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AHIP Final Exam Latest Solutions

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AHIP Final Exam Latest Solutions Mr. Davies is turning 65 next month. He would like to enroll in a Medicare health plan, but does not want to be limited in terms of where he obtains his care. What sh... ould you tell him about how a Medicare Cost Plan might fit his needs? Correct Answer: a. Cost plan enrollees can choose to receive Medicare covered services under the plan's benefits by going to plan network providers and paying plan cost sharing, or may receive services from non-network providers and pay cost-sharing due under Original Medicare. b. Ms. Lopez is considered a marketing representative of Best Care and thus is obligated to comply with CMS marketing requirements, including those regarding using only approved call scripts. Correct Answer: Ms. Lopez is an independent agent under contract with Market Co, a third-party marketing organization. Markets has a contract with Best Care health plan, a Medicare Advantage (MA) organization, to offer marketing services through its contracted agents and agencies. Ms. Lopez returns calls to individuals who contact Markets in response to its mailers promoting Best Care health plan. Which of the following best describes the responsibilities of Ms. Lopez? a. Ms. Lopez is considered a marketing representative of Best Care but is exempt from the marketing rules regarding approved call scripts because she works directly for Market Co. b. Ms. Lopez is considered a marketing representative of Best Care and thus is obligated to comply with CMS marketing requirements, including those regarding using only approved call scripts [Show More]

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