AHIP Final Exam Questions With 100%
Correct Answer
Mr. Davies is turning 65 next month. He would like to enroll in a
Medicare health plan, but does not want to be limited in terms of
where he obtains his care. What should you tell him about how a
Medicare Cost Plan might fit his needs?
Ans:>> a.
Cost plan enrollees can choose to receive Medicare covered
services under the plan's benefits by going to plan network providers
and paying plan cost sharing, or may receive services from non-network
providers and pay cost-sharing due under Original Medicare.
Quiz b. Ms. Lopez is considered a marketing representative of BestCare
and thus is obligated to comply with CMS marketing requirements,
including those regarding using only approved call scripts.
Ans:>> Ms.Lopez is an independent agent under contract with MarketCo,
a third-party marketing organization. MarketCo has a contract with
BestCare health plan, a Medicare Advantage (MA) organization, to offer
marketing services through its contracted agents and agencies. Ms.
,Lopez returns calls to individuals who contact MarketCo in response to
its mailers promoting BestCare health plan. Which of the following best
describes the responsibilities of Ms. Lopez?
a. Ms. Lopez is considered a marketing representative of BestCare but is
exempt from the marketing rules regarding approved call scripts
because she works directly for MarketCo.
b. Ms. Lopez is considered a marketing representative of BestCare and
thus is obligated to comply with CMS marketing requirements,
including those regarding using only approved call scripts.
c. Ms. Lopez no longer needs to be concerned about state licensure
since she is marketing an MA product subject to federal rules.
d. Ms. Lopez needs to maintain state licensure, but because she is
working for a third-party marketing organization she is exempt from
CMS training requirements that apply to BestCare captive agents.
Quiz Mr. Edwards, a marketing representative of the ACME Insurance
Company, scheduled a marketing event and expects about 40 people to
attend. He has hired a magician at a cost of $200 to entertain
attendees. Can he do this in a way that complies with guidance from
the Medicare agency?
,Ans:>> a.
He can do this because the estimated number of attendees is
based on the venue size and response rate and the value of the gift
does not exceed $15.
Quiz Mrs. Ramos is considering a Medicare Advantage PPO and has
questions about which providers she can go to for her health care.
What should you tell her?
Ans:>> b.Mrs. Ramos can obtain care from any provider who participates
in Original Medicare, but generally will have a higher cost-sharing
amount if she sees a provider who/that is not a part of the PPO
network.
Quiz Julia Harris is turning 66 in July, at which time she will retire. She
has contacted your office and requested a meeting so that she can
learn about Medicare and the products you represent. How should you
respond?
Ans:>> c.
Tell Julia that you will meet with her to explain Medicare and
should she be interested you can accept and submit an enrollment
request, since this is an initial enrollment qualifying her for a special
enrollment period.
, Quiz Mr. Rivera has Qualified Medicare Beneficiary (QMB) eligibility and
is thus covered by both Medicare and Medicaid. He decides to enroll in
a Medicare Advantage (MA) PPO plan. Later he sees an out-of-network
doctor to receive a Medicare covered service. How much The doctor
may only collect from Mr. Rivera the cost sharing allowable under the
state's Medicaid program.may the doctor collect from Mr. Rivera?
Ans:>> The
doctor may only collect from Mr. Rivera the cost sharing
allowable under the state's Medicaid program.
Quiz During a sales presentation in Ms. Sullivan's home, she tells you
that she has heard about a type of Medicare health plan known as
Private Fee-for-Service (PFFS). She wants to know if this would be
available to her. What should you tell her about PFFS plans?
Ans:>>
Quiz Choose one answer.
Ans:>>
Quiz
Correct Answer
Mr. Davies is turning 65 next month. He would like to enroll in a
Medicare health plan, but does not want to be limited in terms of
where he obtains his care. What should you tell him about how a
Medicare Cost Plan might fit his needs?
Ans:>> a.
Cost plan enrollees can choose to receive Medicare covered
services under the plan's benefits by going to plan network providers
and paying plan cost sharing, or may receive services from non-network
providers and pay cost-sharing due under Original Medicare.
Quiz b. Ms. Lopez is considered a marketing representative of BestCare
and thus is obligated to comply with CMS marketing requirements,
including those regarding using only approved call scripts.
Ans:>> Ms.Lopez is an independent agent under contract with MarketCo,
a third-party marketing organization. MarketCo has a contract with
BestCare health plan, a Medicare Advantage (MA) organization, to offer
marketing services through its contracted agents and agencies. Ms.
,Lopez returns calls to individuals who contact MarketCo in response to
its mailers promoting BestCare health plan. Which of the following best
describes the responsibilities of Ms. Lopez?
a. Ms. Lopez is considered a marketing representative of BestCare but is
exempt from the marketing rules regarding approved call scripts
because she works directly for MarketCo.
b. Ms. Lopez is considered a marketing representative of BestCare and
thus is obligated to comply with CMS marketing requirements,
including those regarding using only approved call scripts.
c. Ms. Lopez no longer needs to be concerned about state licensure
since she is marketing an MA product subject to federal rules.
d. Ms. Lopez needs to maintain state licensure, but because she is
working for a third-party marketing organization she is exempt from
CMS training requirements that apply to BestCare captive agents.
Quiz Mr. Edwards, a marketing representative of the ACME Insurance
Company, scheduled a marketing event and expects about 40 people to
attend. He has hired a magician at a cost of $200 to entertain
attendees. Can he do this in a way that complies with guidance from
the Medicare agency?
,Ans:>> a.
He can do this because the estimated number of attendees is
based on the venue size and response rate and the value of the gift
does not exceed $15.
Quiz Mrs. Ramos is considering a Medicare Advantage PPO and has
questions about which providers she can go to for her health care.
What should you tell her?
Ans:>> b.Mrs. Ramos can obtain care from any provider who participates
in Original Medicare, but generally will have a higher cost-sharing
amount if she sees a provider who/that is not a part of the PPO
network.
Quiz Julia Harris is turning 66 in July, at which time she will retire. She
has contacted your office and requested a meeting so that she can
learn about Medicare and the products you represent. How should you
respond?
Ans:>> c.
Tell Julia that you will meet with her to explain Medicare and
should she be interested you can accept and submit an enrollment
request, since this is an initial enrollment qualifying her for a special
enrollment period.
, Quiz Mr. Rivera has Qualified Medicare Beneficiary (QMB) eligibility and
is thus covered by both Medicare and Medicaid. He decides to enroll in
a Medicare Advantage (MA) PPO plan. Later he sees an out-of-network
doctor to receive a Medicare covered service. How much The doctor
may only collect from Mr. Rivera the cost sharing allowable under the
state's Medicaid program.may the doctor collect from Mr. Rivera?
Ans:>> The
doctor may only collect from Mr. Rivera the cost sharing
allowable under the state's Medicaid program.
Quiz During a sales presentation in Ms. Sullivan's home, she tells you
that she has heard about a type of Medicare health plan known as
Private Fee-for-Service (PFFS). She wants to know if this would be
available to her. What should you tell her about PFFS plans?
Ans:>>
Quiz Choose one answer.
Ans:>>
Quiz
