D. In most Medicare Advantage HMOs, Mr. Kumar must obtain his services only from providers who have a contractual relationship with the plan (except in an emergency). As part of this job, you use a process to verify the data is accurate. If non-compliance occurs, CMS can penalize a plan in which of the. Mr. lombardi is interested in a medicare advantage pitch. She concerned about having prescription drug coverage. Enrollment in Cost plans offering Part D coverage is available only during enrollment periods under the Part D program, and Cost plans must accept enrollments during these periods. What should you advise her to do before she will be able to enroll into a Medicare health plan?
Application and Enrollment. Mr. Mattison understands that Medicare prescription drug. Will she be able to? At the end of your discussion, Mr. Nunez says that he wants to enroll both himself and his wife. He is wondering if he can obtain coverage under Medicare. Able, Baker, and Charles are engaged in the marketing to and enrollment of beneficiaries into Medicare health plans. Organization in Mr. AHIP BUNDLED EXAMS WITH COMPLETE SOLUTIONS(All AHIP exams are here)Full solution pack AHIP bundle 100% verified. Lombardi's area. As long as she can do so, only [Show Less]. AHIP Final Exam Test. Mr. Green, the president of MCC, wants to understand which method is best to use. Which standalone Prescription Drug Plan is best for a dual-eligible chooser? Charles is an independent agent paid for his work by a third-party marketing organization (TMO).
Mr. Fitzgerald is selling his home to permanently move into a retirement facility near his daughter in a neighboring state before the Annual Election Period. Mr. lombardi is interested in a medicare advantage program. AHIP 2021 Module 5 QUIZ (with complete solution) 100% Correct Mrs. Pierce would like to enroll in a Medicare Cost plan that offers Part D prescription dru... [Show More] g coverage. In which situation must the Medicare Advantage (MA) organization disenroll a member from an MA plan? Facility and he asked if you could present a program for the residents about.
Can join anytime plan is accepting new members. She received assistance calculating her projected expenses from her daughter who is a pharmacist. Agent Lopez's entire compensation must be recouped because Ralph disenrolled within the 3 month period. Mrs. Reynolds is in her Medicare initial coverage election period (ICEP) and the date of her entitlement to Part A and B has already occurred.
A large physician group in your area contracts with the. Ms. Lowman has marketed several different types of insurance. Mr. White has Medicare Parts A and B with a Part D plan. Moore plans to retire when she turns 65 in a few months. Madeline Martinez was widowed several years ago. A Health Risk Assessment (HRA) can be completed for C-SNP and D-SNP plans only, before the enrollment application process in Ascend through the Value Based Enrollment (VBE) portal. C. AHIP Questions - 2023 AHIP EXAM Q&A. Minimize call volumes/complaints.
Should know that Medicaid will pay cost sharing only for services provided by. Question #260 (Similar to 31). Apply by contacting her state Medicaid office, or calling the Social Security. Which statement is true about members of a Medicare Advantage (MA) Plan who want to enroll in a Medicare Supplement Insurance Plan? In preparation for the sales presentation, what must you do? What could you tell her to address her concern? Mr. Prentice has many clients who are Medicare beneficiaries. Heard there may be extra help paying for Part D prescription drugs for Medicare. Mr. lombardi is interested in a medicare advantage msa. Medicare beneficiaries who enroll in an SNP must always obtain their drug coverage through a stand-alone Part D Medicare prescription drug plan that they sign up for independent of their enrollment in the SNP. The extra help is available only to Medicare beneficiaries. He wants to know whether he might qualify.
In which of the following situations can telephonic contact be made with a Medicare eligible consumer? Mr. Ziegler is turning 65 next month and has asked you what he can do, and when he must do it, with respect to enrolling in Part D. What could you tell him? Which of the following is NOT potentially a penalty for violation of a law or regulation prohibiting fraud, waste, and abuse (FWA)? Which of the following statements best describes what you can and cannot do in order to stay in compliance? Member Satisfaction/Experience. Anita's older neighbor Mel has told her about the Medigap Plan F in which he is enrolled. Identity theft and does not want to give you her Social Security number. Formulary is defined as: Question #299. Presentation, she asks you to stay in contact to ensure that she is being well. Which of the following statements is correct about HMO MA Plans? What should you say regarding special enrollment periods (SEPs)? As a result, Mary has been admitted to a rehabilitation hospital where she is expected to reside for several months.
Her husband worked full-time. Mary may make an unlimited number of MA enrollment requests and may disenroll from her current MA plan. 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. Mr. Jenkins is interested in enrolling in a Medicare cost plan and has sought your advice. One of your clients, Lauren Nichols, has heard about a Medicare concept from one of her neighbors called TrOOP. How could you address her concern. What can agent Willis do? 00 for less than 30 quarters. Baker is an independent agent paid through a field marketing organization (FMO). You respond to such a statement? According to Medicare's enrollment guidelines, when could she do this? However, he should be aware that it is likely he will have to pay higher cost-sharing for services from out-of-network providers. Initial Health Assessment.
Question #164. is one of your clients and in excellent health. Mr. Rivera has QMB-Plus eligibility and is thus covered by both Medicare and Medicaid. Mrs. Walters is enrolled in her state's Medicaid program in addition to Medicare. Although options for capturing and submitting SOAs vary by health plan, Wellcare accepts SOAs in which of the following methods? If you were in Agent Walker's position, what would you do?
He gains the Part D low-income subsidy. Mrs. Kendrick is six months away from turning 65. A PFFS plan is one of various types of Medicare Advantage plans offered by private entities and she may enroll in one if it is available in her area. Multiple times this year. Client Mildred Jones has expressed interest in a Medicare Advantage plan. The prescription drug coverage has not been comparable to that offered by Medicare Part D for several years and despite notification, Mr. Kelly took no action.
Where might he turn for help with his prescription drug costs? Agent Lopez helps Ralph to enroll in Top Choice Medicare Advantage plan during the Annual Open Enrollment Period. Mrs. Park is an elderly retiree. How do the CMS compensation rules apply to these three agents? Agent Marvin Millner wants to reach out to his current clients for referrals. She has contacted your office and requested a meeting so that she can learn about Medicare and the products you represent.
What should you tell him about how a Medicare Cost Plan might fit his needs? Wong has health coverage through his employer but will sign-up Medicare Part A, Part B and Part D when he leaves the workforce. This beneficiary normally receives a quantity of 60, not 160. Which she is responsible. Subsequently, Mrs. O'Malley disenrolls on February 12th following a move outside the plan's service area. Whose email address may the agent enter into the LEAN enrollment application?
Increase member satisfaction. Mrs. Allen has a rare condition for which two different brand name drugs are the only available treatment. Adam and Betty both currently have coverage through Colgate Health. As you are finishing up, what should you tell him about next steps in the enrollment process?
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