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AHIP Module 5 Exam Elaborations 2023| 2024 Graded A+

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AHIP Module 5 Exam Elaborations 2023| 2024 Graded A+ 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? 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? 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? 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

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AHIP Module 5 Answers
Mrs. Walters is entitled to Part A and has
medical coverage without drug coverage c. Yes. Mrs. Walters must be entitled
through an employer retiree plan. She is not to Part A or enrolled in Part B to be
enrolled in Part B. Since the employer plan eligible for coverage under the
does not cover prescription drugs, she wants Medicare prescription drug program.
to enroll in a Medicare prescription drug plan. Correct
Will she be able to?

Mr. Sanchez is entitled to Part A, but has not
enrolled in Part B because he has coverage c. He will have to enroll in Part B.
through an employer plan. If he wants to enroll Correct
in a Medicare Advantage plan, what will he
have to do?

Mr. Kelly wants to know whether he is eligible
to sign up for a Private fee-for-service (PFFS) a. You would need to ask Mr. Kelly if
plan. What questions would you need to ask he is enrolled in Part A and Part B
to determine his eligibility? 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 d. He will have to enroll in Part B prior
Private Fee-for-Service (PFFS) plan, what will to enrolling in the PFFS plan. Correct
he have to do?

Mrs. Berkowitz wants to enroll in a Medicare
Advantage plan that does not include drug c. If the Medicare Advantage plan is a
coverage and also enroll in a stand-alone Private Fee-for-Service (PFFS) plan
Medicare prescription drug plan. Under what that does not offer drug coverage or a
circumstances can she do this? 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 d. A Medicare Advantage Prescription
(PFFS) plan. All types of PFFS plans are Drug (MA-PD) PFFS plan that
available in her area. Which options could combines medical benefits and Part
Mrs. Roberts consider before selecting a D prescription drug coverage, a PFFS
PFFS plan? 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 d. Jose, a grandfather who was
Advantage or Part D Plan? 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 d. As long as she is able to do so,
come to their home to clear up a few only Mrs. Nunez can sign her
questions. During the presentation, Mrs. enrollment form. Mrs. Nunez will have
Nunez feels tired and tells you that her to wake up to sign her form or do so
husband can finish things up. She goes to at another time. Correct
bed. At the end of your discussion, Mr. Nunez
says that he wants to enroll both himself and
his wife. What should you do?

You are visiting with Mr. Tully and his daughter
at her request. He has advanced Alzheimer’s c. Mr. Tully’s daughter can do so only,
and is incapable of understanding the if she is authorized under state law as
implications of choosing a Medicare a court-appointed legal guardian, has
Advantage or prescription drug plan. Can his durable power of attorney for health
daughter fill out the enrollment form and sign it care decisions, or is authorized under
for him? 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 c. You may correct this information as
plan you represent. You notice that her long as you add your initials and date
handwriting is illegible and as a result, the next to the correction Correct
spelling of her street looks incorrect. She asks
you to fill in the corrected street name. What
should you do?

Phiona works in the IT Department of
BestCare Health Plan. Phiona is placed in b. II and III only Correct
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.

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