When you market Medicare Advantage and Part D plans, what may you offer
as a gift to induce enrollment in a plan? Correct ans - You may provide
gifts or prizes to all potential enrollees during an event that does not e
...
When you market Medicare Advantage and Part D plans, what may you offer
as a gift to induce enrollment in a plan? Correct ans - You may provide
gifts or prizes to all potential enrollees during an event that does not exceed
$15 in retail value.
By contacting plans available in your area, you have learned that the plan
you represent has a significantly lower monthly premium than the others.
Furthermore, you see that the plan you represent has a unique benefits
package. What should you do to make sure your clients know about these
pieces of information? Correct ans - You may make comparisons
between plans if you can support them by studies or statistical data and
such comparisons are factually based.
Mr. Cole has been a Medicaid beneficiary for some time, and recently
qualified for Medicare as well. He is concerned about changes in his cost-
sharing. What should you tell him? Correct ans - He should know that
Medicaid will pay cost sharing only for services provided by Medicaid
participating providers.
If a beneficiary is enrolled in a stand-alone prescription drug plan and wants
to keep that plan, what type of Medicare health plan could the individual also
enroll in, without being automatically disenrolled from the stand-alone
prescription drug plan? Correct ans - The beneficiary could enroll in a
private fee-for-service (PFFS) plan that does not include prescription drug
coverage; a cost plan; or a Medicare Medical Savings Account (MSA) plan.
Which of the following statements about Medicare Part D are correct?
I. Part D plans must enroll any eligible beneficiary who applies regardless of
health status except in limited circumstances.
II. Private fee-for-service (PFFS) plans are not required to use a pharmacy
network but may choose to have one.
III. Beneficiaries enrolled in a MA-Medical Savings Account (MSA) plan may
only obtain Part D benefits through a standalone PDP.
IV. Beneficiaries enrolled in a MA-PPO may obtain Part D benefits through a
standalone PDP or through their plan. Correct ans - I, II, and III only
Mr. Olsen is concerned that a Medicare Advantage plan will not cover the
same range of services that would be covered under Original fee-for-service
Medicare. What should you tell him? Correct ans - Though their cost-
sharing may differ from Original Medicare's, Medicare Advantage plans are
required to cover all services covered by original Medicare.
This study source was downloaded by 100000805751619 from CourseHero.com on 07-25-2023 01:49:35 GMT -05:00
https://www.coursehero.com/file/179948518/AHIP-2023-Final-Exam-7docx/
Mrs. Sanchez lives in a state located near Canada. She has recently become
eligible for Medicare and is considering enrollment in Part D prescription drug
coverage. One of her friends has told her that she needs to be aware of
something called TrOOP. What should you tell her when she asks you about
TrOOP? Correct ans - TrOOP are out-of-pocket costs that count toward
the annual out-of-pocket threshold to move into catastrophic coverage and
generally include the annual deductible(s) and costs for drugs on the plan's
formulary purchased at a plan's participating pharmacy. In some instances,
amounts not directly paid by the enrollee (like manufacturer discounts) count
toward TrOOP.
[Show More]
