The value proposition for the AARP brand is seen in what kinds of benefits for the members? (Select 3) - ANSWER-Quality of products offered.
Efforts to
... [Show More] improve the lives of members.
Security and reputation of the AARP name.
Which of the following must you ensure a consumer who is making a plan change understands? (Select 2) - ANSWER-I must make sure the consumer understands the benefits, costs, and limitations of the new plan
I must make sure the consumer understands what they are giving up by enrolling in the new plan I'm recommending
Which of the following consumers are eligible for Medicare if other eligibility requirements are met? - ANSWER-Consumers age 65 or older, consumers under 65 years of age with certain disabilities for more than 24 months and consumers of all ages with ESRD or ALS
Which of the following best describes a "like" plan change? - ANSWER-When a consumer enrolls in a plan that is of the same type as their current plan, such as any medicare advantage plan to any other medicare advantage plan
which of the following is not true about UnitedHealth Care Medicare plans carrying the AARP name? - ANSWER-AARP endorses UnitedHealth Care MA, PDP, and Medicare supplement plans
AARP expects agents offering AARP-branded products to demonstrate 5 key behaviors when interacting with customers. AARP wants customers we work with to feel their relationship with AARP is _________________ - ANSWER-Effortless and inspiring
Which of the following are part of being straightforward when servicing a customer? - ANSWER-Communicating clearly to alleviate any confusion
Being upfront about what information means
providing the right information
Do consumers have to be an AARP member to enroll in an AARP-branded plan with UnitedHealth Care? - ANSWER-yes, if the consumer is enrolling in a medicare supplement plan
How many status levels are in the Authorized to offer program? - ANSWER-2
which of the following statements about AARP are true? (select 2) - ANSWER-The AARP motto is to serve, not be served
AARP advocates for the 50+ population in congress for legislation to lower medical costs
which of the following is true about the production requirement for the authorized to offer Elite status? - ANSWER-Each calendar year, agents need to have at least 30 commission-eligible, accepted, and paid AARP medicare supplement plan and / or medicare select plan sales or retain a book of business of 150 or more active members
The value proposition for the AARP brand is seen in what kinds of benefits for the members (select 3)? - ANSWER-ensuring products are well below the going market rate
efforts to improve the lives of members
quality of products offered
Which AARP brand medicare products does UnitedHealth Care offer? (select 3) - ANSWER-Prescription drug plans
medicare advantage plans
mediare supplement plans
The 3 types of special needs plans are - ANSWER-dual, chronic condition and institutional / institutional-equivalent.
When does the special election period for dual / LIS change in status begin for D-SNP members that lose medicaid eligibility? - ANSWER-Upon notification or effective date of the loss, whichever is earlier
which statement describes the primary characteristic of a consumer who may benefit from a D-SNP? - ANSWER-Is enrolled in their state Medicaid program, typically as a full dual, with their Medicare cost sharing paid by the state in which they reside.
which program is available to support the unique health care needs of C-SNP and D-SNP members? - ANSWER-A care management program that varies depending upon the level of the member's health risk level
which statement is true about C-SNPs, D-SNPs, and prescription drug coverage? - ANSWER-C-SNPs and D-SNPs include Medicare part D prescriptions drug coverage.
when selling D-SNPs, agent must: - ANSWER-confirm the customer's medicaid level and that the consumer is entitled to Medicare part A and enrolled in part B
The consumer states they currently pay a percentage of charges when they receive medical care. This means - ANSWER-The consumer is not likely to be a full dual-eligible and may be better suited for enrollment in another type of plan
which of the following consumer characteristics demonstrates a good fit for a C-SNP? - ANSWER-A consumer with a qualifying chronic condition who wants a plan that will help them manage their illness and health care costs
On May 10, Michael meets with an agent and says he is enrolled in another carrier's C-SNP due to his diabetes. When can Michael enroll in a different C-SNP that also covers diabetes (his only chronic condition), assuming he has not moved out of his current plan's service area? - ANSWER-During the annual election period (AEP) or open enrollment period (OEP)
which service will a C-SNP or D-SNP member in the high risk care management category receive? - ANSWER-Case management ( telephonic, digital and / or face to face) according to individual needs
it is very important for consumers enrolling in a C-SNP to know the following about accessing providers: - ANSWER-some C-SNP are preferred provider organization (PPO) or point service (POS) plans that allow members to see out of network providers for covered services, generally with higher cost sharing.
