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Gifts of nominal retail value ($15 or less). The option that Mrs. Roberts could consider before selecting a PFFS plan is: A Medicare Advantage Prescription Drug PFFS plan that had both medical benefits and Part D prescription drug coverage. What sort of penalty might the plan impose on this individual? Mrs. roberts has original medicare for all. Prior to conducting the presentation, obtain, and document having obtained h interest in the specific products you will present. State licensure laws are pre-empted and do not apply to marketing representatives marketing MA and Part D plans. Cost sharing in a PFFS plan will, on average, be two percent lower than what she experiences in Original Medicare as specified in the PFFS plan's terms and conditions. D. Unless she chooses a Medicare Part D prescription drug plan on her own, sh available in her area.
PFFS plans are designed to cover only prescription drugs and if that is the ty enroll in one if it is available in her area. Question6 One of your colleagues argues that face-to-face meetings with potential enrollees should be required because they cannot make an appropriate decision with the minimal information that can be provided over the phone or in small brochures. Which of the following statements provides the best advice? Question4 Mrs. Radford asks whether there are any special eligibility requirements for Medicare Advantage. C. That the PFFS plan will cover all costs not covered by Original Medicare. There is likely an error because she will be paying 86 percent of the cost of gene in2012. AHIP Module 5 Continued... Flashcards. McConnell to include information in his sales presentation about all types of plans, not just the MA plan he is representing. Under Original Medicare, the inpatient hospital co-payment is a percentage of increases after 60 days and again after 90 days. During the first year he is covered under Part B, his premiums will be 10% higher than they otherwise would be, after which point they will return to normal. Yes, he can purchase such a policy, as long as it is through his employer's retiree group plan. Sanchez lives in a state located near Canada. Waste includes any misuse of resources, such as the overuse of services or other practices that directly or indirectly result in unnecessary costs to the Medicare Program.
You appreciate the opportunity and would be happy to schedule an appointm. She could enroll in the PFFS plan and a Medigap plan that offers drug coverage, but not in a stand-alone Medicare prescription drug plan. Ms. What should you tell her about the sort of help available to low income individuals under the Medicare program? D. Accept the form and wait until the Annual Election Period begins to send it to the p Source: Enrollment Periods: Annual Election Period, cont'd. Furthermore, you see that the plan you represent has a unique benefit package. 162. Who is most likely to be eligible to enroll in a Part D prescription drug plan? What statement best describes the marketing and compliance rules that apply to Agent Armstrong? To help her determine when she is likely to qualify for catastrophic coverage, she asked which expenses count toward the out-of-pocket limit that qualifies her for catastrophic coverage. Mr. Schumer has diabetes and heart trouble and is generally satisfied with the care he has received under Original Medicare, but he would like to know more about Medicare Advantage Special Needs Plans (SNPs). He wants to know whether he might qualify. You work for a Sponsor. Mr. Mrs. roberts has original medicare vs medicare. Berwick has many clients who are Medicare beneficiaries. C. You should tell your colleague no because participation in an educational event may n d. Whether or not a sales presentation is allowed at this educational event is entirely up Source: Educational Events, cont'd.
D. Plan sponsors can use any marketing representative, as long as they are licensed in at lea Source: Medicare Marketing Rules: Marketing Representatives – State Licensure. AHIP Exam Test Review Unit 1 to 5 - Question and Answe - Study-Guide. Mr. Fitts did not quite qualify for the extra help low-income subsidy under the Medicare Part D Prescription Drug program and he is wondering if there is any other option he has for obtaining help with his considerable drug costs. Part B primarily covers physician services. You may send an e-mail to all current plan members who have given permission to email them asking for the names, e-mail addresses, and phone numbers of referrals. Medicare prescription drug plans are not permitted to cover the prescription medicatio under Part D coverage, however, plans may cover them as supplemental benefits and th possibility.
After day 60 the amount grad days he would pay the full amount of all costs. Mrs. roberts has original medicare cover. Source: Promotional Activities: Referral Programs Question7. Question4 You have been providing a pre-Thanksgiving meal during sales presentations in November for many years and your clients look forward to attending this annual event. Cost sharing in a PFFS plan may include a deductible and copayments and providers are not permitted to charge the beneficiary more than the cost sharing specified in the PFFS plan's terms and conditions of payment.
You must have her sign a scope of appointment form, indicating which products she wishes to discuss, and note on the form that she is a "walk in. " Tell her that Medicare recommends that beneficiaries enroll in a Medicare Advantage plan because it will serve her better than Original Medicare. Shapiro should check with his plan to see if he qualifies. Source: Educational Events; Educational Events cont'd. What should you tell them Choose one answer. Individuals who enroll into any portion of their state Medicaid p or Part D. c. Steeley must wait until the Annual Election Period to make MA or Part D plan. She must have previously been enrolled in Original Fee-for-Service Medicare for at least one year before she may enroll in an MA plan. Will gaining eligibility for this program affect her ability to enroll in a Medicare Advantage or Medicare Prescription Drug plan? Roberta is a retiree who has just learned that she has purchased a Medicare Advantage (MA) plan from an unlicensed individual representing BestCare Health Plan.
Mrs. Weems wants to know generally how the benefits under Original Medicare might compare to the benefit package of a Medicare Health Plan before she starts looking at specific plans. The scope of appointment forms must be retained for a period of ten (10) yea. D. Tell her that the Medicare agency does not endorse or recommend any plan. For enrollees in an MSA, after the annual deductible is met, the MSA plan generally pays 75% of covered services. It means that he will have a one time opportunity to enroll into a Medigap policy with drug coverage. He generally would pay only a per-prescription co-payment.
The company told Mr. Yoo that, because he was affected by this change, he would qualify for a Special Election Period. Mr. Biden is trying to understand the difference between Original Medicare and Medicare Advantage. Source: Involuntary Disenrollment from MA, Part D, or Cost Plans – At Plan Option, cont'd; Involuntary Disenrollment from MA, Part D, or Cost Plans – At Plan Option, cont'd. What are you permitted to say during your conversation with him? A stand-alone prescription drug plan in combination with a PFFS plan or a PFFS Medigap Supplemental Insurance plan. If she brings up the topic of her health, you can ask Mrs. Brown as many questions determine which plan is most suitable for her health needs. D. Source: Part 4, Frequently Asked Questions; Promotional Activities: Nominal Gifts. Coverage always begins on the first of July, or the first of January after a first.
Thomas' daughter can do so because she is an immediate family member who has taken responsibility for her father's care. PFFS plans are the same as Medicare supplement plans and he may obtain care from any provider in the U. Daniel is a middle-income Medicare beneficiary. Medicare health plans must include in all marketing representative contracts requirements to abide by all guidance from the Federal agency overseeing Medicare and all applicable state laws. Which one of the following would count? Most individuals who are citizens and over age 65 and are covered under Part A must pay a monthly premium for that coverage. Prescription drug plan. All individuals who are citizens and over age 65 will be covered under Part A. His entitlement to Part A makes him eligible to enroll in any Medicare Advantage plan. Costs under the VA are significantly higher than those under a Medicare Par. What do you need to do with your materials before using them for marketing purposes? What should you tell her about coverage of emergency care?