Test100%
Corect
AgentGaryfromFlorida-
TEST2sentmehisAHIP2020TestQuestionsandAnswers.
AtachedismyAHIPFinalExam–Igota98%
onithefirstime.RealizethatIhavebendoingtheseAHIPe
xams
since2010andMedicareismyprimarybusines.Iamsurpri
sedIgotanywrong.Notsurewhichansweris
incorect.Sincerely,AgentGary
(IbelievethatIfoundthewronganswer-pleasecomment)-
PatyandSusanfoundthewronganswer-al50
questionsarenowansweredcorectly.
Question1.
Ms.Gibsonrecentlylostheremployergroupheal
thanddrugcoverageandnowshewantstoenroll
inaPOthatdoesnotincludedrugcoverage.Whats
houldyoutellheraboutobtainingdrug
a
coverage?
.
ShecanenrollinthePO,butshewillnotbeab
letopurchaseastand-aloneMedicarePartD
prescriptiondrugplan-Corect.
b.b.ShecanenrollinthePOandpurchasedrugc
overagethroughastand-aloneMedicarePart
Dprescriptiondrugplan.
c.c.ShecanenrollinthePOandpurchasedrugco
veragethroughaMedigapplan.
d.d.ShecanenrollinthePOandifshedecidesth
atshewantsdrugcoverage,shewillbeable
todropherPOatanytimeinfavorofaMedicare
Advantageplanthatincludesuchdrug
coverage
Question2.
Mr.ColehasbenaMedicaidbeneficiaryforsome
time,andrecentlyqualifiedforMedicareas
well.Heisconcernedaboutchangesinhiscost-
sharing.Whatshouldyoutellhim?
a.Medicaidwillcoverhiscost-
sharing,regardlesofromwhichphysicianorh
ospitalhereceives hisMedicare-
coveredservices.
b.HeshouldknowthatMedicaidwillpaycostsha
,ringonlyforservicesprovidedbyMedicaid
participatingproviders-Corect.
c.ForMedicaidbeneficiaries,Medicarereduce
sitscost-
sharingamountstomatchthosechargedby
thestateMedicaidprogramsotherewillbenoch
angeinhiscost-
sharingamounts.d.Medicaidwill
nolongerpayanycostsharingonceheiseligibl
eforMedicare,sohewillnedtorelyonlyon
Medicareproviders
Question3.
Youhavedecidedtofocusondoingin-
homepresentationstomarketheMedicareAdvant
age(MA)
a
plansyourepresent.Beforeyouconductsuchsal
.
espresentations,whatmustyoudo?
Youmustreceiveaninvitationfromthebe
neficiaryanddocumenthespecifictypesof
productsthebeneficiarywantstodiscusp
riortomakinganin-homepresentation.
b.b.Thereisnospecialactionthatyoumustake
.Iftheychoose,youmaygotoanindividual’s
housetoprovidepresentationsandofferasist
ancewithenrollinginaplan.
c.c.YoumustfirstcontactheMedicareagencyto
ensurethatheindividualisactuallya
Medicarebeneficiary.
d.d.Aproperintroductionathedoorthatinclu
desadisclaimeregardingyourelationship
withtheplanyourepresentistheonlyrequir
edactionyoumustake,priortoenteringthe
, beneficiary’shome.
Question4.
Mr.RiverahasQualifiedMedicareBeneficiary(QM
B)eligibilityandisthuscoveredbyboth
MedicareandMedicaid.HedecidestoenrollinaM
edicareAdvantage(MA)POplan.Laterhe
sesanout-of-
networkdoctortoreceiveaMedicarecoveredser
vice.Howmuchmaythedoctor
collectfromMr.Rivera?
a.Thedoctormayonlycollectheamountallowabl
.
eunderMedicareplus25percentbalancebilling.
b.Thedoctormayonlycollectheamountallowabl
eunderMedicareAdvantage(MA)POplan
costsharingfornon-QMBenrolles.
c.Thedoctormayonlycollectheamountallowabl
eunderMedicareplus15percentbalancebilling
.
dThedoctormayonlycollectfromMr.Riverathec
ostsharingallowableunderthestate’s
Medicaidprogram
Question5
BMrs.ShieldsiscoveredbyOriginalMedicare.