which statement is true about the Medicaid program? - ANSWER-It helps pay medical costs for certain groups of people with limited income and resources.
Ginny just enrolled in a C-SNP that uses the post-enrollment verification method. When will the plan send her a termination notification letter if it has not yet been able to verify a qualifying chronic condition - ANSWER-at the end of her second month of enrollment
member who lose their eligibility for the D-SNP due to a change or loss of Medicaid status are responsible for what cost sharing? - ANSWER-All, such as premiums, deductibles, copayments, and coininsurance.
which statement is true of D-SNP members? - ANSWER-Members who are QMB+ or are full dual eligible are not required to pay copayments for medicare-covered services obtained from a D-SNP in-network provider. Their provider should bill the state Medicaid program, as appropriate, for these costs
Inez, a consumer, called the number on a piece of mail she received during the Annual Election Period. When you answer, you can hear a lot of background noise. What actions should you take to help ensure Inez will understand the information you share with her? (select 3) - ANSWER-Ask her to either move into another room or turn off the TV to help her hear me clearly and without distraction
Ask if someone assists her with making enrollment decisions and make sure that person is present to participate in the call
Speak clearly, at an appropriate volume, and at a moderate pace.
Which of the items listed are examples of Fraud, Waste, and Abuse (FWA)? (Select 3) - ANSWER-Submitting claims for services or supplies that were never provided.
Billing for brand name drugs when generics were dispensed.
Consulting with a number of doctors in order to obtain multiple prescriptions for the same drug.
Name the abbreviation: PA - ANSWER-physician assistant
What is a physician's assistant licensed to do? - ANSWER-practice medicine with physician supervision
T/F: Physicians assistants can prescribe CII medications without physician authorization - ANSWER-false
Name the abbreviation: RA - ANSWER-radiologist assistant
What is a radiologist assistant? - ANSWER-an advanced level radiologic technologist who extends the capacity of the radiologist
Name the abbreviation: OT - ANSWER-occupational therapist
What is an occupational therapist? - ANSWER-a professional who treats injured, ill, or disabled patients through the therapeutic use of everyday activities to improve their daily life
Name the abbreviation: APRN - ANSWER-advanced practice registered nurse
What is required to become an APRN - ANSWER-a few years of experience and a nursing graduate degree
T/F: APRNs cannot specialize - ANSWER-false
Name the abbreviation: NP - ANSWER-nurse practitioner
Name the abbreviation: ACNP - ANSWER-acute pediatric care nurse practitioner
Name the abbreviation: ACNPCAG - ANSWER-adult gerontology acute care nurse practitioner
Name the abbreviation: CNM - ANSWER-certified nurse midwife
Name the abbreviation: CRNA - ANSWER-certified registered nurse anesthetists
Name the abbreviation: CNS - ANSWER-certified nurse specialist
Name the abbreviation: RT - ANSWER-respiratory therapist
what is the purpose of a needs assessment - ANSWER-To gather as much information about the consumer as possible to ensure I am recommending the plan that is the best fit for the consumer
What is the purpose of a respiratory therapist? - ANSWER-to diagnose lung and breathing disorders, recommend treatments, and manage ventilators/ artificial airway devices
Name the abbreviation: MD - ANSWER-Doctor of Medicine
What does a Doctor of Medicine do? - ANSWER-someone who diagnosis, treats, and performs surgery
T/F: MDs cannot specialize - ANSWER-false
What is an allopathic physician? - ANSWER-one that diagnoses or treats with medication or surgery
Name the abbreviation: DO - ANSWER-doctor of osteopathic medicine
