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AHIP Test 2 Gary Corr Test 100% & Test 3 Judy.

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Test100% Corect AgentGaryfromFlorida-TEST2sentmehisAHIP2020TestQuestionsandAnswers. AtachedismyAHIPFinalExam–Igota98% onithefirstime.RealizethatIhavebendoingtheseAHIPexams since2010andMedicareismy... primarybusines.IamsurprisedIgotanywrong.Notsurewhichansweris incorect.Sincerely,AgentGary (IbelievethatIfoundthewronganswer-pleasecomment)-PatyandSusanfoundthewronganswer-al50 questionsarenowansweredcorectly. Question1. Ms.Gibsonrecentlylostheremployergrouphealthanddrugcoverageandnowshewantstoenroll inaPOthatdoesnotincludedrugcoverage.Whatshouldyoutellheraboutobtainingdrug coverage? ShecanenrollinthePO,butshewillnotbeabletopurchaseastand-aloneMedicarePartD prescriptiondrugplan-Corect. b.b.ShecanenrollinthePOandpurchasedrugcoveragethroughastand-aloneMedicarePart Dprescriptiondrugplan. c.c.ShecanenrollinthePOandpurchasedrugcoveragethroughaMedigapplan. d.d.ShecanenrollinthePOandifshedecidesthatshewantsdrugcoverage,shewillbeable todropherPOatanytimeinfavorofaMedicareAdvantageplanthatincludesuchdrug coverage Question2. Mr.ColehasbenaMedicaidbeneficiaryforsometime,andrecentlyqualifiedforMedicareas well.Heisconcernedaboutchangesinhiscost-sharing.Whatshouldyoutellhim? a.Medicaidwillcoverhiscost-sharing,regardlesofromwhichphysicianorhospitalhereceives hisMedicare-coveredservices. b.HeshouldknowthatMedicaidwillpaycostsharingonlyforservicesprovidedbyMedicaid participatingproviders-Corect. c.ForMedicaidbeneficiaries,Medicarereducesitscost-sharingamountstomatchthosechargedby thestateMedicaidprogramsotherewillbenochangeinhiscost-sharingamounts.d.Medicaidwill nolongerpayanycostsharingonceheiseligibleforMedicare,sohewillnedtorelyonlyon Medicareproviders Question3. Youhavedecidedtofocusondoingin-homepresentationstomarketheMedicareAdvantage(MA) plansyourepresent.Beforeyouconductsuchsalespresentations,whatmustyoudo? Youmustreceiveaninvitationfromthebeneficiaryanddocumenthespecifictypesof productsthebeneficiarywantstodiscuspriortomakinganin-homepresentation. b.b.Thereisnospecialactionthatyoumustake.Iftheychoose,youmaygotoanindividual’s housetoprovidepresentationsandofferasistancewithenrollinginaplan. c.c.YoumustfirstcontactheMedicareagencytoensurethatheindividualisactuallya Medicarebeneficiary. d.d.Aproperintroductionathedoorthatincludesadisclaimeregardingyourelationship withtheplanyourepresentistheonlyrequiredactionyoumustake,priortoenteringthe beneficiary’shome. Question4. Mr.RiverahasQualifiedMedicareBeneficiary(QMB)eligibilityandisthuscoveredbyboth MedicareandMedicaid.HedecidestoenrollinaMedicareAdvantage(MA)POplan.Laterhe sesanout-of-networkdoctortoreceiveaMedicarecoveredservice.Howmuchmaythedoctor collectfromMr.Rivera? a.ThedoctormayonlycollectheamountallowableunderMedicareplus25percentbalancebilling. b.ThedoctormayonlycollectheamountallowableunderMedicareAdvantage(MA)POplan costsharingfornon-QMBenrolles. c.ThedoctormayonlycollectheamountallowableunderMedicareplus15percentbalancebilling. dThedoctormayonlycollectfromMr.Riverathecostsharingallowableunderthestate’s Medicaidprogram Question5 BMrs.ShieldsiscoveredbyOriginalMedicare.Shesustainedahipfractureandisbeing sucesfulytreatedforthatcondition.However,sheandherphysiciansfelthatafterherlengthy hospitalstayshewillnedamonthortwoofnursingandrehabilitativecare.Whatshouldyoutell themaboutOriginalMedicare’scoverageofcareinaskillednursingfacility? a.Onceshehasexpendedherliquidasets,Medicarewillcover80% ofMrs.Shields'long-term carecosts. b.b.Medicarewillcoveranunlimitednumberofdaysinaskilled-nursingfacility,aslongasa physiciancertifiesthatsuchcareisneded. c.c.Mrs.ShieldswillhavetoapplyforMedicaidtohaveherskillednursingservicescovered becauseMedicaredoesnotprovidesuchabenefit. d d.MedicarewillcoverMrs.Shields'skillednursingservicesprovidedduringthefirst20days ofherstay,afterwhichshewouldhaveacoinsuranceuntilshehasbeninthefacilityfor100 days Question6. Youareworkingwithanumberofplansandcommunityorganizationstosponsoraneducational event.Whenputingtogetheradvertisementsforthisevent,whatshouldyoudo? a.Youmustensurethatheadvertisementsindicateitisaneducationalevent,otherwiseitwillbe