AHIP FINAL EXAM TEST QUESTIONS LATEST VERSION /AHIP FINAL EXAM TEST REAL EXAM QUESTIONS AND ANSWERS

AHIP FINAL EXAM TEST QUESTIONS LATEST VERSION /AHIP FINAL EXAM TEST REAL EXAM QUESTIONS AND ANSWERS Ms. Gardner is currently enrolled in an MA-PD plan. However, she wants to disenroll from the MAPD plan and instead enroll in a Part D only plan and go back to Original Medicare. According to Medicare's enrollment guidelines, when could she do this? -CORRECT ANSWER-- : She may make such a change during the Annual Election Period that runs from Oct. 15 to December 7, or during the MA Open Enrollment Period which takes place from January 1- March 31 of each year (beginning in 2019). Agent Lopez helps Ralph to enroll in Top Choice Medicare Advantage plan during the Annual Open Enrollment Period. Ralph's effective enrollment date is January 1st. Ralph disenrolls on February 12th because he did not understand that the plan did not cover services furnished by several of his longtime providers. Which of the following statements best describes the impact of Ralph's action upon Agent Lopez's compensation? -CORRECT ANSWER-- Answer: Agent Lopez's entire compensation must be recouped because Ralph disenrolled within 3 months of enrollment. 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? -CORRECT 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. Jenkins is interested in enrolling in a Medicare cost plan and has sought your advice. What would you tell him? -CORRECT ANSWER-- Cost plans are required to be open to enrollment at least 30 days per year, and many are open for enrollment all year. So open enrollment will be dependent on the plan he chooses. Mr. Rice has coverage for medical services and medications through his employer's retiree plan. He is considering switching to a Medicare prescription drug plan because his retiree plan does not cover two important medications. What should he consider before making a change? -CORRECT ANSWER-- If Mr. Rice drops his drug coverage through the retiree plan, he may not be able to get it back and he also may lose his medical health coverage. Mary Samuels recently suffered a stroke while visiting her daughter and grandchildren. As a result, Mary has been admitted to a rehabilitation hospital where she is expected to reside for several months. The rehabilitation hospital is located outside the geographic area served by her current Medicare Advantage (MA) plan. What options are available to Mary regarding her health plan coverage? -CORRECT ANSWER-- Mary may make an unlimited number of MA enrollment requests and may disenroll from her current MA plan. Mr. Jackson just turned 65. He has been seeing the same general practitioner for annual check-ups for the past 15 years, likes these yearly visits, and would like to continue obtaining these services as a Medicare beneficiary. What should you tell him about annual check-ups? - CORRECT ANSWER-- Medicare will cover an annual wellness visit, even if he has no illnesses or injuries. Mr. Wells is trying to understand the difference between Original Medicare and Medicare Advantage. What would be a correct description? -CORRECT ANSWER-- Medicare Advantage is a way of covering all the Original Medicare benefits through private health insurance companies. Mr. Katz reached the Part D coverage gap in August last year. His prescriptions have not changed, he is keeping the same Part D plan and the benefits, cost-sharing, and coverage of his drugs are all the same as last year. He asked what to expect for this year about his out-ofpocket costs. What could you tell him? -CORRECT ANSWER-- Because he reached the coverage gap last year, he will probably reach it again this year close to the same time. Mr. Greco is in excellent health, lives in his own home, and has a sizeable income from his investments. He has a friend enrolled in a Medicare Advantage Special Needs Plan (SNP). His friend has mentioned that the SNP charges very low cost-sharing amounts and Mr. Greco would like to join that plan. What should you tell him? -CORRECT ANSWER-- SNPs limit enrollment to certain sub-populations of beneficiaries. Given his current situation, he is unlikely to qualify and would not be able to enroll in the SNP. Several agents you work with are planning sales events in your area. One plans on giving door prizes worth $5, refreshments valued at $8 per anticipated attendee, and coupon books with discounts worth $10. Since no gift or prize exceeds the $15 limit he believes his plan is acceptable. What should you tell them -CORRECT ANSWER-- He can give away more than one gift during a single event, but the aggregate retail value cannot exceed $15 Mrs. Fiore was in the Army for 35 years and is now retired. She has drug coverage through the VA. What issues might she consider with regard to whether to enroll in a Me