AHIP MEDICARE TRAINING EXAM 2021 WITH COMPLETE SOLUTIONS
Mr. Moreno invited his neighbor, Agent Tom Smith, to discuss Medicare Advantage (MA) and
Part
... [Show More] D plans that Agent Smith sells at the regular Tuesday brunch the neighbors have for
senior citizens. What should Agent Tom Smith tell Mr. Moreno about the kinds of food that
can be provided to potential enrollees who attend the sales presentation? - A meal cannot
be provided, but light snacks would be permitted.
Ms. Levi is considering enrollment in a Medicare Advantage HMO plan offered in her area. Ms.
Levi often travels to visit relatives and is concerned that she may need emergency care
outside of her plan's service area. What should you tell her about coverage of emergency
care? - Plans are required to cover out-of-network emergency care.
Mr. Albert has heard about something called the Star Rating system for Medicare Advantage
plans. He asks you to explain it to him since he is interested in enrolling in a plan that is
newly available in his area. After you explain that it is the way for consumers to judge plan
performance, what else would you say? - New plans and Part D sponsors that do not have
any Star Rating are not required to provide Star Rating information until the next contract
year.
Ms. Lewis understands that Medicare prescription drug plans may use various methods to
control the use of specific drugs. She has heard about a technique called "step therapy" and
is wondering if you can explain what that is. What should you tell her? - Step therapy
involves using one or more lower priced drugs before trying a more expensive drug when all
are used to treat the same condition.
You have decided to focus on doing in-home presentations to market the Medicare
Advantage (MA) plans you represent. Before you conduct such sales presentations, what
must you do? -You must receive an invitation from the beneficiary and document the
specific types of products the beneficiary wants to discuss prior to making an in-home
presentation.
Ms. Jensen has heard about "Original Fee-for-Service Medicare" and "Private Fee-forService" plans. She wants to know what the difference is if any. What should you tell her? -
PFFS plans are a type of Medicare Advantage plan offered by private companies.
This year you decide to focus your efforts on marketing to employer and union groups.
Which of the following statements best describes what you can and cannot do in order to
stay in compliance? -You are not required to submit communication and marketing
materials specific only to those employer plans to CMS at the time of use, but CMS may
request and review copies if employee complaints occur.
Agent Suma has recently had several clients request his assistance in completing their
paper enrollment form. What advice would you give him? - Agent Suma is only permitted to
fill out the applicant's name and contact information. The applicant must fill in the remaining
information in order to protect his or her privacy.
Mrs. Quinn recently turned 66 and decided after many years of work to begin receiving
Social Security benefits. Shortly thereafter Mrs. Quinn received a letter informing her that
she has been automatically enrolled in Medicare Part B. She wants to understand what this
means. What should you tell Mrs. Quinn? - Part B primarily covers physician services. She
will be paying a monthly premium and, with the exception of many preventive and screening
tests, generally will have 20% coinsurance for these services, in addition to an annual
deductible.
Mrs. Turner is comparing her employer's retiree insurance to Original Medicare and would
like to know which of the following services Original Medicare will cover if the appropriate
criteria are met? What could you tell her? - Original Medicare covers ambulance services.
Mr. Diaz continued working with his company and was insured under his employer's group
plan until he reached age 68. He has heard that there is a premium penalty for those who
did not sign up for Part B when first eligible and wants to know how much he will have to pay.
What should you tell him? - Mr. Diaz will not pay any penalty because he had continuous
coverage under his employer's plan.
Anita Magri will turn age 65 in August 2020. Anita intends to enroll in Original Medicare Part
A and Part B. She would also like to enroll in a Medicare Supplement (Medigap) plan. Anita's
older neighbor Mel has told her about the Medigap Part F plan in which he is enrolled. It not
only provides foreign travel emergency benefits but also covers his Medicare Part B
deductible. Anita comes to you for advice. What should you tell her -You are sorry to
disappoint Anita but a Medigap Part F plan is no longer available to those who turn age 65
after January 1,2020. Anita might instead consider other Medigap plans that offer foreign
travel benefits but do not cover the Part B deductible.
Mr. Moy's wife has a Medicare Advantage plan, but he wants to understand what coverage
Medicare Supplemental Insurance provides since his health care needs are different from
his wife's needs. What could you tell Mr. Moy? - Medicare Supplemental Insurance would help
cover his Part A and Part B cost sharing in Original Fee-for-Service (FFS) Medicare as well
as possibly some services that Medicare does not cover.
Mr. Bauer is 49 years old, but eighteen months ago he was declared disabled by the Social
Security Administration and has been receiving disability payments. He is wondering
whether he can obtain coverage under Medicare. What should you tell him? - After receiving
such disability payments for 24 months, he will be automatically enrolled in Medicare,
regardless of age.
Mr. Schmidt would like to plan for retirement and has asked you what is covered under
Original Fee-for-Service (FFS) Medicare? What could you tell him? - Part A, which covers
hospital, skilled nursing facility, hospice, and home health services and Part B, which covers
professional services such as those provided by a doctor are covered under Original
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