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Thursday, 11 July 2024

The Wellcare preferred pharmacy network includes Walgreens, CVS, and many grocery chains in 2023. Approved by the Medicare agency and the plan you represent. Keep up to date with FWA policies and procedures, standards of conduct, laws, regulations, and the Centers for Medicare & Medicaid Services (CMS) guidance. He could check with the manufacturers of his medications to see if they offer an assistance program to help people with limited means obtain the medications they need. Ms. Gibson recently lost her employer group health and drug coverage and now she wants to enroll in a PPO that does not include drug coverage. Financial decisions for her. You review the same type of procedure for other diagnostic providers and realize Doe Diagnostics' claims far exceed any other provider you reviewed. You have finished a sales presentation with Mrs. Slade, who. Generic prescription drugs from his employer's retiree coverage, but he wants. Phiona works in the IT Department of BestCare Health Plan. Mr. lombardi is interested in a medicare advantage (ma) ppo plan. Had enrollment/disenrollment issues (e. g., disenrollment/cancellation requests, late enrollment penalty, loss of entitlement). His plan premiums deducted from his Social Security check.

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During a sales presentation in Ms. Sully's home, she tell you that she has hard about a type of Medicare health plan known as PFFS. Ms. Stuart has heard about a special needs plan (SNP) that one of her friends is enrolled in and is interested in that product. Mr. lombardi is interested in a medicare advantage ppo. Medicare Supplemental Insurance would help cover his Part A and Part B cost sharing in Original Fee-for-Service (FFS) Medicare as well as possibly some services that Medicare does not cover. Agent Antonio is preparing for a presentation on Medicare and Medicare Advantage before a local senior citizen civic group where he hopes to enroll some attendees. Centene continues to expand its reach by offering more products in a wider geography.

Mr. Ziegler is turning 65 next month and has asked you what he can do, and when he must do it, with respect to enrolling in Part D. What could you tell him? Enrollment form for a MA-PD plan you represent. Key areas you as a broker/agent have control over and impact upon regarding Star Ratings for quality are: a. In setting up the enrollment site, which of the following must Phiona consider? Mrs. Willard wants to know generally how the benefits under Original Medicare might compare to the benefits package of a Medicare Advantage Plan before she starts looking at specific plans. It helped me a lot to clear my final semester exams. Which of the following is NOT a consideration when making the change? Ways to report a compliance issue include: reporting to the compliance department/supervisor. AHIP Questions - 2023 AHIP EXAM Q&A. Co-payments associated with Original Medicare. Non-network providers must accept the same amount that Original Medicare would pay them as payment in f. Question #219. home for a sales presentation. Mr. Wong's taxable income is in excess of $100, 000. To be in compliance with requirements for. Plans can use a formulary, or list of covered drugs. During an appointment scheduled to discuss a Medicare.

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Assistance could do for him if he qualifies. Application and Enrollment. An educational event may not include a sales presentation. He wants to know if he must use doctors in a network as his current HMO plan requires him to do. Could enroll in one of the MA plans that include prescription drug coverage or. He doesn't know what he should do. What advice would you give Melanie if she wishes to continue to receive renewal fees? Reduce its coverage for a given drug mid-way through the year? They do not need to be. Mrs. Goodman enrolled in an MA-PD plan during the Annual Election Period. Mr. Nunez attended one of your sales presentations. Mr. lombardi is interested in a medicare advantage pitch. When a paper SOA form is used, it must be completed __________ hosting the sales presentation. Which of the following is true about Medicare Supplement Insurance Plans? How would the guidelines for marketing MA and Part D plans apply to this practice?

Medicare Enrollment Period - Individuals who do not enroll in Part B when first eligible can enroll during a General Enrollment Period, Jan 1st to Mar 31st each year. Janice wants to enroll in a Medicare Advantage plan. Locate points of contact. Under the rules applicable to. AHIP BUNDLED EXAMS WITH COMPLETE SOLUTIONS(All AHIP exams are here)Full solution pack AHIP bundle 100% verified. He or his physician could obtain the standardized request form on the plan's. Mr. Perry is entitled to Medicare Part A but has not yet enrolled in Part B, even though he is 69 years old. He has tried two, but had an allergic reaction to them. Which of the following statements does NOT correctly define prescription drug stages?

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The signature element must be completed via certified mail. She has heard about a technique called "step therapy" and is wondering if you can explain what that is. Which consumer might benefit the most by enrolling in a D-SNP? Ajax Agency is targeting potential enrollees for MSA plans. Before you conduct such sales presentations, what must you do? He is currently enrolled in Original Medicare. Mrs. Roberts has just received a new Medicare identity card in the mail. She is in excellent health and will have considerable income when she retires. Rosanna is enrolled in a Medicare Advantage Only (MA-Only) Private Fee-for-Service (PFFS) Plan. Operating costs and/or may offer enhanced coverage in return for an additional. How would you advise Ms. Thomas? Advertised the event in their monthly newsletter and asked anyone interested to. Before engaging in such a discussion, what should you do? Able, Baker, and Charles are engaged in the marketing to and enrollment of beneficiaries into Medicare health plans.

Melissa would like to use the power of social media to reach potential prospects. His current plan is suitable for his medical needs, but he would like to add prescription drug coverage only. Have Part B to enroll. Of any one beneficiary and a plan sponsor may not end a member's enrollment. What should her agent remind her about? 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 statements is correct about HMO MA Plans? Mr. Rodriguez is currently enrolled in a MA plan, but his plan doesn't sufficiently cover his prescription drug needs. Agent Jennings distributes materials that are solely educational in nature.

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Which service will a C-SNP or D-SNP member in the high risk care management category receive? As part of this job, you use a process to verify the data is accurate. He is certain his plan will disenroll him because that is what happened to a friend of his in a similar type of plan. Xi that best describes the health coverage provided to Medicare beneficiaries? Verify all information provided to you. He would like to know his options since he has decided to drop his retiree coverage and is eligible for Medicare. He would like to enroll in a Medicare Part D prescription drug plan but is concerned that he will have to sign up for Part B as well in order to qualify for enrollment in a Part D plan. Richard has several clients who have recently come to him for help who are in their initial coverage election period (ICEP) and are interested in enrolling in one of Spartan Health Plan's MA plans. Ramos can obtain care from any provider who participates in Original Medicare, but generally will have a higher cost-sharing amount if she sees a provider who/that is not part of the PPO network.

Individuals sometimes referred to as dual eligibles Medicare Cost Plan - Type of Medicare health plan. Received incorrect plan benefit information or were dissatisfied with plan benefits. If Dr. Elizabeth Brennan does not contract with the PFFS plan, but accepts the plan's terms and conditions for payment, how will she be paid? Are not subject to the same requirements as the plans themselves. She has recently also become eligible for Medicaid and would like to enroll in a MA-PD plan. Available in his area and noted a wide range in premiums. In preparation for the sales presentation, what must you do? Andrews was preparing a budget for next year because she takes quite a few Rx drugs, she will reach the coverage gap, and wants to be sure she has enough money set aside for those months. She is concerned that since no generic prescription drug is available and these drugs are very high cost, she will not be able to find a Medicare Part D prescription drug plan that covers either one of them.

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