AHIP MCQ 4

Question 1

An agent sells a Medicare Advantage plan to a beneficiary who was not eligible because they were not enrolled in Medicare Parts A and B. What should happen?

Accepted Answer

The enrollment is invalid and must be voided; the beneficiary cannot be enrolled

Answer

Enrollment in a Medicare Advantage plan requires the beneficiary to have both Medicare Parts A and B; ineligible enrollments are voided.

Question 2

What is the Medicare Annual Enrollment Period (AEP) for Medicare Advantage and Part D plans?

Accepted Answer

October 15 – December 7

Answer

The AEP runs October 15 through December 7 each year; plan changes made during this period take effect January 1.

Question 3

Under CMS marketing guidelines, which activity is PROHIBITED for Medicare Advantage plan agents?

Accepted Answer

Conducting sales presentations at a healthcare provider's office during patient care hours

Answer

CMS prohibits sales activities in healthcare provider settings during patient care hours to prevent inappropriate influence on beneficiaries.

Question 4

Which of the following is a characteristic of a Preferred Provider Organization (PPO) health plan?

Accepted Answer

Members can see out-of-network providers at higher cost-sharing

Answer

PPO plans allow members to use out-of-network providers, but cost-sharing is higher than for in-network care.

Question 5

A dual-eligible beneficiary (enrolled in both Medicare and Medicaid) is automatically eligible for which Part D program?

Accepted Answer

Extra Help (Low Income Subsidy)

Answer

Full dual-eligible beneficiaries automatically qualify for Extra Help (Low Income Subsidy), which reduces Part D premiums, deductibles, and cost-sharing.

AHIP - America's Health Insurance Plans Practice Test

AHIP - America's Health Insurance Plans Practice Test

AHIP MCQ 4