Shesustainedahipfractureandisbeing
sucesfulytreatedforthatcondition.Howeve
r,sheandherphysiciansfelthatafterherlen
gthy
hospitalstayshewillnedamonthortwoofnurs
ingandrehabilitativecare.Whatshouldyout
ell
themaboutOriginalMedicare’scoverageofca
reinaskillednursingfacility?
a.Onceshehasexpendedherliquidasets,Medic
arewillcover80% ofMrs.Shields'long-term
carecosts.
b.b.Medicarewillcoveranunlimitednumberof
daysinaskilled-
nursingfacility,aslongasa
physiciancertifiesthatsuchcareisneded.
c.c.Mrs.ShieldswillhavetoapplyforMedicai
dtohaveherskillednursingservicescovered
.becauseMedicaredoesnotprovidesuchabenef
t.
, d
d.MedicarewillcoverMrs.Shields'skilledn
ursingservicesprovidedduringthefirst20da
ys
ofherstay,afterwhichshewouldhaveacoinsu
ranceuntilshehasbeninthefacilityfor100
days
Question6.
Youareworkingwithanumberofplansandcommuni
tyorganizationstosponsoraneducational
event.Whenputingtogetheradvertisementsfor
thisevent,whatshouldyoudo?
a.Youmustensurethatheadvertisementsindica
teitisaneducationalevent,otherwiseitwillbe
consideredamarketingevent.
b.Plansmaynotparticipateinadvertisingsuch
anevent.Alladvertisingmustbedoneby
communityorganizations.
c.Youmuststateintheadvertisementhatitwill
beaneducationaleventandthatheeducationwill
consistofspecificinformationabouthepartici
patingplans.
d.Youmustonlyensurethatheadvertisementisf
actuallyacurate.
Question7.
YouarevisitingwithMr.Tullyandhisdaughter
atherequest.HehasadvancedAlzheimer’sandi
s
incapableofunderstandingtheimplicationsof
choosingaMedicareAdvantageorprescription
drug
plan.Canhisdaughterfilloutheenrolmentform
andsignitforhim?
Corect
AgentGaryfromFlorida-
TEST2sentmehisAHIP2020TestQuestionsandAnswers.
AtachedismyAHIPFinalExam–Igota98%
onithefirstime.RealizethatIhavebendoingtheseAHIPe
xams
since2010andMedicareismyprimarybusines.Iamsurpri
sedIgotanywrong.Notsurewhichansweris
incorect.Sincerely,AgentGary
(IbelievethatIfoundthewronganswer-pleasecomment)-
PatyandSusanfoundthewronganswer-al50
questionsarenowansweredcorectly.
Question1.
Ms.Gibsonrecentlylostheremployergroupheal
thanddrugcoverageandnowshewantstoenroll
inaPOthatdoesnotincludedrugcoverage.Whats
houldyoutellheraboutobtainingdrug
a
coverage?
.
ShecanenrollinthePO,butshewillnotbeab
letopurchaseastand-aloneMedicarePartD
prescriptiondrugplan-Corect.
b.b.ShecanenrollinthePOandpurchasedrugc
overagethroughastand-aloneMedicarePart
Dprescriptiondrugplan.
c.c.ShecanenrollinthePOandpurchasedrugco
veragethroughaMedigapplan.
d.d.ShecanenrollinthePOandifshedecidesth
atshewantsdrugcoverage,shewillbeable
todropherPOatanytimeinfavorofaMedicare
Advantageplanthatincludesuchdrug
coverage
Question2.
Mr.ColehasbenaMedicaidbeneficiaryforsome
time,andrecentlyqualifiedforMedicareas
well.Heisconcernedaboutchangesinhiscost-
sharing.Whatshouldyoutellhim?
a.Medicaidwillcoverhiscost-
sharing,regardlesofromwhichphysicianorh
ospitalhereceives hisMedicare-
coveredservices.
b.HeshouldknowthatMedicaidwillpaycostsha
,ringonlyforservicesprovidedbyMedicaid
participatingproviders-Corect.
c.ForMedicaidbeneficiaries,Medicarereduce
sitscost-
sharingamountstomatchthosechargedby
thestateMedicaidprogramsotherewillbenoch
angeinhiscost-
sharingamounts.d.Medicaidwill
nolongerpayanycostsharingonceheiseligibl
eforMedicare,sohewillnedtorelyonlyon
Medicareproviders
Question3.
