AHIP FWA Exam Questions With100% Verified
Answers |
Mrs. West wears glasses and dentures and has enjoyed considerable pain
relief from arthritis through massage therapy. She is concerned about
whether or not Medicare will cover these items and services. What should
you tell her? - ANSWER Medicare does not cover massage therapy, or, in
general, glasses or dentures.
You are meeting with Mrs. Hall in her home. On her scope of appointment
form, she asked to discuss Medicare Advantage plans. During the meeting,
she asks to discuss a stand-alone prescription drug plan. She is leaving the
next day to visit her family for a week in another state, so it is important for
her to make a decision before she leaves. What must happen before that
additional discussion can take place? - ANSWER Since Mrs. Hall
specifically asked that you discuss the stand-alone Part D plan, you may do
so, as long as she signs a new scope of
appointment form first, indicating that she wants to discuss the
Part D plan.
Monica is an agent focused on serving seniors eligible for Medicare. As
she reviews her records, she is trying to determine which of the following
items are considered compensation. What do you tell her?
I. Commissions
II. Bonuses
III. Mileage reimbursement
IV. Awards - ANSWER I, II and IV only
, Agent Harriet Walker has recently begun marketing Medicare Advantage
and related products aimed at meeting the needs of senior citizens. Client
Mildred Jones has expressed interest in a Medicare Advantage plan. It is
now the beginning of September. If you were in Agent Walker's position,
what would you do? - ANSWER Inquire whether the client qualifies for a
special enrollment period, and if not, solicit an enrollment application once
the annual open enrollment election period begins on October 15th.
You market many different types of insurance and ordinarily you spend
time each evening calling potential clients. To comply with requirements for
marketing Medicare Advantage and Part D plans, what must you do about
contacting potential clients to market those plans? - ANSWER You will
have to avoid calling any potential client unless he or she initiates contact
with you and specifically asks that you give him or her a call.
During a sales presentation to Ms. Daley for a Medicare Advantage plan
that has a 5-star rating in customer service and care coordination, and
received an overall plan performance rating of a 4-star, which of the
following would be the best statement to say to her? - ANSWER The
Medicare Advantage plan received a 5-star rating in customer service and
care coordination with an overall performance rating of 4-stars.
Ms. Claggett is sixty-six (66) years old. She has been covered under
Original Medicare for the last six years due to her disability and has never
been enrolled in a Medicare Advantage or a Part D plan before. She wants
to enroll in a Part D plan. She knows that there is such a thing as the "Part
D Initial Enrollment Period" (IEP) and has concluded that, since she has
never enrolled in such a plan before, she should be eligible to enroll under
this period. What should you tell her about how the Part D Initial Enrollment
Period applies to her situation? - ANSWER Ms. Claggett has had two IEPs
and missed them both. The first occurred three months before and three
months after the month when she was first entitled to Part A OR enrolled in
Part B. Because she was eligible for Medicare before age 65, Ms. Claggett
had a second IEP based on turning age 65, which has also expired.
, Mr. Wilcox has been enrolled in Lexington Private Fee-forService (PFFS)
Medicare Advantage Health Plan (Lexington) for several years. Recently,
Mr. Wilcox decided to spend time with his children who live in another state
that is not in Lexington's service area. In the future, he may relocate near
his children permanently. How does this move to another service area
impact his PFFS MA coverage? - ANSWER Lexington can allow for Mr.
Wilcox's continued enrollment for up to 12 months whether or not he is in a
visitor/traveler (V/T) program since it is a PFFS plan.
Mrs. Quinn recently turned 66 and decided after many years of work to
begin receiving Social Security benefits. Shortly thereafter Mrs. Quinn
received a letter informing her that she has been automatically enrolled in
Medicare Part B. She wants to understand what this means. What should
you tell Mrs. Quinn? - ANSWER Part B primarily covers physician
services. She will be paying a monthly premium and, with the exception of
many preventive and screening tests, generally will have 20% coinsurance
for these services, in addition to an annual deductible.
Mrs. Geisler's neighbor told her she should look at her Part D options
during the annual Medicare enrollment period because features of Part D
might have changed. Mrs. Geisler can't remember what Part D is so she
called you to ask what her neighbor was talking about. What could you tell
her? - ANSWER Part D covers prescription drugs and she should look at
her premiums, formulary, and cost-sharing among other factors to see if
they have changed.