What does a doctor of osteopathic medicine do? - ANSWER-diagnose/ treat patieitns and perform surgery
T/F: DOs can specialize - ANSWER-true
What is an osteopathic physician? - ANSWER-one that regards the body as an integrated whole rather than treating for specific symptoms only
Name the abbreviation: DC - ANSWER-doctor of chiropractic
T/F: Chiropractics is a drug free and non-surgical science - ANSWER-true
T/F: doctors of chiropractic can prescribe medication - ANSWER-false
What is the goal of a doctor of chiropractic? - ANSWER-to adjust the structure of the body to improve function
Name the abbreviation: DDS - ANSWER-Doctor of Dental surgery
T/F: DDS and DMD are the same degree - ANSWER-true
T/F: DDS cannot prescribe medications - ANSWER-false
T/F: DDS can pursue residency training to specialize? - ANSWER-true
Name the abbreviation: DVM - ANSWER-Doctor of Veterinary Medicine
What can a DVM do? - ANSWER-treat, diagnose, and perform surgery
T/F: DVMs can prescribe medications for animals even if it is an off-label use - ANSWER-true
Name the abbreviation: DPM - ANSWER-doctor of podiatric medicine
What does a DPM focus on? - ANSWER-foot, ankle, and related structures of the leg
T/F: a DPM cannot prescribe medication - ANSWER-false
Name the abbreviation: CDE - ANSWER-Certified Diabetes educator
What does a CDE do? - ANSWER-educate on diabetes self management
Name the abbreviation: BCACP - ANSWER-Board Certified Ambulatory Care pharmacist
Name the abbreviation: BCCCP - ANSWER-Board Certified Critical Care Pharmacist
Name the abbreviation: BCNP - ANSWER-Board Certified Nuclear Pharmacist
Name the abbreviation: BCNSP - ANSWER-Board certified nutrition support pharmacist
Name the abbreviation: BCOP - ANSWER-Board certified oncology pharmacist
Name the abbreviation: BCPPS - ANSWER-board certified pediatric pharmacy specialist
Name the abbreviation: BCPP - ANSWER-board certified psychiatric pharmacist
Name the abbreviation: BCIDP - ANSWER-board certified infectious diseases pharmacist
Name the abbreviation: BCCP - ANSWER-board certified cardiology pharmacist
Name the abbreviation: BCGP - ANSWER-Board Certified Geriatric Pharmacist
Name the abbreviation: BCSCP - ANSWER-Board Certified Sterile Compounding Pharmacist
Name the abbreviation: BCTXP - ANSWER-Board Certified Transplant Pharmacist
Name the abbreviation: BCPS - ANSWER-Board Certified Pharmacotherapy Specialist
Educational events allow for which of the following to occur?
Provide objective information about the Medicare program and/or health improvement and wellness.
Provide an opportunity to review benefits, premiums and product information with consumers.
Provide an opportunity to steer a consumer toward a specific or limited number of plans.
Provide an opportunity to give an introductory presentation followed by an informal marketing/sales event. - ANSWER-Provide objective information about the Medicare program and/or health improvement and wellness.
Which of the following describes Permission to Contact guidelines?
It allows the agent to discuss the products identified during the marketing appointment.
It does not have to be provided by the consumer, but can be provided by the consumer's spouse or adult child.
It is method specific, (e.g., telephone, email), short term (i.e., expires when contact is made), and event specific (i.e., limited to the products identified). - ANSWER-It is method specific, (e.g., telephone, email), short term (i.e., expires when contact is made), and event specific (i.e., limited to the products identified).
Janine, currently enrolled in a 3-star plan, discovers there is 5-star plan available where she lives. She asks her agent, Josh, to enroll her in the 5-star plan. Josh can advise Janine of each of the following except: - ANSWER-Josh should tell Janine that she can only change her current plan to a 5 star plan during the Annual Election Period.