Youhavedecidedtofocusondoingin-
homepresentationstomarketheMedicareAdvant
age(MA)
a
plansyourepresent.Beforeyouconductsuchsal
.
espresentations,whatmustyoudo?
Youmustreceiveaninvitationfromthebe
neficiaryanddocumenthespecifictypesof
productsthebeneficiarywantstodiscusp
riortomakinganin-homepresentation.
b.b.Thereisnospecialactionthatyoumustake
.Iftheychoose,youmaygotoanindividual’s
housetoprovidepresentationsandofferasist
ancewithenrollinginaplan.
c.c.YoumustfirstcontactheMedicareagencyto
ensurethatheindividualisactuallya
Medicarebeneficiary.
d.d.Aproperintroductionathedoorthatinclu
desadisclaimeregardingyourelationship
withtheplanyourepresentistheonlyrequir
edactionyoumustake,priortoenteringthe
, beneficiary’shome.
Question4.
Mr.RiverahasQualifiedMedicareBeneficiary(QM
B)eligibilityandisthuscoveredbyboth
MedicareandMedicaid.HedecidestoenrollinaM
edicareAdvantage(MA)POplan.Laterhe
sesanout-of-
networkdoctortoreceiveaMedicarecoveredser
vice.Howmuchmaythedoctor
collectfromMr.Rivera?
a.Thedoctormayonlycollectheamountallowabl
.
eunderMedicareplus25percentbalancebilling.
b.Thedoctormayonlycollectheamountallowabl
eunderMedicareAdvantage(MA)POplan
costsharingfornon-QMBenrolles.
c.Thedoctormayonlycollectheamountallowabl
eunderMedicareplus15percentbalancebilling
.
dThedoctormayonlycollectfromMr.Riverathec
ostsharingallowableunderthestate’s
Medicaidprogram
Question5
BMrs.ShieldsiscoveredbyOriginalMedicare.
Shesustainedahipfractureandisbeing
sucesfulytreatedforthatcondition.Howeve
r,sheandherphysiciansfelthatafterherlen
gthy
hospitalstayshewillnedamonthortwoofnurs
ingandrehabilitativecare.Whatshouldyout
ell
themaboutOriginalMedicare’scoverageofca
reinaskillednursingfacility?
a.Onceshehasexpendedherliquidasets,Medic
arewillcover80% ofMrs.Shields'long-term
carecosts.
b.b.Medicarewillcoveranunlimitednumberof
daysinaskilled-
nursingfacility,aslongasa
physiciancertifiesthatsuchcareisneded.
c.c.Mrs.ShieldswillhavetoapplyforMedicai
dtohaveherskillednursingservicescovered
.becauseMedicaredoesnotprovidesuchabenef
t.
, d
d.MedicarewillcoverMrs.Shields'skilledn
ursingservicesprovidedduringthefirst20da
ys
ofherstay,afterwhichshewouldhaveacoinsu
ranceuntilshehasbeninthefacilityfor100
days
Question6.
Youareworkingwithanumberofplansandcommuni
tyorganizationstosponsoraneducational
event.Whenputingtogetheradvertisementsfor
thisevent,whatshouldyoudo?
a.Youmustensurethatheadvertisementsindica
teitisaneducationalevent,otherwiseitwillbe
consideredamarketingevent.
b.Plansmaynotparticipateinadvertisingsuch
anevent.Alladvertisingmustbedoneby
communityorganizations.
c.Youmuststateintheadvertisementhatitwill
beaneducationaleventandthatheeducationwill
consistofspecificinformationabouthepartici
patingplans.
d.Youmustonlyensurethatheadvertisementisf
actuallyacurate.
Question7.
YouarevisitingwithMr.Tullyandhisdaughter
atherequest.HehasadvancedAlzheimer’sandi
s
incapableofunderstandingtheimplicationsof
choosingaMedicareAdvantageorprescription
drug
plan.Canhisdaughterfilloutheenrolmentform
andsignitforhim?
