The neighbors may not provide anything to either eat or drink during the sales presentation. He should drop the employer coverage and enroll in a Medicare prescription dr always more costly for beneficiaries and most do not cover the same range of dru. How would you advise him? She will need to have her physician help her select a new drug that i. Mr. Mrs. roberts has original medicare.gov. What could you tell him to do? He decides to enroll in a Medicare Advantage (MA) plan. A bottled water distributor wants to determine whether the mean amount of water contained in 1-gallon bottles purchased from a nationally known water bottling company is actually 1 gallon.
Brokers and agents cannot require face-to-face meetings in order to answer questions or complete an enrollment application. He or his physician could obtain the standardized request form on the plan's website, fill it out, and submit it to his plan. Shapiro should check with his plan to see if he qualifies. Source: Required Practices: Plan Ratings. D. He may only use the SEP to disenroll from his MA plan and return to Origina Source: Enrollment Periods: Special Enrollment Periods (SEPs), cont'd. No, prizes of any kind can never be offered as a marketing tool for Medicare Advantage or Medicare Prescription Drug plans. Given his c and would not be able to enroll in the SNP. Mrs. roberts has original medicare cover. D. SNPs offer care from any doctor or hospital Mr. Sinclair would like to use and Original Medicare. Question2 During a sales presentation for a Private Fee-for-Service (PFFS) plan, which of the following points must you explain? He can keep his plan indefinitely because prescription drug plan's must be available to all beneficiary's regardless of where they live. Drug coverage and intends to obtain his drug coverage through a stand-alone Medicare prescription drug plan. The administrator is uncomfortable with the suggestion.
As long as you market only health-related products, you can make an initial call to any beneficiary, but then must honor "do not call again" requests. What should you tell Mr. Xi that best describes the health coverage provided to Medicare beneficiaries? AHIP Module 5 Continued... Flashcards. If she does not sign up for a Medicare prescription drug plan, she will incur no penalty, as long as she can demonstrate that she was in good health and did not take any medications. C. That the PFFS plan will cover all costs not covered by Original Medicare. Releases of information by physicians to brokers or agents concerning their patients is permitted by state law, however, you should consult an attorney who specializes in your state privacy laws before proceeding. Brokers and agents cannot require face to face meetings in order Medicare beneficiary.
D. His entitlement to Part A makes him e Advantage plan. You have clear evidence that your plan is the best and can say so to your clients. For enrollees in an MSA, after the annual deductible is met, the MSA plan generally pays 75% of covered services. Mr. Rainey is experiencing paranoid delusions and his physician feels that he should be hospitalized. Mrs. roberts has original medicare and medicaid. He is currently in the Part D Initial Enrollment Period (IEP) and, during this time, he may only enroll in an MA-PD plan. You can countersign Mrs. Nunez' application, along with her husband, indicating th This witness signature is sufficient to make the enrollment valid. In setting up the enrollment site, which of the following must Phiona consider? If he wants to enroll in a Private Fee-for-Service (PFFS) plan, what will he have to do? Question4 Ms. Claggett is sixty-six (66) years old.
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. Fields wants to know whether applying for the Part D low income subsidy will be worth the time to fill out the paperwork. When medication costs exceed a certain threshold amount, which rises each year, permitted to exclude coverage for all but the least expensive of the medications in a gi encourage her physician to prescribe the least expensive of the two alternatives. Question3 Mr. AHIP Exam Test Review Unit 1 to 5 - Question and Answe - Study-Guide. Diaz will not pay any penalty because he had continuous coverage unde. 1 All plans must cover at least the standard Part D coverage or its actuarial equivalent. Part D covers prescription drugs and she should look at her premiums, formulary, and cost sharing to see if they have changed. Mr. Only the third drug works for him and it is not on his Part D plan's formulary. He is worried that he will lose his coverage now when he needs it the most. Question7 Mr. Can he do this in a way that complies with guidance from the Medicare agency?
The Medicare Advantage plan received the best star rating in customer service and care coordination. This is not a possibility. Block wants to enroll in both a MA-PD and a stand-alone PDP, he may buy the extra coverage without any adverse effect. Her daughter should come sometime between January 1 and February 14. Mr. Karathanos is in excellent health, lives in his own home, and has a sizeable income from his investments. He recently suffered complications following hip replacement surgery. Hall is leaving the state, you can immediately present her with information on the prescription drug plan, so she can make a decision before it is too late. Agent Harriet Walker has recently begun marketing Medicare Advantage and related products aimed at meeting the needs of senior citizens. She takes a number of medications and is concerned that she has not been able to identify a plan that covers all of her medications. A PFFS plan is a type of Medicare Supplement plan and she may enroll in o. B. Diaz will pay a penalty, which will be a flat amount each year, paid during.
Mr. Klasen wants to know whether he is eligible to sign up for a Private fee-for-service (PFFS) plan. If she uses non-network providers, she would not be permitted to obtain care outside of her plan's service area. Source: Different Ways to Get Medicare, cont'd. SNPs only serve individuals eligible for both Medicaid and Medicare, so he cannot enroll.
D. He will need to do nothing. You must tell him you are not permitted to take the form. She has heard that to qualify for Medicare Part A she has to have worked and paid Medicare taxes for a sufficient time. Medicare will cover a total of 190 days of inpatient psychiatric care during M 2. Share or Embed Document. Lopez takes several high-cost prescription drugs. The government pays a per-beneficiary dollar amount to the Medicare Part D p premiums for their low-income enrollees in accordance with the plan's set criteria plan to see if he qualifies. D. The VA will not offer drug coverage to Mrs. Fiore once she qualifies for th Source: Employer/Union Coverage of Drugs. He will incur a late enrollment penalty.
D. Diaz will pay a penalty, which will be a flat amount each year, paid during Source: Medicare Premium for Part B, cont'd. Source: Required Practices: Marketing Activities; Prohibited Practices: Marketing Activities, cont'd. Mrs. Tabe has just turned 65, is in excellent health, and has a relatively high income. If a PFFS enrollee shows his/her card when obtaining services from a provider who participates in Original Medicare, then that provider is required to accept the plan's terms and conditions. Agent Adams is considering suggesting that he and Mrs. Young complete the application together before she leaves. 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 PFFS Medigap Supplemental Insurance plan. Medicare prescription drug plans are required to cover drugs in each therapeutic category.