Ahip Exam Practice With 100% Correct Answers - Ahip - Us

July 5, 2024, 5:14 am
• If a beneficiary is considering this option, he/she should call the plan first. Medicare Savings Program: help paying for the Medicare Part B premium and, in some cases, deductibles and coinsurance. Mrs. paterson is concerned about the deductibles differently however. What should Agent Tom Smith tell Mr. Moreno about the kinds of food that can be provided to potential enrollees who attend the sales presentation? You are doing a sales presentation for Mrs. Pearson. He is wondering if he can switch to a lower cost Part D plan.

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She is worried that she will not be able to enroll in another plan available in her new residence until the Annual Election Period. 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. Do not delay even if you do not take any prescription drugs regularly right now. Who is eligible for a SEP based on change of residence? One plans on giving door prizes worth $5, refreshments valued at $8 per anticipated attendee, and coupon books with discounts worth $10. ▪ Social media (e. g., Facebook, Twitter, YouTube, etc. ) 1) Beneficiaries who lose their LIS eligibility because they are no longer deemed eligible for the following calendar year. Mrs. paterson is concerned about the deductible des impots. Mrs. Schmidt is moving and a friend told her she might qualify for a "Special Election Period" to enroll in a new Medicare Advantage plan. ▪ Marketing representative scripts or outlines for telemarketing, enrollment or other presentations.

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2) Beneficiaries who lose their LIS eligibility during the year outside of the annual redetermination does the SEP take place? Mr. Block is currently enrolled in a Medicare Advantage plan that includes drug coverage. You plan to participate in an educational event sponsored by a large regional health care system. You would like to market an MA plan at a neighborhood pharmacy. They may not enroll in a standalone PDP. Ms. Jones can receive all Medicare covered services through her Medicare Advantage plan cost sharing. MarketCo has a contract with BestChoice health plan, a Medicare Advantage organization, to offer marketing services through its contracted agents and agencies. During individual appointments, marketing representatives may: ▪ Distribute plan materials such as an enrollment kit or marketing materials. Several agents you work with are planning sales events in your area. Next week you will be participating in your first "educational event" for prospective enrollees. Employed or independent agents/brokers must be state-licensed and follow all state appointment regulations in order to sell Medicare Advantage plans. How would you advise him? Mrs. paterson is concerned about the deductibles are usually. What could you tell her? However, she and her physicians feel that after her lengthy hospital stay she will need a month or two of nursing and rehabilitative care.

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As previously noted this enrollment is only valid when executed by the beneficiary/legal representative or as State law allows. You have had a good meeting with Mr. Claggett and he has selected a Medicare Advantage plan. Enrollees may be enrolled in a stand-alone PDP only if they are enrolled in: Original fee-for-service Medicare; Private Fee-for-Service (PFFS) plan without Part D drug coverage; Medical Savings Account (MSA) plan; or 1876 Cost plan. He has signed up for Medicare Part A, but he did not enroll in Part B because he has employer-sponsored coverage and intends to keep working for several more years. Question, who is fairly well off, would like to enroll in a Medicare prescription drug plan you represent and simply give you a check to cover his premiums for the entire year. Mrs. Goodman enrolled in an MA-PD plan during the Annual Election Period. Beneficiaries who have moved into a plan service area from a location where there was no Part D plan available (e. overseas) qualify for an SEP just for Part D election purposes MA eligible and Part D eligible beneficiaries who experience certain qualifying events are allowed an SEP Timeframes for SEPs are variable, however, most begin on the first day of the month in which the qualifying event occurs and last for a total of three months. If the application does not include information supporting a permissible election period, plans must contact the beneficiary to decide if enrollment is and Part D Enrollment periods are:MA Initial Coverage Election Period (ICEP)Part D Initial Enrollment Period (IEP)MA and Part D Annual Election Period (AEP)MA and Part D Special Enrollment Periods (SEP)Open Enrollment Period for Institutionalized Individuals (OEPI)MA 45-Day Disenrollment Period (MADP).