Agent Ralph wants to market Medicare Advantage Plans in his neighborhood - an area that consists of single-family houses, an assisted living facility, a church, and public library. Which of the following methods of contact is permitted?
Ralph sends a flyer inviting consumers to a marketing/sales event to each resident via postal mail.
Ralph stands in the lobby of the assisted living facility and hands out to the residents a flyer inviting them to a marketing/sales event.
Ralph puts a flyer inviting consumers to a marketing/sales event on the door of each house.
Ralph puts a flyer inviting consumers to a marketing/sales event on the windshield of each car in the church parking lot on Sunday morning. - ANSWER-Ralph sends a flyer inviting consumers to a marketing/sales event to each resident via postal mail.
An individual with Power of Attorney is an example of what authority?
Permission by the health plan to act on behalf of a consumer or member.
Legal authority under state law to act on behalf of another individual.
Legal authority under federal law to act on behalf of another individual.
Permission by the consumer to act on their behalf. - ANSWER-Legal authority under state law to act on behalf of another individual.
whose email address may the agent enter into the applicant information section of Lean enrollment application - ANSWER-Only the consumer's email
what is the purpose of the statement of understanding for medicare - ANSWER-It ensures that when consumers complete the Medicare Advantage and / or Part D Enrollment application. They are acknowledging their understanding that they are actually enrolling, in which plan they are enrolling, and standard disclosures.
Which of the following is not considered unsolicited contact with a Medicare eligible consumer according to CMS regulations and UnitedHealthcare's rules, policies, and procedures?
Mailing a marketing brochure to the consumer via postal mail.
Emailing a marketing brochure to a consumer whose email address was obtained on a purchased lead list.
Approaching a consumer in a common area of a senior living complex.
Placing a marketing brochure on the door handle of the consumer's residence. - ANSWER-Mailing a marketing brochure to the consumer via postal mail.
Who has the authority to sign an Enrollment Application?
The consumer, the consumer's spouse, or the consumer's adult child.
The consumer or any individual authorized by the consumer.
The consumer only.
The consumer or the consumer's authorized legal representative (e.g., Power of Attorney). - ANSWER-The consumer or the consumer's authorized legal representative (e.g., Power of Attorney).
When marketing UnitedHealthcare Medicare Advantage plans to consumers, which of the following must an agent do?
Review and complete an SOA form with each consumer after a personal/individual (e.g., in-home or telephonic) marketing appointment.
Provide current marketing materials that have been approved by CMS and UnitedHealthcare.
Provide only the information for which the consumer asks.
Review the Summary of Benefits only upon request. - ANSWER-Provide current marketing materials that have been approved by CMS and UnitedHealthcare.
As an agent, you have an obligation to only enroll a consumer in a product:
That provides a financial advantage to a network of providers.
That meets the sales goal of the Centers for Medicare and Medicaid Services, UnitedHealthcare and the Social Security Administration.
That is suitable for the consumer's needs, goals and financial resources.
That meets the interest you have in the transaction, for example commissions received for the sale. - ANSWER-That is suitable for the consumer's needs, goals and financial resources.
What is the purpose of the Statement of Understanding?
It ensures that when consumers sign the Medicare Advantage and/or Part D Enrollment Application, they are acknowledging their understanding that they will continue to receive materials and information at the agent's discretion.
It ensures that when consumers sign the Medicare Advantage and/or Part D Enrollment Application, they are acknowledging their understanding of standard enrollment and disenrollment procedures.
It ensures that when consumers sign the Medicare Advantage and/or Part D Enrollment Application, they are acknowledging their understanding of monthly premiums and deductibles.
