Ahip 2025 final
A Medicare beneficiary has walked into your office and requested that you sit down
with her and discuss her options under the Medicare Advantage program. Before
engaging in such a discussion, what should you do? - ANS-You must have her sign a
scope of appointment form, indicating which products she wishes to discuss. You
may then proceed with the discussion.
\Agent Chan is conducting a sales presentation on senior issues where he hopes to
enroll some attendees in the Medicare Advantage (MA) plans he represents. What
action(s) may Agent Chan take during the event? - ANS-Discuss plan specific
information such as premiums and benefits.
\Anita Magri will turn age 65 in August 2023. 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 Plan F 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? - ANS-You are sorry to disappoint Anita, but a Medigap 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.
\Dr. Elizabeth Brennan does not contract with the ABC PFFS plan but accepts the
plan's terms and conditions for payment. Mary Rodgers sees Dr. Brennan for
treatment. How much may Dr. Brennan charge? - ANS-
\Mr. Barker enjoys a comfortable retirement income. He recently had surgery and
expected that he would have certain services and items covered by the plan with
minimal out-of-pocket costs because his MA-PD coverage has been very good.
However, when he received the bill, he was surprised to see large charges in excess
of his maximum out-of-pocket limit that included some services and items he thought
would be fully covered. He called you to ask what he could do? What could you tell
him? - ANS-You can offer to review the plans appeal process to help him ask the
plan to review the coverage decision.
\Mr. Carlini has heard that Medicare prescription drug plans are only offered through
private companies under a program known as Medicare Advantage (MA), not by the
government. He likes Original Medicare and does not want to sign up for an MA
product, but he also wants prescription drug coverage. What should you tell him? -
ANS-Mr. Carlini can stay with Original Medicare and also enroll in a Medicare
prescription drug plan through a private company that has contracted with the
government to provide only such drug coverage to eligible Medicare beneficiaries.
\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? -
ANS-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.
A Medicare beneficiary has walked into your office and requested that you sit down
with her and discuss her options under the Medicare Advantage program. Before
engaging in such a discussion, what should you do? - ANS-You must have her sign a
scope of appointment form, indicating which products she wishes to discuss. You
may then proceed with the discussion.
\Agent Chan is conducting a sales presentation on senior issues where he hopes to
enroll some attendees in the Medicare Advantage (MA) plans he represents. What
action(s) may Agent Chan take during the event? - ANS-Discuss plan specific
information such as premiums and benefits.
\Anita Magri will turn age 65 in August 2023. 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 Plan F 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? - ANS-You are sorry to disappoint Anita, but a Medigap 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.
\Dr. Elizabeth Brennan does not contract with the ABC PFFS plan but accepts the
plan's terms and conditions for payment. Mary Rodgers sees Dr. Brennan for
treatment. How much may Dr. Brennan charge? - ANS-
\Mr. Barker enjoys a comfortable retirement income. He recently had surgery and
expected that he would have certain services and items covered by the plan with
minimal out-of-pocket costs because his MA-PD coverage has been very good.
However, when he received the bill, he was surprised to see large charges in excess
of his maximum out-of-pocket limit that included some services and items he thought
would be fully covered. He called you to ask what he could do? What could you tell
him? - ANS-You can offer to review the plans appeal process to help him ask the
plan to review the coverage decision.
\Mr. Carlini has heard that Medicare prescription drug plans are only offered through
private companies under a program known as Medicare Advantage (MA), not by the
government. He likes Original Medicare and does not want to sign up for an MA
product, but he also wants prescription drug coverage. What should you tell him? -
ANS-Mr. Carlini can stay with Original Medicare and also enroll in a Medicare
prescription drug plan through a private company that has contracted with the
government to provide only such drug coverage to eligible Medicare beneficiaries.
\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? -
ANS-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.