Mrs. Duarte is enrolled in Original Medicare Parts A and B. She has
recently reviewed her Medicare Summary Notice (MSN) and disagrees with
a determination that partially denied one of her claims for services. What
advice would you give her? - ANSWER Mrs. Duarte should file an appeal
of this initial determination within 120 days of the date she received the
MSN in the mail.
Mr. Rainey is experiencing paranoid delusions and his physician feels that
he should be hospitalized. What should you tell Mr. Rainey (or his
, representative) about the length of an inpatient psychiatric hospital stay
that Medicare will cover? - ANSWER Medicare will cover a total of 190
days of inpatient psychiatric care during Mr. Rainey's entire lifetime.
Mrs. Park is an elderly retiree. Mrs. Park has a low fixed income.
What could you tell Mrs. Park that might be of assistance? - ANSWER She
should contact her state Medicaid agency to see if she qualifies for one of
several programs that can help with Medicare costs for which she is
responsible.
Anita Magri will turn age 65 in August 2022. Anita intends to enroll in
Original Medicare Part A and Part B. She would also like to enroll in a
Medicare Supplement (Medigap) plan. Anita's older neighbor Mel has told
her about the Medigap Part F plan in which he is enrolled. It not only
provides foreign travel emergency benefits but also covers his Medicare
Part B deductible. Anita comes to you for advice. What should you tell her?
- ANSWER You are sorry to disappoint Anita but a Medigap Part F plan is
no longer available to those who turn age 65 after January 1,2020.
Anita might instead consider other Medigap plans that offer foreign travel
benefits but do not cover the Part B deductible.
Ms. Henderson believes that she will qualify for Medicare Coverage when
she turns 65, without paying any premiums, because she has been working
for 40 years and paying Medicare taxes. What should you tell her? -
ANSWER To obtain Part B coverage, she must pay a standard monthly
premium, though it is higher for individuals with higher incomes.
Mr. Alonso receives some help paying for his two generic prescription
drugs from his employer's retiree coverage, but he wants to compare it to a
Part D prescription drug plan. He asks you what costs he would generally
expect to encounter when enrolling into a standard Medicare Part D
prescription drug plan. What should you tell him? - ANSWER He generally
would pay a monthly premium, annual deductible, and per-prescription
costsharing.
Answers |
Mrs. West wears glasses and dentures and has enjoyed considerable pain
relief from arthritis through massage therapy. She is concerned about
whether or not Medicare will cover these items and services. What should
you tell her? - ANSWER Medicare does not cover massage therapy, or, in
general, glasses or dentures.
You are meeting with Mrs. Hall in her home. On her scope of appointment
form, she asked to discuss Medicare Advantage plans. During the meeting,
she asks to discuss a stand-alone prescription drug plan. She is leaving the
next day to visit her family for a week in another state, so it is important for
her to make a decision before she leaves. What must happen before that
additional discussion can take place? - ANSWER Since Mrs. Hall
specifically asked that you discuss the stand-alone Part D plan, you may do
so, as long as she signs a new scope of
appointment form first, indicating that she wants to discuss the
Part D plan.
Monica is an agent focused on serving seniors eligible for Medicare. As
she reviews her records, she is trying to determine which of the following
items are considered compensation. What do you tell her?
I. Commissions
II. Bonuses
III. Mileage reimbursement
IV. Awards - ANSWER I, II and IV only
, Agent Harriet Walker has recently begun marketing Medicare Advantage
and related products aimed at meeting the needs of senior citizens. Client
Mildred Jones has expressed interest in a Medicare Advantage plan. It is
now the beginning of September. If you were in Agent Walker's position,
what would you do? - ANSWER Inquire whether the client qualifies for a
special enrollment period, and if not, solicit an enrollment application once
the annual open enrollment election period begins on October 15th.
You market many different types of insurance and ordinarily you spend
time each evening calling potential clients. To comply with requirements for
marketing Medicare Advantage and Part D plans, what must you do about
contacting potential clients to market those plans? - ANSWER You will
have to avoid calling any potential client unless he or she initiates contact
with you and specifically asks that you give him or her a call.
During a sales presentation to Ms. Daley for a Medicare Advantage plan
that has a 5-star rating in customer service and care coordination, and
received an overall plan performance rating of a 4-star, which of the
following would be the best statement to say to her? - ANSWER The
Medicare Advantage plan received a 5-star rating in customer service and
care coordination with an overall performance rating of 4-stars.
