Ahip Questions - 2023 Ahip Exam Q&A

The information contained within ACT will equip brokers/agents to certify, market, and sell which health plans? On her scope of appointment form, she asked to discuss Medicare Advantage plans. The following is a characteristic of consumers for whom a C-SNP may be most appropriate: Question #324. Had enrollment/disenrollment issues (e. g., disenrollment/cancellation requests, late enrollment penalty, loss of entitlement). Her husband worked full-time throughout his long career. What should you tell Mrs. Quinn? Recently, Mrs. Garcia has completed an enrollment application for a plan offered by Caring Health, which is waiting for a reply from CMS indicating whether or not Mrs. Garcia's enrollment has been accepted. That are not on her Part D plan's formulary. He may sign up for Medicare at any time however coverage usually begins on the fourth month after dialysis treatments start Mr. Xi will soon turn age 65 and has come to you for advice as to what services are provided under Original Medicare. A broker/agent may be terminated for cause if they fail to comply with a compliance investigation, encourage others to avoid the compliance interview process, or fail to provide truthful or complete information. Ms. Bushman has two homes in different states and is concerned about restrictions on where she can get her medications. She has heard that to qualify for Medicare Part A she has to have worked and paid Medicare taxes for a sufficient time. Mr. Lombardi is interested in a Medicare Advantage (MA) PPO.

• Mr. lombardi is interested in a medicare advantage
• Mr. lombardi is interested in a medicare avantage concurrentiel
• Mr. lombardi is interested in a medicare advantage (ma) ppo plan
• Mr. lombardi is interested in a medicare advantage program
• Mr. lombardi is interested in a medicare advantage plan
• Mr. lombardi is interested in a medicare advantage work

Mr. Lombardi Is Interested In A Medicare Advantage

Mrs. Radford asks whether there are any special eligibility requirements for Medicare Advantage. You are in charge of paying claims submitted by providers. Mr. Barker had surgery recently and expected that he would have certain services and items covered by the plan with minimal out-of-pocket costs because his MA-PD coverage has been very good. In mid-January of the following year, she wants to switch back to Original Medicare and enroll in a stand-alone prescription drug plan. One plans on giving door. Which of the following defines a Medicare Advantage (MA) Plan? You are seeking to represent an individual Medicare Advantage plan and an individual Part D plan in your state. Ms. Tranchida has some cognitive. He is not eligible to enroll in a Medicare Advantage plan until he re-enrolls in Medicare Part B (W) Mrs. Billings have in regard to her MA plan during the next open enrollment season? The MSA plan does not offer prescription drug coverage, so Agent Roderick also enrolls Mrs. Martinez in a standalone prescription drug plan (PDP). Which of the following statements best describes how business reply cards (BRCs) may be employed in the marketing of Medicare Advantage products?

Mr. Lombardi Is Interested In A Medicare Avantage Concurrentiel

Mr. Wingate is a newly enrolled Medicare Part D beneficiary and one of your clients. A D-SNP member loses his eligibility due to a change or loss of Medicaid status. What is the purpose of the Statement of Understanding? Key areas you as a broker/agent have control over and impact upon regarding Star Ratings for quality are: a. Which of the following can she not do during the ICEP? What statement best describes the marketing and compliance rules that apply to Agent Armstrong? She doesn't think the calculations are correct because her out of pocket expenses would be lower than last year. On July 19, each of the following consumers met with an agent. Impairment and her son informs you that he has power of attorney to make. What should you keep in mind to comply with the marketing requirements for MA plans? He has been covered under Original Medicare but would like to know if he can enroll in a Medicare Advantage plan. She is leaving for vacation in two weeks and wants to know if her new coverage will start before she leaves. Wellcare's quality focus consists of six drivers.

