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AHIP ALREADY GRADED A+
(a) Question: Which of the following statements about
Medicare Part D are correct? I, II, and III only-I. Part D plans must enroll any eligible beneficiary who applies regardless of health status except in limited circumstances.II. Private fee-for-service (PFFS) plans are not required to use a pharmacy network but may choose to have one.III. Beneficiaries enrolled in a MA-Medical Savings Account (MSA) plan may only obtain Part D benefits through a standalone PDP.
Correct answer: I, II, and III only-I. Part D plans must
enroll any eligible beneficiary who applies regardless of health status except in limited circumstances.II. Private fee-for-service (PFFS) plans are not required to use a pharmacy network but may choose to have one.III.Beneficiaries enrolled in a MA-Medical Savings Account (MSA) plan may only obtain Part D benefits through a standalone PDP.
(b) Question: ABC is a Medicare Advantage (MA) plan
sponsor. It would like to use its enrollees' information to market non-health related products such as life insurance
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and annuities. Which statement best describes ABC's obligation to its enrollees regarding marketing such products? b.It must obtain a HIPAA compliant authorization from an enrollee that indicates the plan or plan sponsor may use their information for marketing purposes.
Correct answer: b.It must obtain a HIPAA compliant
authorization from an enrollee that indicates the plan or plan sponsor may use their information for marketing purposes.
Question: Mrs. Park is an elderly retiree. Mrs. Park has a
low fixed income. What could you tell Mrs. Park that might be of assistance?
Correct answer: She should contact her state Medicaid
agency to see if she qualifies forprograms that can help with Medicare costs for which she is responsible.
Question: Madeline Martinez was widowed several years
ago. Her husband worked for many years and contributed into the Medicare system. He also left a substantial estate which provides Madeline with an annual income of
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approximately $130,000. Madeline, who has only worked part-time for the last three years, will soon turn age 65 and hopes to enroll in Original Medicare. She comes to you for advice. What should you tell her?
Correct answer: You should tell Madeline that she will be
able to enroll in Medicare Part A without paying monthly premiums due to her husband's long work record and participation in the Medicare system. You should also tell Madeline that she will pay Part B premiums at more than the standard lowest rate but less than the highest rate due her substantial income.
Question: 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?
Correct answer: After receiving such disability payments
for 24 months, he will be automatically enrolled in Medicare, regardless of age.
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Question: 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?
Correct answer: 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 Medicare.
Question: Mrs. Peňa is 66 years old, has coverage under
an employer plan, and will retire next year. She heard she must enroll in Part B at the beginning of the year to ensure no gap in coverage. What can you tell her?
Correct answer: She may enroll at any time while she is
covered under her employer plan, but she will have a special eight month enrollment period that differs from the standard general enrollment period, during which she may enroll in Medicare Part B.
Question: Agent John Miller is meeting with Jerry Smith,
a new prospect. Jerry is currently enrolled in Medicare Parts A and B. Jerry has also purchased a Medicare