2020 AHIP, 2022 AHIP, AHIP Questions
Mrs. Chou likes a PFFS plan available in her area that does not offer drug coverage. She wants to enroll in
... [Show More] the plan and enroll in a stand-alone prescription drug plan. What should you tell her? - CORRECT ANSWER She could enroll in a PFFS plan and a stand-alone Medicare prescription drug plan.
Mrs. Geisler's neighbor told her she should look at her Part D options during the annual Medicare enrollment period because features of Part D might have changed. Mrs. Geisler can't remember what Part D is so she called you to ask what her neighbor was talking about. What could you tell her? - CORRECT ANSWER Part D covers prescription drugs and she should look at her premiums, formulary and cost-sharing among other factors to see if they have changed.
Mr. Moreno invited his neighbor, Agent Tom Smith, to discuss Medicare Advantage (MA) and Part D plans that Agent Smith sells at the regular Tuesday brunch the neighbors have for senior citizens. What should Agent Smith tell Mr. Moreno about the kinds of food that can be provided to potential enrollees who attend the sales presentation? - CORRECT ANSWER A meal cannot be provided, but light snacks would be permitted.
Mr. Rainey is experiencing paranoid delusions and his physician feels that he should be hospitalized. What should you tell Mr. Rainey (or his representative) about the length of an inpatient psychiatric hospital stay that Medicare will cover? - CORRECT ANSWER Medicare will cover a total of 190 days of inpatient psychiatric care during Mr. Rainey's entire lifetime.
Mr. Bickford did not quite qualify for the extra help low-income subsidy under the Medicare Part D Prescription Drug program and he is wondering if there is any other option he has for obtaining help with his considerable drug costs. What should you tell him? - CORRECT ANSWER He could check with the manufacturers of his medications to see if they offer an assistance program to help people with limited means to obtain the medications they need. Alternately, he could check to see whether his state has a pharmacy assistance program to help him with expenses.
Mr. Wong is a single individual. He has a successful business career and is now able to retire with a comfortable income. Mr. Wong's taxable income is in excess of $80,000. Mr. Wong has health coverage through his employer but will sign-up for Medicare Part A, Part B and Part D when he leaves the workforce. How would you advise him as he budgets for Medicare premiums? - CORRECT ANSWER Due to his participation in the workforce he will not have to pay a premium for Part A but he will pay higher premiums for Part B and Part D due to the amount of his income.
During an appointment scheduled to discuss a Medicare Advantage Prescription Drug plan (MA-PD), Mr. Peters asked his agent to describe a stand-alone prescription drug plan (Part D plan) that his neighbor told him about. What should his agent do? - CORRECT ANSWER Since Mr. Peters requested a description of the Part D plan, his agent must have Mr. Peters sign a new scope of appointment form that includes Part D, and then the agent may discuss the Part D plan so Mr. Peters can compare plans and make an informed enrollment choice during the appointment.
By contacting plans available in your area, you have learned that the plan you represent has a significantly lower monthly premium than the others. Furthermore, you see that the plan you represent has a unique benefit package. What should you do to make sure your clients know about these pieces of information? - CORRECT ANSWER You may make comparisons between plans if you can support them by studies or statistical data and such comparisons are factually based.
Mrs. Fields wants to know whether applying for the Part D low income subsidy will be worth the time to fill out the paperwork. What could you tell her? - CORRECT ANSWER The Part D low income subsidy could substantially lower her overall costs. She can apply by contacting her state Medicaid office or calling the Social Security Administration.
Mr. Decaro has looked a Medicare prescription drug plans available in his area and noted a wide range in premiums. He thought that all drug plans were required to offer the same standard benefits and would like you to explain why there is such a range in premiums. What should you tell him? - CORRECT ANSWER Some prescription drug plans may have higher operating costs and/or may offer enhanced coverage in return for an additional premium amount. He could look at plan designs to see if one of the enhanced plans would serve his needs better than a plan based on the standard design.
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 5 she comes to you for advise 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 five-star plan.
Mr. Landry is approaching his 65th birthday. He has signed up for Medicare Part A, but he did not enroll in Part B because he has employer-sponsored coverage and intends to keep working for several more years. But he is considering enrolling in Part D prescription drug coverage because he believes it is superior to his employer plan. How would you advise him? - CORRECT ANSWER Mr. Landry is eligible for Part D since he has Part A, and his initial enrollment period (IEP) for Part D will continue for three months after his 65th birthday.
Ms. Gates is dually eligible for Medicare and Medicaid. She is very concerned about being locked into a specific Medicare prescription drug plan for the entire year. what should you tell her? - CORRECT ANSWER Individuals who are enrolled in Medicaid can change their Part D plans throughout the year, so if she is not satisfied with her prescription drug plan, she can change to a different Part D plan. (NOTE: On the AHIP test this is the best answer. However, She can change once per quarter for the first 9 months of the year)
You are visiting with Mr. Tully and his daughter at her request. He has advanced Alzheimer's and is incapable of understanding the implications of choosing a Medicare Advantage or prescription drug plan. Can his daughter fill out the enrollment form and sign it for him? - CORRECT ANSWER Mr. Tully's daughter can do so only if she is authorized under state law as a court-appointed legal guardian, has a durable power of attorney for health care decisions, or is authorized under state surrogate consent laws to make health decisions.
Which of the following steps may a Part D sponsor adopt for beneficiaries who are at risk of misusing or abusing frequently abused drugs? [Show Less]