays.
He heard about a neighbor's MA-PD plan that you represent and because he takes
numerous prescription drugs, he is considering signing up for it. What should you tell
him? - correct answer Beneficiaries should check with their employer or union group
