AHIP 2020 Final Exam Questions And Answers/ 100%
Correct.
Mr. Davies is turning 65 next month. He would like to enroll in a Medicare
health plan, but
... [Show More] 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? Correct 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 nonnetwork providers and pay cost-sharing due under Original Medicare.
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. Correct 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.
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? Correct
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. [Show Less]