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Which type of SNP is likely to be most appropriate for him? Who qualifies for the opt-in simplified enrollment mechanism? AHIP Questions - 2023 AHIP EXAM Q&A. Some of the laws governing Medicare Part C and D fraud, waste, and abuse (FWA) include the Health Insurance Portability and Accountability Act (HIPAA), the False Claims Act the Anti-Kickback Statute, and the Health Care Fraud Statute. Mr. Decaro has looked at Medicare prescription drug plans.

Mr. Lombardi Is Interested In A Medicare Advantage Msa

Assistance could do for him if he qualifies. He wants to know whether he might qualify. 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. Which of the following best describes the responsibilities of Ms. AHIP BUNDLED EXAMS WITH COMPLETE SOLUTIONS(All AHIP exams are here)Full solution pack AHIP bundle 100% verified. Lopez? This month, you identify the same enrollees on the report again.

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Mrs. Gonzalez is enrolled in Original Medicare and has a Medigap policy as well, but it provides no drug coverage. After receiving such disability payments for 24 months, he will be automatically enrolled in Medicare, regardless of age. Ms. Claggett is sixty-six (66) years old. Ms. Morris will turn 65 on June 10 th. At the beginning of the presentation, Mrs. Mr. lombardi is interested in a medicare advantage msa. Midler tells you that she has a copy of her medical records available because she thinks this will help you understand her needs. Adam and Betty both currently have coverage through Colgate Health. Agent John Miller is meeting with Jerry Smith, a new prospect. He or his physician could obtain the standardized request form on the plan's. To compare it to a Part D prescription drug plan. Plans, but want to be sure you follow the CMS requirements. Ways to report a compliance issue include: reporting to the compliance department/supervisor.

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Mr. Fera is selling his home to move into a retirement. 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. Sharing and Part D prescription drug coverage. Forms on behalf of all the residents who would like to attend. She asks you to explain it. The Medicare Advantage plan received a 5-star rating in customer service and care coordination with an overall performance rating of 4-stars. 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? Mr. lombardi is interested in a medicare advantage ppo. Medicare Entitlement/Enrollment - Part A & Part B - Individuals with ESRD may sign up at anytime. She concerned about having prescription drug coverage.

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He would like to pay for his monthly Part D premiums with an automatic monthly withdrawal from his savings account until it is exhausted, and then have his premiums withheld from his Social Security check. The signature element must be completed via certified mail. Contacting potential clients to market those plans? Mr. lombardi is interested in a medicare avantage concurrentiel. Mr. Fitzgerald is selling his home to permanently move into a retirement facility near his daughter in a neighboring state before the Annual Election Period. How should agent Erin respond when consumer Mrs. Rose notices that the presented MA Plan has a Star Rating of 2 stars? He has heard there may be extra help paying for Part D prescription drugs for Medicare beneficiaries with limited income.

Mr. Lombardi Is Interested In A Medicare Advantage Ppo

Which statement is true for Aries? A client wants to give you an enrollment application on October 1 prior to the beginning of the Annual Election Period because he is leaving on vacation for two weeks and does not want to forget about turning it in. Medicare Part A Premium - Free if worked 40 quarters of your life and paid Medicare taxes. You are completing a PFFS plan sale to Mr. West who is new to Medicare and prefers to be contacted by telephone. She may enroll in an MA plan beginning three months immediately before her first entitlement to both Medicare Part A and Part B. Goodman enrolled in an MA-PD plan during the Annual Election Period. Brokers/Agents may be investigated after being suspected of noncompliant activity reported through a: - Complaint Tracking Module (CTM). Mountainair Construction Company (MCC) crushes boulders to obtain decorative rock, which they sell through various outlets. Mr. Liu turns 65 on June 19.

Mr. Lombardi Is Interested In A Medicare Advantage

Which elements are available as part of Wellcare's sales support model? Recently, Mrs. Garcia has completed an enrollment application for a plan offered by Caring Health, which is waiting for a reply from CMS indicating whether or not Mrs. Garcia's enrollment has been accepted. You suspect no one is processing the appeals. All data elements required to complete an enrollment request must be captured. AHIP 2018 Module 2 - Medicare Advantage and Prescription Drugs. Mr. Valesquez asked if the Private Fee-for-Service plan you have discussed is like Original Medicare or a Medigap supplement plan.

When marketing Medicare Advantage and Part D plans, what are you permitted to do with respect to meals? For PDP Medication Home Delivery, the ____ plan will continue to offer a discount for 90-day tier 2, tier 3 and tier 6 prescriptions. 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. Generic prescription drugs from his employer's retiree coverage, but he wants. CMS marketing representative compensation rules generally apply to: Question #57. Ordinarily, you obtain referrals from a third party that initiates contact with potential clients and usually sets up appts. Interdisciplinary Care Team. Wellcare 2023 Exam key. AHIP 2021 Module 5 QUIZ (with complete solution) 100% Correct Mrs. Pierce would like to enroll in a Medicare Cost plan that offers Part D prescription dru... [Show More] g coverage.

Mr. Polanski likes the cost of an HMO plan available in his area but would like to be able to visit one or two doctors who aren't participating providers. According to Medicare's enrollment. Qualified sign language interpreters. Which of the following is not a Wellcare quality driver? Advertised the event in their monthly newsletter and asked anyone interested to. Phone or in small brochures. You are planning what materials to use to easily show the differences in benefits, premiums and cost sharing for each of the products. Which of the following individuals is most likely to be eligible to enroll in a Medicare Advantage or Part D Plan? A. Shred documents that contain PHI or PII using appropriate means.

Mr. Shultz was still working when he first qualified for Medicare. Agent Harriet Walker has recently begun marketing Medicare Advantage and related products aimed at meeting the needs of senior citizens. You would like to market an MA plan at a neighborhood pharmacy. Geisler can't remember what Part D is so she called you to ask what her neighbor was talking about. Wellcare's quality focus consists of six drivers. As part of that discussion, what should you be sure to tell her? You may then proceed with the discussion. Juan Perez, who is turning age 65 next month, intends to work for several more years at Smallcap, Incorporated. What would you advise her regarding seeking such approval for materials she uses to market Medicare Advantage plans? He is worried that he will lose his coverage now when he needs it the most. He will then submit the paper application before the start of the annual enrollment period (AEP). In the MA-only PPO plan and a stand-alone prescription drug plan.

Mrs. Reeves is newly eligible to enroll in a Medicare Advantage plan and her MA Initial Coverage Election Period (ICEP) has just begun. Under the rules applicable to. Cost-sharing amounts to match those charged by the state Medicaid program so. She has recently become eligible for Medicare and is considering enrollment in Part D prescription drug coverage. There will be no change in his cost-sharing amounts.