If non-compliance occurs, CMS can penalize a plan in which of the. Mr. Lee was intending to enroll in MaxCare's Medicare Advantage plan this year. You must advise consumers enrolling in a D-SNP that: Question #359.
You have approached a hospital administrator about marketing in her facility. Agent Mary Jennings makes a presentation on Medicare advertised as an educational event. To be in compliance with requirements for. C. You will not be able to represent any Medicare Advantage or Part D plan until you complete the training and achieve an adequate ever, you will not have to take a test if you exclusively market employer/union group plans and the companies do not require testing [Show Less]. He will then submit the paper application before the start of the annual enrollment period (AEP). Which standalone Prescription Drug Plan is best for a dual-eligible chooser? What cost sharing is he responsible for while in the grace period? Mr. lombardi is interested in a medicare advantage work. Mr. Shultz was still working when he first qualified for Medicare.
He recently heard about a Medication Therapy Management (MTM) program in which his friend is enrolled. Ms. Jensen has heard about "Original Fee-for-Service Medicare" and "Private Fee-for-Service" plans. Mr. Green, the president of MCC, wants to understand which method is best to use. You notice a certain diagnostic provider ("Doe Diagnostics") requested a substantial payment for a large number of members. Mr. lombardi is interested in a medicare advantages. Another agent working for your agency claims that because you are not employed by the Medicare Advantage plans that you represent, you are not subject to the same marketing requirements as the plans themselves. Contact us if you would like to learn more. " This beneficiary normally receives a quantity of 60, not 160.
Ms. Lewis understands that Medicare prescription drug plans may use various methods to control the use of specific drugs. Juan Perez, who is turning age 65 next month, intends to work for several more years at Smallcap, Incorporated. Which of the following statements best describes how business reply cards (BRCs) may be employed in the marketing of Medicare Advantage products? Debbie would like to ensure that her father is still able to enroll in MaxCare's plan, but she is unsure what her role is to help with his enrollment request. Mrs. McIntire is enrolled in her state's Medicaid plan and has just become eligible for Medicare as well. Mr. Lombardi is interested in a Medicare Advantage (MA) PPO plan that you represent. It is one of - Brainly.com. She is in excellent health and will have considerable income when she retires. How should agent Erin respond when consumer Mrs. Rose notices that the presented MA Plan has a Star Rating of 2 stars? Original Medicare and would like to know which of the following services. She has heard about a technique called "step therapy" and is wondering if you can explain what that is. You respond to such a statement? She would like to meet and discuss plan choices with you. Ms. Jefferson has heard about "Original Fee-for-Service. Auxiliary aids and services must be provided to individuals with disabilities, such as those suffering from vision or hearing impairments, free of charge, and in a timely manner.
Should you include on your tip list? They are not required to offer the standard plan. An educational event may not include a sales presentation. Later in the year, Mr. Rivera needs dentures, a service only covered under Medicaid. What should you tell her about how the Part D Initial Enrollment Period applies to her situation? I. Enrollees have a right to obtain a review (appeal) of certain decisions about prescription drug coverage. Duarte has some cognitive impairment and her son informs you that he has power of attorney to make financial decisions for her. Mr. lombardi is interested in a medicare avantage concurrentiel. What would be a correct description? Responded, and the Chamber decided to cancel the event. He has a stand-alone. Which is a service provided to a C-SNP or D-SNP member placed in the low to moderate care management risk level? You may develop and use your own materials, as long as they. She has been informed that her group coverage will end on her retirement effective date.
Which statement describes the primary characteristic of a consumer who may benefit from a D-SNP? He wants to know whether he might qualify. An attempt to set up a sales appointment. However, she wants to make sure she does not end up paying premiums for two plans. What should you tell her when she asks you about TrOOP? AHIP Questions - 2023 AHIP EXAM Q&A. Under the rules applicable to. He is not eligible to enroll in a Medicare Advantage plan until he re-enrolls in Medicare Part B. Billings enrolled in the ABC Medicare Advantage (MA) plan several years ago. Which of the following steps should he take in order to be in compliance with Medicare marketing rules? AHIP Module 2 EXAM GRADED A Mr. What would be a correct des... [Show More] cription? Telephonic enrollments must include all required elements necessary to complete an enrollment.
May do it only during the MA Disenrollment Period, which runs from January 1 to. Step Therapy, Prior Authorization, Quantity Limit, 7-day limit, Dispensing Limit and Limited Access are all examples of what? Agent Jennings distributes materials that are solely educational in nature. Wellcare offers a range of Medicare plans to provide members with affordable access to: Question #427. She is concerned that her expenses have reached the maximum out-of-pocket costs and now her special needs plan (SNP) will disenroll her. The board has expressed concern over increasing the dividend above a level it could not sustain for at least eight years. She is entitled to Medicare Part A and intends to enroll in Part B. Agent Chan is conducting a sales presentation on senior issues where he hopes to enroll some attendees in the Medicare Advantage (MA) plans he represents. Which of the following is NOT true about UnitedHealthcare Medicare plans carrying the AARP name? He should apply for coverage under his state's. A period, outside of the Annual Election Period, when a Medicare beneficiary can select a new or different Medicare Advantage and/or Part D prescription drug plan. These are examples of issues that should be reported to a Compliance Department: suspected fraud, waste, and abuse (FWA); potential health privacy violation, unethical behavior, and employee misconduct.
Opportunity to enroll receive incentive gifts for enrolling. Agent John Miller is meeting with Jerry Smith, a new prospect. 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). Able is an independent agent paid directly by a health plan. Many of these claims are for a certain procedure. Members who lose their eligibility for the D-SNP due to a change or loss of Medicaid status are responsible for what cost sharing? For catastrophic coverage. Which of the following statements does NOT correctly define prescription drug stages? What should you tell Mr. Rainey (or his representative) about the length of an inpatient psychiatric hospital stay that Medicare will cover? There is no limit on the expenses a plan can incur on behalf. Charles has just turned age 65 and is now back in the United States. B. SNPs have special programs for enrollees with chronic conditions, like Mr. Sinclair, and they provide prescription drug coverage that could be very helpful as well. Mr. Anderson is a very organized individual and has filled out and brought to you an enrollment form on October 10 for a new plan available January 1 next year.
What should you tell Mrs. Quinn? If a Part D benefit is offered through her plan she may choose in enroll in that plan or a standalone PDP. 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. Mr. James has end-stage renal disease (ESRD). Mr. Rockwell, age 67, is enrolled in Medicare Part A, but because he continues to work and is covered by an employer health plan, he has not enrolled in Part B or Part D. He receives a notice on June 1 that his employer is cutting back on prescription drug benefits and that as of July 1 his coverage will no longer be creditable.
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