Mr. Lombardi Is Interested In A Medicare Advantage (Ma) Ppo Plan

Mr. Lombardi Is Interested In A Medicare Advantage Program

You should plan to ensure that the educational event is an informative event and must not conduct a sales presentation or distribute or accept enrollment forms at the event. Agent Willis believes that the choices they made are not ideal for them and would like to get their business back during the Medicare Advantage Open Enrollment Period (MA-OEP). She currently is enrolled in Original Medicare Parts A and B but has heard about a Medicare Advantage plan offered by Senior Health from a neighbor. How could you address her concern. All PDPs will continue to offer $0 tier 1 preferred cost-sharing through CVS Medication Home Delivery (Mail Order). Mrs. Quinn recently turned 66 and decided after many years of work to begin receiving Social Security benefits. Mrs. Reynolds just signed up for a Medicare Advantage plan on the second of the month. Will gaining eligibility for this program affect her ability to enroll in a Medicare Advantage or Medicare Prescription Drug plan? Anita's older neighbor Mel has told her about the Medigap Plan F in which he is enrolled. An educational event may not include a sales presentation.

Mr. Lombardi Is Interested In A Medicare Advantage Plan

A Medicare beneficiary has walked into your office and requested that you sit down with her and discuss her options under the Medicare Advantage program. However, she wants to disenroll from the MA-PD plan and instead enroll in a Part D only plan and go back to Original Medicare. Under ACA Section 1557, a health plan. Mrs. Ramos is considering a Medicare Advantage PPO and has questions about which providers she can go to for her health care. Mr. Lynn, an agent for Acme Insurance, Inc. thinks that, since state laws are preempted concerning the marketing of Medicare health plans, he doesn't have much to worry about. Typically the Special election period is beneficiary specific and results from events, such as when the beneficiary moves outside of the service area.

Mr. Lombardi Is Interested In A Medicare Advantage Work

In general, he must select a single Part D premium payment mechanism that will be used throughout the year. He is entitled to premium free Part A and thinking of enrolling in Part B and switching to an MA-PD because he is paying a very large part of his group coverage premium and it does not provide coverage for a number of his medications. Mary Rodgers sees Dr. Brennan for treatment. Docmerit is super useful, because you study and make money at the same time! You respond to such a statement? Mr. Lopez has heard that he can sign up for a product called "Medicare Advantage" but is not sure about what type of plan designs are available through this program. Bribes or kickbacks of any kind for services that are paid under a Federal health care program (which includes Medicare) constitute fraud by the person making as well as the person receiving them.

Medicare Advantage (MA) organization must disenroll a member from an MA plan in which situation? Events are designed to inform the people that attend about Medicare Advantage, Prescription Drug, or other Medicare programs without going into the specifics of a particular carrier. Ordinarily, you obtain referrals from a third party that initiates contact with potential clients and usually sets up appts. Later in the year, Mr. Rivera needs dentures, a service only covered under Medicaid. His current plan is suitable for his medical needs, but he would like to add prescription drug coverage only. Mr. Chen is enrolled in his employer's group health plan and will be retiring soon.

An individual materially misrepresents information to a PDP sponsor regarding reimbursement for third-party coverage. Which one of the following would count? Received incorrect plan benefit information or were dissatisfied with plan benefits. Term/Date||AHIP Medicare Certification|. He doesn't know what he should do. Smallcap has a workforce of 15 employees and offers employer-sponsored healthcare coverage. It is now the beginning of September.

Mrs. Johnson calls to tell you she has not received her new plan ID card yet, but she needs to see a doctor. Under the rules applicable to. Original Medicare and would like to know which of the following services. B. I, II, and III only Correct [Show Less]. How much may the doctor collect from Mr. Rivera? For catastrophic coverage. Medicare Star Ratings and performance are at the forefront of Wellcare's quality strategy. He would like to enroll in a Medicare Part D prescription drug plan but is concerned that he will have to sign up for Part B as well in order to qualify for enrollment in a Part D plan. She comes to you for advice about when she can enroll in a plan you have previously discussed. February 14 of each year. Secret Shop Finding. Under ACA Section 1557, a health plan premium sold through a state exchange may, based on an individual's age, Question #363. What could you say to her? He has limited financial resources but failed to qualify for the Part D low-income subsidy.

Denise is an independent agent who markets to different types of groups. Health plans you market, and modify it to include information about preventive. In the MA-only PPO plan and a stand-alone prescription drug plan. What are some of the penalties for violating fraud, waste, and abuse (FWA) laws? How should you respond? Which of these statements is true about the drug utilization management (UM) rules? On January 15 she comes to you for advice as to what options, if any, she has.