AHIP FINAL EXAM LATEST EXAM 2024 WITH UPDATED QUESTIONS AND DETAILED CORRECT ANSWERS (GRADED A+)

AHIP FINAL EXAM LATEST EXAM 2024
WITH UPDATED QUESTIONS AND
DETAILED CORRECT ANSWERS (GRADED
A+)
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. Liu turns 65 on June 19. He has never previously qualified for
Medicare so his first Medicare eligibility date will be by June 1. Mr.
Liu's ICEP and Part D IEP begin March 1 and end on September
30. He wants prescription drug coverage with his Part A and Part B
benefits. What advice can you provide him? - ANSWER-He can
enroll in a MA-PD as long as he enrolls in Part B and is entitled to
Part A.
BestCare Health Plan has received a request from a state
insurance department in connection with the investigation of
several marketing representatives licensed by the state who sell
Medicare Advantage plans. What action(s) should BestCare take in
response? - ANSWER-Cooperate with the state and supply
requested information.
Mrs. Andrews asked how a Private Fee-for-Service (PFFS) plan
might affect her access to services since she receives some
assistance for her health care costs from the State. What should
you tell her? - ANSWER-Medicaid may provide additional benefits,
but Medicaid will only pay for these services if they are furnished by
Medicaid participating providers.
Miles is a licensed agent who represents Colgate Health and its
Medicare Advantage (MA) plans. Miles has several clients who
have recently come to him for help. They are in their initial
coverage period9s) (ICEP) and are interested in enrolling in one of
Colgate Health's MA plans. Adam will soon turn 68 and has
decided to retire. Betty is about to turn 65 and has also decided to
retire. Adam and Betty both currently have coverage through
Colgate Health. Charles had health coverage through Colgate but
dropped the coverage when he retired early to travel to Europe.
Charles has just turned age 65 and is now back in the United
States. Diedre, who will turn 65 next month, currently has coverage
through Ditmas Health - a company that Miles also represents.
Who qualifies for the opt-in simplified enrollment mechanism? -
ANSWER-Adam and Betty because each of them will not have a
break between their non-Medicare and Medicare coverage through
Colgate Health Plan.
Mr. Wilcox has been enrolled in Lexington Private Fee-for-Service
(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.
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Mrs. Allen has a rare condition for which two different brand name
drugs are the only available treatment. She is concerned that since
no generic prescription drug is available and these drugs are very
high cost, she will not be able to find a Medicare Part D prescription
drug plan that covers either one of them. What should you tell her?
- ANSWER-Medicare prescription drug plans are required to cover
drugs in each therapeutic category. She should be able to enroll in
a Medicare prescription drug plan that covers the medications she
needs.