AHIP AHM-250 Exam - Topic 5 Question 108 Discussion

Actual exam question for AHIP's AHM-250 exam

Question #: 108
Topic #: 5

The following statements are about the non-group market for managed care products in the United States. Select the answer choice containing the correct statement.

AIn order to promote a product to the individual market, MCOs typically rely on personal selling by captive agents rather than on promotional tools such as direct mail, telemarketing, and advertising.

BManaged Medicare plans typically are allowed to reject a Medicare applicant on the basis of the results of medical underwriting of the applicant.

CHCFA (now known as the Centers for Medicare and Medicaid Services) must approve all membership and enrollment materials used by MCOs to market managed care products to the Medicare population.

DManaged care plans are not allowed to health screen individual market customers who are under age 65, even if the health screen could help prevent anti selection.

Show Suggested Answer

Suggested Answer: C

by Helene at Mar 04, 2025, 04:22 AM

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Bambi

4 months ago

B is misleading, they can’t just reject based on underwriting.

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Rocco

4 months ago

A seems outdated; personal selling isn't the norm anymore.

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Catrice

4 months ago

Wait, are you sure about D? That sounds off.

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Lavonne

4 months ago

Totally agree, C makes the most sense!

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Leslee

5 months ago

I think C is correct. CMS does review marketing materials.

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Stevie

5 months ago

I thought managed care plans could health screen under 65s to avoid anti-selection, but I'm not completely confident about the rules on that.

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Jacqueline

5 months ago

I vaguely recall that HCFA had to approve marketing materials, but I can't remember if that applies to all managed care products or just Medicare.

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Sheron

5 months ago

I practiced a question about Medicare plans rejecting applicants, and I feel like they can't really do that based on medical underwriting, right?

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Mel

5 months ago

I think I remember that MCOs do use personal selling, but I'm not sure if they rely on it exclusively over other methods like advertising.

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Arthur

5 months ago

I think I've got a good handle on this. The question is asking about the individual market, not the group market. So I'll focus on the options that specifically mention the individual or non-group market, and try to identify the one that is correct.

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Diane

5 months ago

I'm a bit confused by the wording of the question. What exactly is the "non-group market" for managed care products? I'll need to review my notes to make sure I understand the distinctions between the different market segments.

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Bea

5 months ago

Okay, let's see. The key here is to identify the correct statement about the non-group market. I remember from our class discussions that MCOs often use personal selling by agents in the individual market, so I'll keep that in mind.

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Royal

5 months ago

Hmm, this seems like a tricky question. I'm not entirely sure about the differences between the individual and group markets for managed care products. I'll need to think this through carefully.

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Sylvia

6 months ago

I'm pretty confident about this one. The question is asking about the non-group market for managed care products, so I'll focus on that and try to eliminate the incorrect options.

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Juan

11 months ago

I'm just going to choose D and hope for the best. Trying to understand all these managed care regulations is enough to give me a headache!

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Lashaun

9 months ago

Yeah, D seems like the most logical choice.

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Cyndy

9 months ago

I agree, D seems like the best option.

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Cordell

10 months ago

I think D is a safe choice, good luck!

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Elden

11 months ago

C is definitely the correct answer. Gotta love those government bureaucrats approving everything! At least they're keeping a close eye on those crafty MCOs.

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Daron

10 months ago

I agree. It's reassuring to know that there are checks and balances in place to ensure that managed care products are marketed ethically and responsibly.

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Nancey

10 months ago

Yeah, it's important to have regulations in place to protect consumers from any potential abuse by the MCOs.

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Tracey

11 months ago

C is definitely the correct answer. Gotta love those government bureaucrats approving everything! At least they're keeping a close eye on those crafty MCOs.

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Germaine

11 months ago

Hmm, I'm torn between B and C. Managed Medicare plans should be able to reject applicants based on medical underwriting, but the enrollment materials also need to be approved. Maybe I'll just flip a coin.

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Bettina

11 months ago

D seems like the right answer to me. Managed care plans should be allowed to health screen individual market customers under 65 to prevent anti-selection. It's a shame the regulations don't allow that.

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Maira

9 months ago

I wonder if there are other ways to prevent anti-selection without health screening individual market customers.

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Lili

9 months ago

It's important to balance preventing anti-selection with ensuring equal access to healthcare.

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Earnestine

10 months ago

I think the regulations are in place to ensure fair access to healthcare for all individuals.

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Elden

10 months ago

I agree, it does seem like a missed opportunity to prevent anti-selection.

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Brent

11 months ago

I think the correct answer is C. HCFA (now known as the Centers for Medicare and Medicaid Services) must approve all membership and enrollment materials used by MCOs to market managed care products to the Medicare population. This seems like the most straightforward and accurate statement.

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Clement

11 months ago

Actually, I think the answer is D. Managed care plans are not allowed to health screen individual market customers who are under age 65, even if the health screen could help prevent anti selection.

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Maia

11 months ago

I'm not sure, but I think it might be A. In order to promote a product to the individual market, MCOs typically rely on personal selling by captive agents rather than on promotional tools such as direct mail, telemarketing, and advertising.

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