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    ms. o’donnell learned about a new ma-pd plan that her neighbor suggested and that you represent. she plans to switch from her old ma hmo plan to the new ma-pd plan during the annual election period. however, she wants to make sure she does not end up paying premiums for two plans. what can you tell her?

    James

    Guys, does anyone know the answer?

    get ms. o’donnell learned about a new ma-pd plan that her neighbor suggested and that you represent. she plans to switch from her old ma hmo plan to the new ma-pd plan during the annual election period. however, she wants to make sure she does not end up paying premiums for two plans. what can you tell her? from EN Bilgi.

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    AHIP MODULE 5 - AHIP MODULE 5

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    You are meeting with Ms. Blum and she has completed an

    enrollment form for a MA-PD plan you represent. You notice that her handwriting

    is illegible and as a result, the spelling of her street looks incorrect. She

    asks you to fill in the corrected street name. What should you do?

    You

    may correct this information as long as you add your initials and date next to

    the correction

    Ms. Gardner is currently enrolled in an MA-PD plan. However,

    she wants to disenroll from the MA-PD plan and instead enroll in a Part D only

    plan and go back to Original Medicare. According to Medicare's enrollment

    guidelines, when could she do this?

    She

    may make such a change during the Annual Election Period that runs from Oct. 15

    to December 7, or during the MA Disenrollment Period that runs from January 1

    to February 14 of each year

    Mrs. Brown wants to enroll in a Medicare Advantage plan that

    does not include drug coverage and also enroll in a stand-alone Medicare

    prescription drug plan. Under what circumstances can she do this?

    If

    the Medicare Advantage plan is a Private Fee-for-Service (PFFS) plan that does

    not offer drug coverage or a Medical Savings Account, Mrs. Brown can do this

    After a sales presentation, Mr. Buffet announces that he is

    ready to enroll in the plan you represent. He would like to know if he can have

    his plan premiums deducted from his Social Security check. What should you tell

    him? He

    may choose withholding from his Social Security check when he completes the

    enrollment form

    Ms. O'Donnell learned about a new MA-PD plan that her

    neighbor suggested and that you represent. She plans to switch from her old MA

    HMO plan to the new MA-PD plan during the Annual Election Period. However, she

    wants to make sure she does not end up paying premiums for two plans. What can

    you tell her?

    . She only needs to enroll in the new MA-PD plan

    and she will automatically be disenrolled from her old MA plan

    You are visiting with Mr. Thomas and his daughter at her

    request. He has advanced Alzheimer's and is incapable of understanding the

    implications of choosing a Medicare Advantage or prescription drug plan. Can

    his daughter fill out the enrollment form and sign it for him?

    Mr.

    Thomas’ daughter can do so only, if she is authorized under state law as a

    court-appointed legal guardian, has durable power of attorney for health care

    decisions, or is authorized under state surrogate consent laws to make health

    decisions

    Mrs. Townsend would like her daughter, who lives in another

    state, to meet with you during the Annual Election Period to help her complete

    her enrollment in a Part D plan. She asked you when she should have her

    daughter plan to visit. What could you tell her?

    Her

    daughter should come in November

    Ms. Claggett, who has been covered under Original Medicare

    for the last six years due to her disability, 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" 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?

    It occurs three months before

    and three months after the month when a beneficiary meets the eligibility

    requirements for Part B, so she will not be able to use it as a justification

    for enrolling in a Part D plan now.------------------------------------------------------------------------------------------------------------------------------

    Mr. Bublitz had surgery recently 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 a number of services and items he thought

    would be fully covered. He called you to ask what he could do? What could you

    tell him? You

    can offer to review the plans appeal process to help him ask the plan to review

    the coverage decision

    Mr. Pintok is interested in joining a MA-PD plan and wants

    Source : freezingblue.com

    AHIP Module 5 Flashcards

    Study with Quizlet and memorize flashcards terms like Mrs. Walters is entitled to Part A and has medical coverage without drug coverage through an employer retiree plan. She is not enrolled in Part B. Since the employer plan does not cover prescription drugs, she wants to enroll in a Medicare prescription drug plan. Will she be able to?, Mr. Sanchez is entitled to Part A, but has not enrolled in Part B because he has coverage through an employer plan. If he wants to enroll in a Medicare Advantage plan, what will he have to do?, 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? and more.

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    Mrs. Walters is entitled to Part A and has medical coverage without drug coverage through an employer retiree plan. She is not enrolled in Part B. Since the employer plan does not cover prescription drugs, she wants to enroll in a Medicare prescription drug plan. Will she be able to?

