AHIP Help

Jul 12, 2019 at 2:31 AM

  1. Carolina Ruzine
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    Carolina Ruzine New Member

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    Hi Everyone,

    I am a new agent and the AHIP exam has been a big challenge for me. It has a lot of information and some of the questions I came across, I am getting stuck between a couple choices. For those of you experienced, could you explain to me which of the answer for the few questions below is accurate and why?


    1. If Mr. Johannsen gains the Part D low-income subsidy, how does that affect his ability to enroll or disenroll in a Part D plan?
    Choose one answer.
    a. The subsidy will become effective next year when he can enroll in a different plan or disenroll from his current plan during the next Annual Election Period.
    b. He qualifies for a special enrollment period and can enroll in or disenroll from a Part D plan and the subsidy will apply to the plan he chooses.
    c. He can only enroll in or disenroll from an MA-PD plan.
    d. He can apply the subsidy amount to his existing plan immediately, but he cannot enroll in a different plan.

    2. Agent Willis had several clients who disenrolled from the plans he represents during the AEP to try new Medicare Advantage plans. Agent Willis believes that the choices they made are not ideal for them and would like to get their business back during the Medicare Advantage Open Enrollment Period (MA-OEP). What can agent Willis do?
    Choose one answer.
    a. He can e-mail them in January and ask them to let him know if they are not happy with their new plans.
    b. He can send them information about the MA-OEP along with a flyer on the plans he represents.
    c. He can call them to let them know that if they do not like their new plans, they can change back during the MA-OEP.
    d. He can wait until October and send them information about the plans he represents.

    3. 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. He wants to know if the Point of Service (POS) option available with some HMOs will be of any help in this situation. What should you tell him?
    Choose one answer.
    a. The POS option will allow him to visit out-of-network providers and generally the plan must provide the same level of cost sharing as if he went to in-network providers.
    b. The POS option is only to allow him to visit in-network specialists without a referral. He will have no coverage if he goes out-of-network.
    c. The POS option refers to a method of processing claims in real time so that Mr. Polanski will be able to finalize his bill at the point of service with the provider, rather than waiting for the plan to mail him statements several weeks later. It does not have anything to do with his ability to access out-of-network providers.
    d. The POS option might be a good solution for him as it will allow him to visit out-of-network providers, generally without prior approval. However, he should be aware that it is likely he will have to pay higher cost-sharing for services from out-of-network providers.

    4. Richard is a licensed agent who represents Spartan Health Plan and its Medicare Advantage (MA) plans. 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. Alice will soon turn 65 and retire. Alice has coverage through Spartan Health Plan offered by her employer. Bob had health coverage through Spartan but dropped the coverage when he retired early to travel overseas. Bob, who has just turned age 65, is now back in the United States. Charlotte, who will turn 65 next month, has coverage through Athena Health plan – a company Richard also represents. Who qualifies for the opt-in simplified enrollment mechanism?

    Choose one answer.
    a. Alice, Bob, and Charlotte because electronic health record interoperability will allow Richard to access any needed information for their applications.
    b. Alice and Charlotte because each of them currently have health coverage and is in their initial coverage election period (ICEP).
    c. Alice because she will not have a break between her non-Medicare and Medicare coverage through Spartan Health Plan.
    d. Alice and Bob because each of them has had coverage through Spartan Health Plan.
     
  2. Chazm
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    Chazm Guru

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    You really should download the slides to pdf and do a search while taking the test. These are basic questions that you should know before going out in the field.

    Except for #4. Simplified enrollment mechanism is something I’ve never heard of before
     
    Chazm, Jul 12, 2019 at 8:10 AM
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  3. David Taylor Jr
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    David Taylor Jr Super Genius

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    On the simplified enrollment question, the answer is Alice because she was already with that carrier and never had a break in coverage. This is only applicable for people who are already enrolled in a specific carrier (currently) and are choosing that same exact carrier for MAPD.
     
  4. goillini52
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    goillini52 MAGA...Eat More Bacon & BUILD THAT WALL!!!

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    That's when they have Major Medical with lets say BCBS, and when you turn 65, they "underhandedly" enroll you into a MAPD plan without your knowledge. I don't think it should be legal.
     
    goillini52, Jul 12, 2019 at 10:03 AM
    #4
  5. vic120
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    vic120 Guru

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    '
    If an agent did anything half as bad they would crucify him

    It should be criminal
     
    vic120, Jul 12, 2019 at 10:05 AM
    #5
  6. Evan
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    Evan Super Genius

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    Thanks for the answer on Alice.. Finally passed today with a 90!
     
    Evan, Jul 13, 2019 at 10:03 AM
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  7. Russ
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    Russ Guru

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    I needed that answer too. I passed last night with a 90. Horrible that an 88 is a failing grade.
     
    Russ, Jul 13, 2019 at 3:10 PM
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  8. Travis Price
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    Travis Price Guru

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    /Sarcasm They're "basic" Medicare questions every agent should if they spent 15 minutes selling any insure /endsarcasm.
     
  9. Russ
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    Russ Guru

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    That make you use your mind and some are just plain stupid.
     
    Russ, Jul 14, 2019 at 5:09 PM
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  10. goillini52
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    goillini52 MAGA...Eat More Bacon & BUILD THAT WALL!!!

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    Question, or agents? :huh::eek:
     
    goillini52, Jul 14, 2019 at 6:14 PM
    #10
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