It ensures that when consumers sign the Medicare Advantage and/or Part D Enrollment Application, they are acknowledging their understanding that they are actually enrolling, in which plan they are enrolling, and standard disclosures. - ANSWER-It ensures that when consumers sign the Medicare Advantage and/or Part D Enrollment Application, they are acknowledging their understanding that they are actually enrolling, in which plan they are enrolling, and standard disclosures.
What is the definition of Fraud?
Fraud includes inaccurate payments for services, such as unintentional duplicate payments, and can include inappropriate utilization and/or inefficient use of resources.
Fraud includes any practice that results in the provision of services that are not medically necessary.
Fraud is intentionally misrepresenting or concealing facts to obtain something of value. - ANSWER-Fraud is intentionally misrepresenting or concealing facts to obtain something of value.
which of the following are examples of phrases that must not be spoken by an agent when a consumer is contemplating a plan change? (select 2) - ANSWER-everything will be the same
nothing will change
Which of the following best describes why it is important to compare plan options to the consumer's current coverage? - ANSWER-I want to make sure the consumer understands what they give up and what they gain by changing plans.
What are examples of phrases you should avoid using with a consumer when comparing plans? (select 3) - ANSWER-Everything will be the same
I am recommending a plan that will add benefits to your current coverage
nothing will change
What should the consumer understand before they agree to proceed with enrolling in a new plan? (select 3) - ANSWER-Their current plan and the new plan that I am recommending are not the same
if the plan has drug coverage, that the medications they use are on the plan's formulary and, it they are, what tier they are in and any utilization management limitations
If the plan is network-based, that the providers they want to use are in the new plan's network.
Which of the following guidelines must you follow before recommending a plan change - ANSWER-Only recommend a plan that is the best fit plan, which may be the consumer's current plan
Conduct a thorough needs assessment
Do not rely only on and become biased by the consumer's stated reason for calling
Simon is currently enrolled in a Medicare advantage plan. He calls saying he saw an ad on TV that says he can get a plan with dental coverage of $3500 per year. What guidelines must you follow before recommending a new plan to Simon? (select 3) - ANSWER-Do not rely only on and become biased by the consumer's stated reason for calling
conduct a thorough needs assessment to gather comprehensive information related to the consumer's situation and needs
Only recommend a plan that is the best fit plan, which may be the consumer's current plan
Which of the following are components that, at minimum, should be included in a thorough needs assessment (select 3) - ANSWER-Identifying their current providers (including primary care, specialists, hospitals, and pharmacies) and the medications they take
Determining consumer eligibility
learning about their current coverage, lifestyle and financial characteristics
Which of the following are the ways to report potential FWA? (Select 2)
Fraud, Waste and/or Abuse hotline
Local law enforcement
Text message to the member
Producer Help Desk (PHD) - ANSWER-Fraud, Waste and/or Abuse hotline
Producer Help Desk (PHD)
Can a consumer who qualifies for low Income Subsidy receive financial assistance for their part of Medicare Part D costs? - ANSWER-Yes, through subsidies such as lower or no monthly plan premiums and lower or no copayments
What is the amount added to the member's monthly plan..........ect - ANSWER-Late Enrollment Penalty (LEP)
What are two options for Medicare consumers to get Part D prescription drug coverage (Select 2) - ANSWER-Enroll in a Medicare Advantage Plan or other Medicare health plan that incudes prescription coverage
and
Enroll in a stand-alone Medicare Prescription Drug Plan (PDP)
When is Mary's Medicare Supplement Open Enrollment period is she turns 65 on September 23,2021, and her Medicare - ANSWER-September 2021 through February2022
Which of the following are MA Plans that focus on using Network Providers to Maximize the benefits and reduce out-of-network expenses - ANSWER-HMO, POS, PPO
Medications that are covered in a Plan's formulary have various levels - ANSWER-Out of pocket expenses
Which statements true of Medicare Supplement Insurance Plans? - ANSWER-To see a specialist, insured members must obtain referrals from primary care providers.
The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) - ANSWER-TRUE [Show Less]