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    c. Yes. Mrs. Walters must be entitled to Part A or enrolled in Part B to be eligible for coverage under the Medicare prescription drug program. Correct

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    Mr. Sanchez is entitled to Part A, but has not enrolled in Part B because he has coverage through an employer plan. If he wants to enroll in a Medicare Advantage plan, what will he have to do?

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    c. He will have to enroll in Part B. Correct

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    Mrs. Walters is entitled to Part A and has medical coverage without drug coverage through an employer retiree plan. She is not enrolled in Part B. Since the employer plan does not cover prescription drugs, she wants to enroll in a Medicare prescription drug plan. Will she be able to?

    c. Yes. Mrs. Walters must be entitled to Part A or enrolled in Part B to be eligible for coverage under the Medicare prescription drug program. Correct

    Mr. Sanchez is entitled to Part A, but has not enrolled in Part B because he has coverage through an employer plan. If he wants to enroll in a Medicare Advantage plan, what will he have to do?

    c. He will have to enroll in Part B. Correct

    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?

    a. 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. Correct

    Mr. Gonzalez is entitled to Part A, but has not yet enrolled in Part B. If he wants to enroll in a Private Fee-for-Service (PFFS) plan, what will he have to do?

    d. He will have to enroll in Part B prior to enrolling in the PFFS plan. Correct

    Mrs. Berkowitz wants to enroll in a Medicare Advantage plan that does not include drug coverage and also enroll in a stand-alone Medicare prescription drug plan. Under what circumstances can she do this?

    c. If the Medicare Advantage plan is a Private Fee-for-Service (PFFS) plan that does not offer drug coverage or a Medical Savings Account, Mrs. Berkowitz can do this. Correct

    Mrs. Roberts has Original Medicare and would like to enroll in a Private Fee-for-Service (PFFS) plan. All types of PFFS plans are available in her area. Which options could Mrs. Roberts consider before selecting a PFFS plan?

    d. A Medicare Advantage Prescription Drug (MA-PD) PFFS plan that combines medical benefits and Part D prescription drug coverage, a PFFS plan offering only medical benefits, or a PFFS plan in combination with a stand-alone prescription drug plan. Correct

    Which of the following individuals is most likely to be eligible to enroll in a Medicare Advantage or Part D Plan?

    d. Jose, a grandfather who was granted asylum and has worked in the United States for many years. Correct

    Mr. and Mrs. Nunez attended one of your sales presentations. They've asked you to come to their home to clear up a few questions. During the presentation, Mrs. Nunez feels tired and tells you that her husband can finish things up. She goes to bed. At the end of your discussion, Mr. Nunez says that he wants to enroll both himself and his wife. What should you do?

    d. As long as she is able to do so, only Mrs. Nunez can sign her enrollment form. Mrs. Nunez will have to wake up to sign her form or do so at another time. Correct

    You are visiting with Mr. Tully and his daughter at her request. He has advanced Alzheimer's and is incapable of understanding the implications of choosing a Medicare Advantage or prescription drug plan. Can his daughter fill out the enrollment form and sign it for him?

    c. Mr. Tully's daughter can do so only, if she is authorized under state law as a court-appointed legal guardian, has durable power of attorney for health care decisions, or is authorized under state surrogate consent laws to make health decisions. Correct

    You are meeting with Ms. Berlin and she has completed an enrollment form for a MA-PD plan you represent. You notice that her handwriting is illegible and as a result, the spelling of her street looks incorrect. She asks you to fill in the corrected street name. What should you do?

    c. You may correct this information as long as you add your initials and date next to the correction Correct

    Phiona works in the IT Department of BestCare Health Plan. Phiona is placed in charge of BestCare's efforts to facilitate electronic enrollment in its Medicare Advantage plans. In setting up the enrollment site, which of the following must Phiona consider?

    I. If a legal representative is completing an electronic enrollment request, he or she must first upload proof of his or her authority.

    II. All data elements required to complete an enrollment request must be captured.

    III. The process must include a clear and distinct step that requires the applicant to activate an "Enroll Now" or "I Agree" type of button or tool.

    IV. The mechanism must capture an accurate time and date stamp at the time the applicant enters the online site.

    Source : quizlet.com

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    Question2. Question3. Choose one answer.