Ms. Claggett is sixty-six (66) years old. She has been covered under
Original Medicare for the last six years due to her disability and has never
been enrolled in a Medicare Advantage or a Part D plan before. She wants
to enroll in a Part D plan. She knows that there is such a thing as the "Part
D Initial Enrollment Period" (IEP) and has concluded that, since she has
never enrolled in such a plan before, she should be eligible to enroll under
this period. What should you tell her about how the Part D Initial Enrollment
Period applies to her situation? - ANSWER Ms. Claggett has had two IEPs
and missed them both. The first occurred three months before and three
months after the month when she was first entitled to Part A OR enrolled in
Part B. Because she was eligible for Medicare before age 65, Ms. Claggett
had a second IEP based on turning age 65, which has also expired.
, Mr. Wilcox has been enrolled in Lexington Private Fee-forService (PFFS)
Medicare Advantage Health Plan (Lexington) for several years. Recently,
Mr. Wilcox decided to spend time with his children who live in another state
that is not in Lexington's service area. In the future, he may relocate near
his children permanently. How does this move to another service area
impact his PFFS MA coverage? - ANSWER Lexington can allow for Mr.
Wilcox's continued enrollment for up to 12 months whether or not he is in a
visitor/traveler (V/T) program since it is a PFFS plan.
Mrs. Quinn recently turned 66 and decided after many years of work to
begin receiving Social Security benefits. Shortly thereafter Mrs. Quinn
received a letter informing her that she has been automatically enrolled in
Medicare Part B. She wants to understand what this means. What should
you tell Mrs. Quinn? - ANSWER Part B primarily covers physician
services. She will be paying a monthly premium and, with the exception of
many preventive and screening tests, generally will have 20% coinsurance
for these services, in addition to an annual deductible.
Mrs. Geisler's neighbor told her she should look at her Part D options
during the annual Medicare enrollment period because features of Part D
might have changed. Mrs. Geisler can't remember what Part D is so she
called you to ask what her neighbor was talking about. What could you tell
her? - ANSWER Part D covers prescription drugs and she should look at
her premiums, formulary, and cost-sharing among other factors to see if
they have changed.
Mrs. Duarte is enrolled in Original Medicare Parts A and B. She has
recently reviewed her Medicare Summary Notice (MSN) and disagrees with
a determination that partially denied one of her claims for services. What
advice would you give her? - ANSWER Mrs. Duarte should file an appeal
of this initial determination within 120 days of the date she received the
MSN in the mail.
Mr. Rainey is experiencing paranoid delusions and his physician feels that
he should be hospitalized. What should you tell Mr. Rainey (or his
, representative) about the length of an inpatient psychiatric hospital stay
that Medicare will cover? - ANSWER Medicare will cover a total of 190
days of inpatient psychiatric care during Mr. Rainey's entire lifetime.
Mrs. Park is an elderly retiree. Mrs. Park has a low fixed income.
What could you tell Mrs. Park that might be of assistance? - ANSWER She
should contact her state Medicaid agency to see if she qualifies for one of
several programs that can help with Medicare costs for which she is
responsible.
Anita Magri will turn age 65 in August 2022. Anita intends to enroll in
Original Medicare Part A and Part B. She would also like to enroll in a
Medicare Supplement (Medigap) plan. Anita's older neighbor Mel has told
her about the Medigap Part F plan in which he is enrolled. It not only
provides foreign travel emergency benefits but also covers his Medicare
Part B deductible. Anita comes to you for advice. What should you tell her?
- ANSWER You are sorry to disappoint Anita but a Medigap Part F plan is
no longer available to those who turn age 65 after January 1,2020.
Anita might instead consider other Medigap plans that offer foreign travel
benefits but do not cover the Part B deductible.
Ms. Henderson believes that she will qualify for Medicare Coverage when
she turns 65, without paying any premiums, because she has been working
for 40 years and paying Medicare taxes. What should you tell her? -
ANSWER To obtain Part B coverage, she must pay a standard monthly
premium, though it is higher for individuals with higher incomes.
Mr. Alonso receives some help paying for his two generic prescription
drugs from his employer's retiree coverage, but he wants to compare it to a
Part D prescription drug plan. He asks you what costs he would generally
expect to encounter when enrolling into a standard Medicare Part D
prescription drug plan. What should you tell him? - ANSWER He generally
would pay a monthly premium, annual deductible, and per-prescription
costsharing.