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Marketing representatives should contact plan sponsor regarding the appropriateness of the food products provided and must ensure that items provided could not be reasonably considered a meal and/or that multiple items are not being "bundled" and provided as if a meal. Examples of foods that may be considered "light snacks" include: ▪ Fruit and raw vegetables ▪ Pastries and muffins ▪ Cookies or other small bite-size dessert items ▪ Crackers ▪ Cheese ▪ Chips ▪ Yogurt ▪ Nuts. Each individual must be advised at the beginning of the electronic enrollment process that he or she is completing an enrollment request. Agents/brokers are subject to rigorous oversight by their contracted health or drug plans and face the risk of loss of licensure with their State and termination with their contracted health or drug plans if they don't comply with strict rules related to selling to and enrolling Medicare beneficiaries in Medicare plans. Agent Armstrong is a marketing representative of BestChoice. She does so using this SEP and her enrollment is effective December 1st. ▪ Enrollee communications including rules; agreements; handbooks; contractual changes; changes in providers, premiums, or benefits; plan procedures; and wallet card instructions to enrollees. She plans to switch from her old MA HMO plan to the new MA-PD plan during the Annual Election Period. Plan sponsors may undertake the following marketing activities with current Medicare Advantage plan members? What does this mean? • When withholding begins, it will be for the 2-3 months of premiums owed. Most individuals who are citizens and over age 65 are covered under Part A by virtue of having paid Medicare taxes while working, though some may be covered as a result of paying monthly premiums. Social media posts are subject to marketing requirements, such as those related to testimonials. Ordinarily, you provide clients who purchase various types of insurance products from you with a gift when they enroll and you let them know that they will receive it after their enrollment is complete.

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Mr. Albert has heard about something called the Star Rating system for Medicare Advantage plans. When you market Medicare Advantage and Part D plans, what may you offer as a gift to induce enrollment in a plan? ▪ We cover all drugs without restrictions. XYZ Agency maintains a website marketing the MA plans with which it has contracts. If enrollment is completed during a face-to-face interview, the plan representative should use the individual's Medicare card to verify the spelling of the name, sex, Medicare number; and Part A and Part B effective dates. Some MA plans, known as dual eligible Special Needs Plans, are tailored to dual eligible individuals, depending on the category (see prior slide) to which they belong. What could you tell her about the implications of such a decision? 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. ABC is a long-term care facility provider.

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What should you tell them about Original Medicare's coverage of care in a skilled nursing facility? ▪ If the gift is one large one that is enjoyed by all attending an event, the total cost must be $15 or less when divided by the estimated attendance. That is, unless a cost plan enrollee opts out, he/she will be automatically enrolled in an MA plan offered by the same dividuals subject to deemed enrollment will be notified by CMS and the plan and given the opportunity to choose another option. She sustained a hip fracture and is being successfully treated for that condition. ▪ There are no limits on services. A number of requirements apply to electronic enrollment mechanisms, including, but not limited to: Plan Sponsors must submit all materials, web pages, and images (e. g. screen shots) related to the electronic enrollment process for CMS dividuals must be provided with all required pre-enrollment information (see module 4) mechanism must comply with CMS' data security policies. After you explain that it is way for consumers to judge plan performance, what else would you say?

CMS makes this determination. Mr. Rivera has QMB-Plus eligibility and is thus covered by both Medicare and Medicaid. You will NOT be able to represent any MA or Part D plan until you compete the training and achieve an adequate score, although you will NOT have to take a test if you exclusively market employer/union group plans and the companies do not require testing. Be a U. citizen or lawfully present in the United States on or before the enrollment effective date. Marketing representatives may offer gifts to potential enrollees if they attend a marketing presentation as long as the gifts are of nominal value and provided regardless of enrollment and without discrimination. What should you tell her about obtaining drug coverage? Continues as long as he or she is eligible for LIS. An institutionalized beneficiary has a continuous open enrollment period (OEPI) for purposes of changing enrollment in Medicare Advantage plans; this period does not end until two months after the month the beneficiary moves out of the institution. 50 coinsurance for days 21-100 each benefit patient psychiatric care (up to 190 lifetime days) Part A does not cover custodial or long-term care Cost-sharing may differ for enrollees of Medicare. Phiona is placed in charge of BestCare's efforts to facilitate electronic enrollment in its Medicare Advantage plans. During individual appointments, marketing representatives may not: ▪ Discuss plan options that were not agreed to in the Scope of Appointment. Ms. Levi often travels to visit relatives and is concerned that she may need emergency care outside of her plan's service area. The Medicare Managed Care Manual Chapter 2 has a full description of the relevant special enrollment periods. Generally the beneficiary must stay with the premium payment option for the entire year.

Non-dual beneficiaries who qualify for LIS but do not receive Medicaid benefits When does the SEP take place? The company has added Medicare Advantage and Part D plans and you will begin marketing those plans this fall. Mrs. Shields is covered by Original Medicare.