AHIP FINAL EXAM 2022/2023 UPDATED VERSION QUESTIONS AND 100%CORRECT ANSWERS+ ELABORATIONS

coverage since it is just as good as Part D. She may keep her current coverage through the Medigap plan.

Question11 ----CORRECT ANSWER---

Marks: 1 ----CORRECT ANSWER---

Richard is a licensed agent who represents Spartan Health Plan and its Medicare Advantage (MA) plans. Richard has several clients who have recently come to him for help who are in their initial coverage election period (ICEP) and are interested in enrolling in one of Spartan Health Plan's MA plans. Alice will soon turn 65 and retire. Alice has coverage through Spartan Health Plan offered by her employer. Bob had health coverage through Spartan but dropped the coverage when he retired early to travel overseas. Bob, who has just turned age 65, is now back in the United States. Charlotte, who will turn 65 next month, has coverage through Athena Health plan - a
company Richard also represents. Who qualifies for the opt-in simplified enrollment mechanism? ----CORRECT ANSWER---

Choose one answer. ----CORRECT ANSWER---

----CORRECT ANSWER---a. Alice because she will not have a break between her non-
Medicare and Medicare coverage through Spartan Health Plan.

----CORRECT ANSWER---b. Alice and Charlotte because each of them currently have
health coverage and is in their initial coverage election period (ICEP).

----CORRECT ANSWER---c. Alice and Bob because each of them has had coverage
through Spartan Health Plan.

----CORRECT ANSWER---d. Alice, Bob, and Charlotte because electronic health record interoperability will allow Richard to access any needed information for their applications.

Question12 ----CORRECT ANSWER---

Marks: 1 ----CORRECT ANSWER---

Under what conditions can a Medicare prescription drug plan reduce its coverage for a
given drug during the first 60 days of the year? ----CORRECT ANSWER---

Choose one answer. ----CORRECT ANSWER---

----CORRECT ANSWER---a. When a formulary change is in response to a drug's
removal from the market.

----CORRECT ANSWER---b. When the Part D plan can demonstrate to CMS that no enrollee has accessed the medication in the past six months, generally the plan can remove the drug from its formulary within the first 60 days of the year.

----CORRECT ANSWER---c. Under no conditions can a Medicare Part D prescription
drug plan reduce its coverage for a given drug at any point during the year.

----CORRECT ANSWER---d. If the Medicare prescription drug plan can show that reducing coverage early in the year will result in savings for the Part D plan and the Medicare program, generally the plan may make such a change.

Question13 ----CORRECT ANSWER---

Marks: 1 ----CORRECT ANSWER---

This year you have decided to focus your efforts on marketing to employer group plans. One employer provides you with a list of their retirees and asks you to contact them to explain the characteristics of the plan they ha