2026 Elevance Health Certification Exam Test with Answers Rated A
The Special Election Period (SEP) for Dual Eligible and
Other LIS Eligible Individuals previously allowed one time
per-calendar-quarter during the first nine months of the
year was replaced beginning Calendar Year 2025 with a True
monthly SEP to enroll in a standalone PDP. Eligible ben-
eficiaries can switch PDPs or leave a MA/MAPD plan for
Original Medicare plus a standalone PDP.
Which of the following statements is NOT true about a
Disenrollment requests can be taken verbally
disenrollment?
Both A and B are correct (A cancellation applies if a request
is received prior to a member's ettective date or by the
How does a cancellation ditter from a disenrollment? date on the Outbound Enrollment Verification (OEV) letter,
Cancellation requests are initiated by the member and can
be received either verbally or in writing)
FEMA disaster SEPs can only be used if members missed
True
a valid enrollment period.
A monthly integrated care SEP beginning calendar year
2025 allows full dual eligible individuals to elect an in-
tegrated Dual Eligible Special Needs Plan (D-SNP) (for
example, Fully Integrated Dual Eligible (FIDE), Highly In-
True
tegrated Dual Eligible (HIDE), and Applicable Integrated
Plan (AIP)). This SEP is allowed only when the individual
receives Medicaid through an aflliated managed care
plan.
Prior to making an enrollment decision, beneficiaries
True
must review and complete the pre-enrollment checklist.
The Open Election Period (OEP) is for beneficiaries who
are enrolled in a MA-only or MA-PD plan, or those who are
False
enrolled in Original Medicare, including those enrolled in
stand-alone PDPs.
1/5
, 2026 Elevance Health Certification Exam Test with Answers Rated A
Which election period describes when a beneficiary first
Initial Coverage Election Period (ICEP)
becomes entitled to both Medicare Part A and Part B?
If a beneficiary has agreed to an in-home appointment
to discuss a PDP product, an agent can discuss an HMO
product with them during that same meeting, if the ben- True
eficiary requests it and a new scope of appointment form
is completed.
An agent can start to market 2026 MA, MA-PD, or PDP
True
plans on October 1.
If a beneficiary currently has drug coverage through an-
other carrier, you must verify their prescriptions would be
covered under our plan's formulary, too. The drugs that True
are actually covered may vary from one carrier to another
or one plan to another.
You MUST tell your PPO plan clients they will have to
pay more when seeking non-emergent eligible services True
outside of the network.
You receive a questionnaire regarding a sales misrepre-
sentation inquiry. You must respond within the designat-
ed time frame, addressing all concerns in the allegation True
and include any pertinent notes from your sales appoint-
ment, event, etc. that may apply to the allegation.
You MUST EXPLAIN the Part D late enrollment penalty. True
CMS will allow Third-Party Marketing Organizations (TP-
MOs) to continue sharing a beneficiary's data as long
as they obtain prior express written consent through a True
clear and conspicuous disclosure for each TPMO that will
receive the beneficiary's data and contact them.
2/5
The Special Election Period (SEP) for Dual Eligible and
Other LIS Eligible Individuals previously allowed one time
per-calendar-quarter during the first nine months of the
year was replaced beginning Calendar Year 2025 with a True
monthly SEP to enroll in a standalone PDP. Eligible ben-
eficiaries can switch PDPs or leave a MA/MAPD plan for
Original Medicare plus a standalone PDP.
Which of the following statements is NOT true about a
Disenrollment requests can be taken verbally
disenrollment?
Both A and B are correct (A cancellation applies if a request
is received prior to a member's ettective date or by the
How does a cancellation ditter from a disenrollment? date on the Outbound Enrollment Verification (OEV) letter,
Cancellation requests are initiated by the member and can
be received either verbally or in writing)
FEMA disaster SEPs can only be used if members missed
True
a valid enrollment period.
A monthly integrated care SEP beginning calendar year
2025 allows full dual eligible individuals to elect an in-
tegrated Dual Eligible Special Needs Plan (D-SNP) (for
example, Fully Integrated Dual Eligible (FIDE), Highly In-
True
tegrated Dual Eligible (HIDE), and Applicable Integrated
Plan (AIP)). This SEP is allowed only when the individual
receives Medicaid through an aflliated managed care
plan.
Prior to making an enrollment decision, beneficiaries
True
must review and complete the pre-enrollment checklist.
The Open Election Period (OEP) is for beneficiaries who
are enrolled in a MA-only or MA-PD plan, or those who are
False
enrolled in Original Medicare, including those enrolled in
stand-alone PDPs.
1/5
, 2026 Elevance Health Certification Exam Test with Answers Rated A
Which election period describes when a beneficiary first
Initial Coverage Election Period (ICEP)
becomes entitled to both Medicare Part A and Part B?
If a beneficiary has agreed to an in-home appointment
to discuss a PDP product, an agent can discuss an HMO
product with them during that same meeting, if the ben- True
eficiary requests it and a new scope of appointment form
is completed.
An agent can start to market 2026 MA, MA-PD, or PDP
True
plans on October 1.
If a beneficiary currently has drug coverage through an-
other carrier, you must verify their prescriptions would be
covered under our plan's formulary, too. The drugs that True
are actually covered may vary from one carrier to another
or one plan to another.
You MUST tell your PPO plan clients they will have to
pay more when seeking non-emergent eligible services True
outside of the network.
You receive a questionnaire regarding a sales misrepre-
sentation inquiry. You must respond within the designat-
ed time frame, addressing all concerns in the allegation True
and include any pertinent notes from your sales appoint-
ment, event, etc. that may apply to the allegation.
You MUST EXPLAIN the Part D late enrollment penalty. True
CMS will allow Third-Party Marketing Organizations (TP-
MOs) to continue sharing a beneficiary's data as long
as they obtain prior express written consent through a True
clear and conspicuous disclosure for each TPMO that will
receive the beneficiary's data and contact them.
2/5