consideredamarketingevent. b.Plansmaynotparticipateinadvertisingsuchanevent.Alladvertisingmustbedoneby communityorganizations. c.Youmuststateintheadvertisementhatitwillbeaneducationaleventandthatheeducationwill consistofspecificinformationaboutheparticipatingplans. d.Youmustonlyensurethatheadvertisementisfactuallyacurate. Question7. YouarevisitingwithMr.Tullyandhisdaughteratherequest.HehasadvancedAlzheimer’sandis incapableofunderstandingtheimplicationsofchoosingaMedicareAdvantageorprescriptiondrug plan.Canhisdaughterfilloutheenrolmentformandsignitforhim? a.AsignatureisnotnecesarysinceMr.Tullyisnotphysicallyormentallycapableoffillingout andsigningtheform.b b..Mr.Tully’sdaughtercandosobecausesheisanimmediatefamilymemberwhohastaken responsibilityforherfather’scare. c.Mr.Tully’sdaughtercandosoonly,ifsheisauthorizedunderstatelawasacourt- appointedlegalguardian,hasadurablepowerofatorneyforhealthcaredecisions,oris authorizedunderstatesurogateconsentlawstomakehealthdecisions. d.d.IftheenrollmentformiscountersignedbyoneofMr.Tully’streatingphysicians,shecan signitforhim. Question8. Mrs.Chenwillbe65soon,hasbenacitizenfortwelveyears,hasbenemployedfulltime,and paidtaxesduringthatentireperiod.Sheisconcernedthatshewillnotqualifyforcoverageunder partAbecauseshewasnotbornintheUnitedStates.Whatshouldyoutellher? a.Allindividualswhoarecitizensandoverage65willbecoveredunderPartA. b.Mostindividualswhoarecitizensandoverage65andarecoveredunderPartAmustpaya monthlypremiumforthatcoverage. c.Mostindividualswhoarecitizensandoverage65andwishtobecoveredunderPartAmust enrollinaMedicareHealthPlan. d.Mostindividualswhoarecitizensandoverage65arecoveredunderPartAbyvirtueof havingpaidMedicaretaxeswhileworking,thoughsomemaybecoveredasaresultofpaying monthlypremiums. Question9. Mr.Lopez,whoisfairlywell-offfinancially,wouldliketoenrollinaMedicareprescriptiondrug planyourepresentandsimplygiveyouachecktocoverhispremiumsfortheentireyear.What shouldyoutellhim? a.Hewillnedtomailinhispaymentwithhisenrollmentform b.Youcantakehisfirstpayment,butafterthat,hewillnedtomakearangementstosendhis monthlypremiumpaymentotheplan. c.Thisisperfectlyaceptable.Youwillbehappytoforwardhispaymentotheplan.d.Enroles shouldpayusingautomaticwithdrawalfromabankacountorcreditordebitcard,direct monthlybillingfromtheplan,ordeductionsfromtheirSocialSecuritycheck. dEnrolleshouldpayusingautomaticwithdrawalfromabankacountorcreditordebitcard, directmonthlybillingfromtheplan,ordeductionsfromtheirSocialSecuritycheck Question10. Mrs.Patersonisanewenrolle intheHealthBestMedicareAdvantage(MA-PD)plan.Sheisnew tothistypeofcoverageandasksyouwhatmaterials,ifany,sheshouldexpectoreceive.How wouldyoureply? a.SheshouldexpectoreceiveEvidenceofCoverage(EOC)within21daysofconfirmationof enrollment. b.Sheshouldexpectoreceivehardcopiesofboththeproviderandpharmacydirectories automaticallywithin30daysofconfirmationofenrollment. c.Sheshouldexpectoreceiveahardcopyoftheproviderdirectoryinandaseparatenotice describingwhereshecanfindmonthlyperiodicupdatesonlineandhowtorequesthardcopies. d.Sheshouldexpecteitherthepharmacydirectoryinhardcopyoradistinctandseparatenotice(in hardcopy)describingwhereshecanfindthepharmacydirectoryonlineandhowtorequestahard copy. Question11. DuringasalespresentationinMs.Sullivan’shome,shetellsyouthatshehasheardaboutatypeof MedicarehealthplanknownasPrivateFe-for-Service(PFS).Shewantstoknowifthiswouldbe availabletoher.WhatshouldyoutellheraboutPFFSplans? a.PFFSplansaredesignedtocoveronlyprescriptiondrugsandifthatisthetypeofcoverageshe wants,shemayenrollinoneifitisavailableinherarea. b.APFSplanisoneofthevarioustypesofMedicareAdvantageplansofferedbyprivateentities andshemayenrollinoneifitisavailableinherarea. c.APFFSplanisatypeofMedicareSupplementplanandshemayenrollinoneifitisavailablein herarea. d.APFFSplanisexactlythesameasOriginalMedicare,onlyofferedbyaprivateentityandshe mayenrollinoneifitisavailableinherarea Question12. Mrs.Turneriscomparingheremployer’sretire insurancetoOriginalMedicareandwouldliketo knowwhichofthefollowingservicesOriginalMedicarewillcoveriftheappropriatecriteriaare met?Whatcouldyoutellher? ......................................................................continued........................................................................ [Show More]

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