AHIP Module 5 Questions And Answers 2022
Mrs. Walters is entitled to Part A and has medical coverage without drug
coverage through an employer retiree plan. She is not enrolled in Part B.
Since the employer plan does not cover prescription drugs, she wants to
enroll in a Medicare prescription drug plan. Will she be able to? - Answer - c.
Yes. Mrs. Walters must be entitled to Part A or enrolled in Part B to be eligible
for coverage under the Medicare prescription drug program. Correct
Mr. Sanchez is entitled to Part A, but has not enrolled in Part B because he
has coverage through an employer plan. If he wants to enroll in a Medicare
Advantage plan, what will he have to do? - Answer - c. He will have to enroll
in Part B. Correct
Mr. Kelly wants to know whether he is eligible to sign up for a Private fee-for-
service (PFFS) plan. What questions would you need to ask to determine his
eligibility? - Answer - a. You would need to ask Mr. Kelly if he is enrolled in
Part A and Part B and if he lives in the PFFS plan's service area. Correct
Mr. Gonzalez is entitled to Part A, but has not yet enrolled in Part B. If he
wants to enroll in a Private Fee-for-Service (PFFS) plan, what will he have to
do? - Answer - d. He will have to enroll in Part B prior to enrolling in the PFFS
plan. Correct
Mrs. Berkowitz wants to enroll in a Medicare Advantage plan that does not
include drug coverage and also enroll in a stand-alone Medicare prescription
drug plan. Under what circumstances can she do this? - Answer - c. If the
Medicare Advantage plan is a Private Fee-for-Service (PFFS) plan that does
not offer drug coverage or a Medical Savings Account, Mrs. Berkowitz can do
this. Correct
Mrs. Roberts has Original Medicare and would like to enroll in a Private Fee-
for-Service (PFFS) plan. All types of PFFS plans are available in her area.
Which options could Mrs. Roberts consider before selecting a PFFS plan? -
Answer - d. A Medicare Advantage Prescription Drug (MA-PD) PFFS plan that
combines medical benefits and Part D prescription drug coverage, a PFFS
plan offering only medical benefits, or a PFFS plan in combination with a
stand-alone prescription drug plan. Correct
Which of the following individuals is most likely to be eligible to enroll in a
Medicare Advantage or Part D Plan? - Answer - d. Jose, a grandfather who was
granted asylum and has worked in the United States for many years. Correct
Mr. and Mrs. Nunez attended one of your sales presentations. They've asked
you to come to their home to clear up a few questions. During the
presentation, Mrs. Nunez feels tired and tells you that her husband can finish
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, things up. She goes to bed. At the end of your discussion, Mr. Nunez says
that he wants to enroll both himself and his wife. What should you do? -
Answer - d. As long as she is able to do so, only Mrs. Nunez can
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, sign her enrollment form. Mrs. Nunez will have to wake up to sign her form or
do so at another time. Correct
You are visiting with Mr. Tully and his daughter at her request. He has
advanced Alzheimer's and is incapable of understanding the implications of
choosing a Medicare Advantage or prescription drug plan. Can his daughter
fill out the enrollment form and sign it for him? - Answer - c. Mr. Tully's
daughter can do so only, if she is authorized under state law as a court-
appointed legal guardian, has durable power of attorney for health care
decisions, or is authorized under state surrogate consent laws to make
health decisions. Correct
You are meeting with Ms. Berlin and she has completed an enrollment form
for a MA- PD plan you represent. You notice that her handwriting is illegible
and as a result, the spelling of her street looks incorrect. She asks you to fill
in the corrected street name. What should you do? - Answer - c. You may
correct this information as long as you add your initials and date next to the
correction Correct
Phiona works in the IT Department of BestCare Health Plan. Phiona is placed
in charge of BestCare's efforts to facilitate electronic enrollment in its
Medicare Advantage plans. In setting up the enrollment site, which of the
following must Phiona consider?
I. If a legal representative is completing an electronic enrollment
request, he or she must first upload proof of his or her authority.
II. All data elements required to complete an enrollment request must
be captured. III. The process must include a clear and distinct step that
requires the applicant to activate an "Enroll Now" or "I Agree" type of
button or tool.
IV. The mechanism must capture an accurate time and date stamp at
the time the applicant enters the online site. - Answer - b. II and III only
Correct
Mr. Block is currently enrolled in a Medicare Advantage plan that includes
drug coverage. He found a stand-alone Medicare prescription drug plan in his
area that offers better coverage than that available through his MA-PD plan
and in addition has a low premium. It won't cost him much more and,
because he has the means to do so, he wishes to enroll in the stand-alone
prescription drug plan in addition to his MA-PD plan. What should you tell
him? - Answer - c. If Mr. Block enrolls in the stand-alone Medicare
prescription drug plan, he will be disenrolled from the Medicare Advantage
plan. Correct
You are doing a sales presentation for Mrs. Pearson. You know that the
Medicare marketing guidelines prohibit certain types of statements. Apply
those guidelines to the following statements and identify which would be
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Mrs. Walters is entitled to Part A and has medical coverage without drug
coverage through an employer retiree plan. She is not enrolled in Part B.
