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FRAUD WASTE AND ABUS E TEST | 50
QUESTIONS WITH 100% CORRECT
ANSWERS | UPDATED & VERIFIED
Question :Monica is an agent focused on serving seniors
eligible for Medicare. As she reviews her records, she is trying to determine which of the following items are considered compensation. What do you tell her?
Correct answer:I, II, and IV only
Question :Alice is a marketing representative employed by a
health plan. Betty is a captive agent of a health plan who markets to multiple plans and sponsors. Carl is a captive agent who markets to only one plan/sponsor. Denise is an independent agent who markets to different types of groups.Edward is an independent agent who markets only to employer and union groups. CMS marketing representative
compensation rules generally apply to:
Correct answer:Betty and Denise, but not Alice (the
employee) or Carl or Edward (to whom exceptions apply).
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Question :You will be holding a sales event in the near future,
at which you would like to offer door prizes to attendees.Under guidelines from the Medicare agency, what types of gifts or prizes would not be allowed in this situation?
Correct answer:Gift cards or gift certificates of $15 or less
that can be readily converted to cash
Question :Several agents you work with are planning sales
events in your area. One plans on giving door prizes worth $5, refreshments valued at $8 per anticipated attendee, and coupon books with discounts worth $10. Since no gift or prize exceeds the $15 limit he believes his plan is acceptable. What should you tell them
Correct answer:He can give away more than one gift during a
single event, but the aggregate retail value cannot exceed $15
Question :Which of the following individuals are likely to
qualify for a special enrollment period (SEP) for both MA and Part D due to a change of residence?
Correct answer:II and IV only
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Question :Phiona works in the IT Department of BestCare
Health Plan. Phiona is placed in charge of BestCare's efforts to facilitate electronic enrollment in its Medicare Advantage plans. In setting up the enrollment site, which of the following must Phiona consider?
Correct answer:II and III only
Question :You are doing a sales presentation for Mrs.
Pearson. You know that the Medicare marketing guidelines prohibit certain types of statements. Apply those guidelines to the following statements and identify which would be prohibited.
Correct answer:If you're not in very good health, you will
probably do better with a different product."
Question :Mr. Lopez has heard that he can sign up for a
product called "Medicare Advantage" but is not sure about what type of plan designs are available through this program.What should you tell him about the types of health plans that are available through the Medicare Advantage program?
Correct answer:They are Medicare health plans such as
HMOs, PPOs, PFFS, SNPs, and MSAs
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Question :(W) Mr. Wells is trying to understand the
difference between Original Medicare and Medicare Advantage. What would be a correct description?
Correct answer:Medicare Advantage is a way of covering all
of the Original Medicare benefits through private health insurance companies.
Question :During a sales presentation in Ms. Sullivan's home,
she tells you that she has heard about a type of Medicare health plan known as Private Fee-for-Service (PFFS). She wants to know if this would be available to her. What should you tell her about PFFS plans?
Correct answer:A PFFS plan is one of various types of
Medicare Advantage plans offered by private entities and she may enroll in one if it is available in her area.
Question :(W) Mrs. Radford asks whether there are any
special eligibility requirements for Medicare Advantage.What should you tell her?