You appreciate the opportunity and will ask the facility to provide a plan brochure and enrollment application in every resident's room before the meeting to promote interest in the event. Mrs. Radford asks whether there are any special eligibility requirements for Medicare Advantage. It means that he qualifies for a one-time opportunity to enroll in an MA-PD or Part D prescription drug plan. AHIP Exam Flashcards. Daniel is a middle-income Medicare beneficiary. He must first enroll in a Medicare Part D plan, before enrolling in a Medicare Advantage plan. Answer & Explanation.
Mr. Jacob understands that there is a standard Medicare Part D prescription drug benefit, but when he looks at information on various plans available in his area, he sees a wide range in what they charge for deductibles, premiums, and cost sharing. Mr. Schmidt would like to plan for retirement and has asked you what is covered under Original Fee-for-Service (FFS) Medicare? The request for authorization may include a brief synopsis of non-health related content. Tell her that if a plan obtains permission from CMS for a marketing event in a provider facility, the event may go forward, regardless of where it occurs in the facility. Yoo contacted you to find out more about what this means. AHIP questions.odt - Mrs. West wears glasses and dentures and has enjoyed considerable pain relief from arthritis through massage therapy. She is | Course Hero. You should plan to conduct sales presentations but must not accept enrollment forms. Students also viewed.
He may sign-up for Medicare at any time and coverage usually begins immediately. Radford must be entitled to Part A and enrolled in Part B to enroll in Medicare Advantage. Dr. Brennan can charge the beneficiary the same cost-sharing as Original Medicare as long as she sends the claim to Medicare and not the plan. This allows Mrs. AHIP Final Exam Test Review Questions and Answers (2022/2023) Latest Update. Tanner to do which of the following? What would you say If you were advising Agent Adams? How can you explain this to him? Part D plans may use varying co-payments for brand name and generic drugs, but they may not restrict access through prior authorization. Mr. Roberts is enrolled in an MA plan.
He or his physician could obtain the standardized request form on the plan's website, fill it out, and submit it to his plan. Marketing representatives may only use internet pop-up ads providing plan-specific information that have been approved by CMS when soliciting prospects through electronic means of communication. Mr. Greco is in excellent health, lives in his own home, and has a sizeable income from his investments. Your friend's mother just moved to an assisted living facility and he asked if you could present a program for the residents about the MA-PD plans you market. University Of Arizona. Dr. Brennan can charge Mary Rodgers more than the cost sharing specified in the PFFS plan's terms and conditions as long as she treats all beneficiaries the same. Other sets by this creator. Ms. Brooks has an aggressive cancer and would like to know if Medicare will cover hospice services in case she needs them. Mrs west wears glasses. They collected the following data: Line Speed (ft/min) 20 20 40 30 60 40 Number of Defective Parts Found 21 19 15 16 14 17. Part C, which always covers dental and vision services, is covered under Original Medicare. He wants to know if he must use doctors in a network as his current HMO plan requires him to do. Marketing representatives may initiate electronic contact through e-mail but an opt-out process must be provided. Mr. Roberts must return to Original Medicare within two months of discharge, but he may continue to enroll and disenroll in Part D for 12 months following discharge.
Mr. Wendt suffers from diabetes which has gotten progressively worse during the last year. 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. Stuck on something else? He called you to ask what he could do? She would like to keep the coverage she has but replace her existing Medigap plan with one that provides drug coverage. You may correct this information as long as you add your initials and date next to the correction. She is concerned about whether or not Medicare will cover these items and services. You appreciate the opportunity and your friend would just need to complete scope of appointment forms on behalf of all the residents who would like to attend. Mrs. Tanner can go to non-plan doctors knowing that cost sharing will generally be the same as with network providers. It helped me a lot to clear my final semester exams. Hospice services are currently only offered under a limited demonstration project.
You should ask Mrs. West to contact either Medicare and ask them personally if they cover the services or ask the company who she receives massage therapy from, her glasses and dentures if they accept Medicare coverage. I find Docmerit to be authentic, easy to use and a community with quality notes and study tips. Mrs. Gonzalez can purchase a Medigap plan that covers drugs, but it likely won't offer coverage that is equivalent to that provided under Part D. Mrs. Gonzalez should purchase a K or L Medigap plan. He has a friend enrolled in a Medicare Advantage Special Needs Plan (SNP). She asks you to fill in the corrected street name. He may not sign-up for Medicare until he reaches age 62, the date he first becomes eligible for Social Security benefits. As a dual eligible beneficiary, her Part D drugs will be covered by Medicare once she is enrolled in a Part D plan. Mr. Roberts has two months following his discharge to continue under his current MA plan before he must return to Original Medicare for the remainder to the calendar year. Agent Armstrong follows up with individuals who request more information about ABC MA plans via the website and tries to persuade them to enroll in ABC plans. You appreciate the opportunity and would ask the facility to provide enrollment applications for the MA-PD plans you represent. Mr. Gomez notes that a Private Fee-for-Service (PFFS) plan available in his area has an attractive premium.
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