    November 29, 2016 | Author: Randell Hines | Category: N/A

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    1 Ms. Moore plans to retire when she turns 65 in a few months. She is in excellent health and will have considerable income when she retires. She is concerned that her income will make it impossible for her to qualify for Medicare. What could you tell her to address her concern? Choose one answer.

    a. Eligibility for Medicare is based on whether or not a person has ever been em she or her husband were ever employed by the federal government, she can e

    b. Medicare is a program for people age 65 or older and those under age 65 w disease or Lou Gehrig’s disease, so she will be eligible for Medicare.

    c. Medicare is a program for people of all ages with specific mental health disa she would not qualify, but should instead look into her state’s Medicaid program

    d. Medicare is a program for people who have incomes and assets below spec exact financial situation before telling her whether she can obtain Medicare cov Source: Medicare Program Basics

    Question2 Mr. Styles would like to plan for retirement and has asked you what is covered under Original Fee-for-Service (FFS) Medicare? What could you tell him? Choose one answer.

    a. Part A, which covers hospital, skilled nursing facility, hospice and home heal professional services such as those provided by a doctor are covered under Or

    b. Part D, which covers prescription drug services, is covered under Original M

    c. Part C, which always covers dental and vision services, is covered under Ori

    d. Part A, which covers long term custodial care services, is covered under Ori Source: Different Ways to Get Medicare

    Question3

    Mr. Hudson is concerned that if he signs up for a Medicare health plan, the health plan may, at some time in the future, reduce his benefits below what is available in Original Medicare. What should you tell him about his concern? Choose one answer.

    a. Medicare health plans offer a menu of benefits, from which he may choos coverage, he need only contact the plan and select other options.

    b. Medicare health plans must cover all benefits available under Medicare P prescription drugs.

    c. He should not be concerned because Medicare health plans must cover a which means that all of them provide substantially greater benefits than are a Part B.

    d. Medicare health plans have the option of deciding, each year, what servic health plan could eliminate some benefits covered by Medicare and he shou Medicare health plan. Source: Different Ways to Get Medicare, cont'd

    Question4 Mrs. Geisler’s neighbor told her she should look at her Part D options during the annual Medicare enrollment period because features of Part D might have changed. Mrs. Geisler can’t remember what Part D is so she called you to ask what her neighbor was talking about. What could you tell her? Choose one answer.

    a. Part D covers hospital and home health services and the cost sharing has ch

    b. Part D covers prescription drugs and she should look at her premiums, form have changed.

    c. Part D covers physician and non-physician practitioner services and the ded the physician charges may go up.

    d. Part D covers long-term care services and she shouldn’t worry because ther Source: Different Ways to Get Medicare, cont'd

    Question5

    Mrs. Weems wants to know generally how the benefits under Original Medicare might compare to the benefit package of a Medicare Health Plan before she starts looking at specific plans. What could you tell her? Choose one answer.

    a. Medicare Health Plans do not necessarily have to cover all of the Original M must include a maximum out-of-pocket limit.

    b. Medicare Health Plans are not permitted to offer any benefits beyond those program and must have the same maximum out-of-pocket limit on Part A and P c. Medicare Health Plans may offer extra benefits that Original Medicare does dental services and must include a maximum out-of-pocket limit on Part A and

    d. All Medicare Health Plans offer cost-sharing that is lower than Original Medic services, but the maximum out-of-pocket limit is higher than in Original Medica Source: Part C Medicare Health Plans

    Question6 Mr. Meoni’s wife has a Medicare Advantage plan, but he wants to understand what coverage Medicare Supplemental Insurance provides since his health care needs are different from his wife’s needs. What could you tell Mr.Meoni? Choose one answer.

    a. Medicare Supplemental Insurance would help cover his Part A and Part B cost (FFS) Medicare as well as possibly some services that Medicare does not cover.

    b. Medicare Supplemental Insurance would cover his dental, vision and hearing s c. Medicare Supplemental Insurance would cover his long-term care services.

    d. Medicare Supplemental Insurance would cover all of his IRS approved health c Original Fee-for-Service (FFS) Medicare. Source: Medigap (Medicare Supplement Insurance)

    1

    Mrs. Chen will be 65 soon, has been a citizen for twelve years, has been employed full time, and paid taxes during that entire period. She is concerned that she will not qualify for coverage under part A because she was not born in the United States. What should you tell her? Choose one answer. a. All individuals who are citizens and over age 65 will be covered under Part A.

    Source : silo.tips

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    James 3 month ago
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    Guys, does anyone know the answer?

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