MLAHP - Minnesota Life Accident and Health Producer Exam

Question 1: A sixty-eight-year-old beneficiary enrolls in a Medicare Advantage plan offered by a private insurer in her county. She asks what happens to her existing Medicare enrollment and premiums. Which of the following correctly describes her obligations after joining the plan?

Her Part B enrollment automatically terminates

Medicare pays her Part B premium

Only the plan premium is owed

She stays enrolled and pays both premiums

Question 2: A younger worker has held covered jobs only intermittently and has earned six credits during the last thirteen quarters. His caseworker explains that this modest record still gives him a recognized standing. Which status does that credit record establish for him?

Currently insured status

Fully insured status

Presumptive eligibility status

Guaranteed renewable status

Question 3: A worker with forty credits plans to stop working and asks when Social Security retirement income can begin and what happens to the size of the check if he claims it at the earliest permitted age. Which answer is correct?

Only full retirement age allows any benefit

Benefits are the same at every age

Retirement benefits require currently insured status

Reduced benefits may begin at age sixty-two

Question 4: A Medicare Advantage plan requires each enrollee to use network providers and to obtain a referral from a chosen primary care physician before seeing a specialist, and it charges small copayments per visit. Which of the following types of Medicare Advantage plan is described here?

A Medicare preferred provider plan

A Medicare managed care plan

A private fee-for-service plan

A Medicare specialty plan

Question 5: A homebound beneficiary receives part-time nursing visits and speech therapy at home, and also asks the aide to do her grocery shopping and laundry while there. Her family wants to know what Medicare will pay. Which statement correctly describes the coverage?

Skilled visits covered; housekeeping chores are not

Everything done in the home is covered

Nothing in the home is covered

Only round-the-clock home nursing is covered

Question 6: A beneficiary enrolled in both Part A and a stand-alone prescription drug plan is admitted to a hospital, where the staff administers her medications during a four-day stay. Which of the following pays for the drugs given during that admission?

Her Part D plan, after a copayment

Part B, as outpatient drug therapy

Part A, as part of inpatient care

The beneficiary, entirely out of pocket

Question 7: A retiree turned down Part B when he first became eligible and now, in February, decides he wants it after all. He signs up during the annual window that runs from January 1 through March 31. When does his coverage start?

Immediately upon signing the application

On the following January 1

Not until he reaches age seventy

The first of the month after enrollment

Question 8: An eighty-year-old woman is treated in a hospital emergency department, sent home the same day, and then enters a Medicare-approved skilled nursing facility the next week. Her family expects Medicare to pay. Why will Medicare refuse to pay for the nursing facility?

The facility was not approved

She is too old to qualify

No qualifying three-day inpatient stay preceded it

Skilled nursing care is never covered

Question 9: A man will turn sixty-five in September and wants to know exactly how long he has to sign up for Medicare around that birthday without any special circumstances applying. Which description correctly states the length and shape of his initial enrollment period?

Three months, ending on his birthday

Twelve months following his birthday month

Six months beginning at age sixty-five

Seven months centered on his birthday month

Question 10: A woman who has worked and paid payroll taxes for thirty years reaches age sixty-five while drawing Social Security. She wonders what she must do to get Medicare hospital coverage and what it will cost her. Which statement is correct?

She must apply and pay premiums

She must apply, but pays nothing

Enrollment is automatic and costs nothing

Enrollment is automatic but premiums apply

Question 11: A health program serves people of any age whose income and resources fall below limits set by the state where they live, and it pays most health care costs for those who qualify. Which of the following describes how that program is funded and run?

Jointly funded, managed by the state

Funded and run entirely federally

Funded by payroll taxes on workers

Funded by enrollee premiums alone

Question 12: An applicant for Social Security disability benefits cannot return to his former trade but could handle lighter work. The examiner applies the federal standard rather than any private policy wording. Which description states the standard the examiner must apply?

Inability to perform his own occupation

Loss of two-thirds of prior earnings

Inability to perform any gainful occupation

Any condition lasting beyond thirty days

Question 13: A seventy-year-old man qualifies for Medicare through age and also meets his state's income and resource test for Medicaid. His producer explains how the two programs work together for him. Which of the following statements about his situation is accurate?

He must choose one program only

Medicare pays his Medicaid share of cost

Medicaid coverage suspends while on Medicare

Medicaid pays his Medicare cost sharing

Question 14: A widow's Social Security survivor checks stop when her youngest child turns sixteen, and they will not start again until she herself turns sixty. Producers give a name to that gap when planning survivor coverage. Which term names it?

The blackout period

The family dependency period

The elimination period

The probationary period

Question 15: An elderly widow enters a nursing home and pays for her care from savings until her assets are nearly exhausted, at which point she applies for state assistance. Which of the following describes the process she has gone through to qualify?

A Medicare elimination period

A Medigap open enrollment

A Part A benefit period

A Medicaid spend-down

Question 16: A beneficiary lists four charges from last month and wants to know which one Medicare Part B pays: a semi-private hospital room during an inpatient stay, hospice counseling, a stay in a skilled nursing facility, and a medically necessary ambulance ride. Which charge does Part B cover?

The semi-private hospital room

The hospice counseling

The medically necessary ambulance ride

The skilled nursing facility stay

Question 17: An insured satisfied a ninety-day elimination period, drew benefits for several months, and then returned to work on February 1. The same back condition disables him again on April 1, and his policy contains a ninety-day recurrent disability provision. What happens to his benefits?

He must satisfy a new elimination period

Coverage terminated when he returned to work

Only half the benefit is payable now

Benefits resume at once, no new wait

Question 18: A claims examiner denies a monthly benefit because the insured, a former long-haul truck driver, could reasonably work as a dispatcher given his education, training and experience, even though he can no longer drive. Which definition of disability supports that denial?

Any occupation

Own occupation

Presumptive disability

Recurrent disability

Question 19: An insured under an accident policy names his wife to receive any death proceeds and names his brother to receive them only if his wife does not survive him. Which pair of labels correctly identifies the wife and the brother?

Irrevocable and revocable beneficiary

Class beneficiary and estate beneficiary

Primary beneficiary and contingent beneficiary

Contingent beneficiary and primary beneficiary

Question 20: An employee is covered by a group medical expense plan whose premium the employer pays and deducts. She also holds an individual medical expense policy she funds herself. Which statement best describes the tax treatment across both of these arrangements?

Both sets of benefits are taxable income

Group premiums are taxable wages to her

Her personal premiums are fully deductible

Benefits are tax free under both policies

MLAHP Minnesota Life Accident and Health Producer Exam - Set 5 - Part 1