Since the employer plan does not cover prescription drugs, she wants to
enroll in a Medicare prescription drug plan. Will she be able to? - Answer - c.
Yes. Mrs. Walters must be entitled to Part A or enrolled in Part B to be eligible
for coverage under the Medicare prescription drug program. Correct
Mr. Sanchez is entitled to Part A, but has not enrolled in Part B because he
has coverage through an employer plan. If he wants to enroll in a Medicare
Advantage plan, what will he have to do? - Answer - c. He will have to enroll
in Part B. Correct
Mr. Kelly wants to know whether he is eligible to sign up for a Private fee-for-
service (PFFS) plan. What questions would you need to ask to determine his
eligibility? - Answer - a. You would need to ask Mr. Kelly if he is enrolled in
Part A and Part B and if he lives in the PFFS plan's service area. Correct
Mr. Gonzalez is entitled to Part A, but has not yet enrolled in Part B. If he
wants to enroll in a Private Fee-for-Service (PFFS) plan, what will he have to
do? - Answer - d. He will have to enroll in Part B prior to enrolling in the PFFS
plan. Correct
Mrs. Berkowitz wants to enroll in a Medicare Advantage plan that does not
include drug coverage and also enroll in a stand-alone Medicare prescription
drug plan. Under what circumstances can she do this? - Answer - c. If the
Medicare Advantage plan is a Private Fee-for-Service (PFFS) plan that does
not offer drug coverage or a Medical Savings Account, Mrs. Berkowitz can do
this. Correct
Mrs. Roberts has Original Medicare and would like to enroll in a Private Fee-
for-Service (PFFS) plan. All types of PFFS plans are available in her area.
Which options could Mrs. Roberts consider before selecting a PFFS plan? -
Answer - d. A Medicare Advantage Prescription Drug (MA-PD) PFFS plan that
combines medical benefits and Part D prescription drug coverage, a PFFS
plan offering only medical benefits, or a PFFS plan in combination with a
stand-alone prescription drug plan. Correct
Which of the following individuals is most likely to be eligible to enroll in a
Medicare Advantage or Part D Plan? - Answer - d. Jose, a grandfather who was
granted asylum and has worked in the United States for many years. Correct
Mr. and Mrs. Nunez attended one of your sales presentations. They've asked
you to come to their home to clear up a few questions. During the
presentation, Mrs. Nunez feels tired and tells you that her husband can finish
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https://www.coursehero.com/file/170542694/aAHIP-module-5docx/
, things up. She goes to bed. At the end of your discussion, Mr. Nunez says
that he wants to enroll both himself and his wife. What should you do? -
Answer - d. As long as she is able to do so, only Mrs. Nunez can
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https://www.coursehero.com/file/170542694/aAHIP-module-5docx/
, sign her enrollment form. Mrs. Nunez will have to wake up to sign her form or
do so at another time. Correct
You are visiting with Mr. Tully and his daughter at her request. He has
advanced Alzheimer's and is incapable of understanding the implications of
choosing a Medicare Advantage or prescription drug plan. Can his daughter
fill out the enrollment form and sign it for him? - Answer - c. Mr. Tully's
daughter can do so only, if she is authorized under state law as a court-
appointed legal guardian, has durable power of attorney for health care
decisions, or is authorized under state surrogate consent laws to make
health decisions. Correct
You are meeting with Ms. Berlin and she has completed an enrollment form
for a MA- PD plan you represent. You notice that her handwriting is illegible
and as a result, the spelling of her street looks incorrect. She asks you to fill
in the corrected street name. What should you do? - Answer - c. You may
correct this information as long as you add your initials and date next to the
correction Correct
Phiona works in the IT Department of BestCare Health Plan. Phiona is placed
in charge of BestCare's efforts to facilitate electronic enrollment in its
Medicare Advantage plans. In setting up the enrollment site, which of the
following must Phiona consider?
I. If a legal representative is completing an electronic enrollment
request, he or she must first upload proof of his or her authority.
II. All data elements required to complete an enrollment request must
be captured. III. The process must include a clear and distinct step that
requires the applicant to activate an "Enroll Now" or "I Agree" type of
button or tool.
IV. The mechanism must capture an accurate time and date stamp at
the time the applicant enters the online site. - Answer - b. II and III only
Correct
Mr. Block is currently enrolled in a Medicare Advantage plan that includes
drug coverage. He found a stand-alone Medicare prescription drug plan in his
area that offers better coverage than that available through his MA-PD plan
and in addition has a low premium. It won't cost him much more and,
because he has the means to do so, he wishes to enroll in the stand-alone
prescription drug plan in addition to his MA-PD plan. What should you tell
him? - Answer - c. If Mr. Block enrolls in the stand-alone Medicare
prescription drug plan, he will be disenrolled from the Medicare Advantage
plan. Correct
You are doing a sales presentation for Mrs. Pearson. You know that the
Medicare marketing guidelines prohibit certain types of statements. Apply
those guidelines to the following statements and identify which would be
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