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Exam (elaborations)

AHIP Module 4 TEST WITH SOLUTIONS

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AHIP Module 4 TEST WITH SOLUTIONS

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2027 AHIP Final test with absolute
answers

,Mr. Khan's Mr. employer has recently dropped comprehensive creditable
prescription drug

coverage that was offered to company retirees. The company told Mr. Khan
that, because he was affected by this change, he would qualify for a special
election period. Mr. Khan contacted you to find out more about what this
means. What can you tell him? - correct ans:It means that he qualifies for a
one-time opportunity to enroll in a Part D prescription drug plan.

Mr. Chambers suffers from diabetes which has gotten progressively worse
during the last year. He is currently enrolled in Original Medicare (Parts A and
B) and a Part D prescription drug plan and did not enroll in a Medicare
Advantage (MA) plan during the last annual open enrollment period (AEP)
which has just closed. Mr. Chambers has heard certain MA plans might
provide him with more specialized coverage for his diabetes and wants to
know if he must wait until the next annual open enrollment period (AEP)
before enrolling in such a plan. What should you tell him? - correct ans:If
there is a special needs plan (SNP) in Mr. Chambers's area that specializes in
caring for individuals with diabetes, he may enroll in the SNP at any time
under a special election period (SEP).



Which of the following individuals are likely to qualify for a special election
period (SEP) for either an MA or Part D due to a change of residence?



I. Edward (enrolled in MA and Part D) moves to a new home within the same
neighborhood in his existing plan's service area.

II. Fiona (enrolled in MA and Part D) moves cross-country to an area outside
her existing plan's service area.

III. Gilbert moves into a plan service area where there is now a Part D plan
available to him from a service area where no Part D plan was available.

IV. Henry makes a permanent move to a new state providing him with new
MA and Part D options - correct ans:II, III, and IV only



Mr. Washington is turning 65 next month and has asked you what he can do,
and when he must do it, with respect to enrolling in Part D. What could you
tell him? - correct ans:He is currently in the Part D Initial Enrollment Period

, (IEP), and during this time, he may make one Part D enrollment choice,
including enrollment in a stand-alone Part D plan or an MA-PD plan.



Mrs. Fowler is moving and a friend told her she might qualify for a "special
election period" to enroll in a new Medicare Advantage plan. She contacted
you to ask what a special election period is. What could you tell her? - correct
ans:It is a period, outside of the Annual Election Period, when a Medicare
beneficiary can select a new or different Medicare Advantage and/or Part D
prescription drug plan. Typically, the special election period is beneficiary
specific and results from events, such as when the beneficiary moves outside
of the service area.



When Emma first became eligible for Medicare, she enrolled in Original
Medicare (Parts A and B). She is now 67 and will turn 68 on July 1. She would
now like to enroll in a Medicare Advantage (MA) plan and approaches you
about her options. What advice would you give her? - correct ans:She should
remain in Original Medicare until the annual election period running from
October 15 to December 7, during which she can select an MA plan.



Mr. and Mrs. Orozco attended one of your sales presentations. They've asked
you to come to their home to clear up a few questions. During the
presentation, Mrs. Orozco feels tired and tells you that her husband can
finish things up. She goes to bed. At the end of your discussion, Mr. Orozco
says that he wants to enroll both himself and his wife. What should you do? -
correct ans:If she can do so, only Mrs. Orozco can sign her enrollment form.
Mrs. Orozco will have to wake up to sign her form or do so at another time.



You are visiting Mr. Connor and his daughter at her request. He has advanced
Alzheimer's and is incapable of understanding the implications of choosing a
Medicare Advantage or prescription drug plan. Can his daughter fill out the
enrollment form and sign it for him? - correct ans:Mr. Connor's daughter can
do so only if she is authorized under state law as a court-appointed legal
guardian, has a durable power of attorney for health care decisions, or is
authorized under state surrogate consent laws to make health decisions.

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