2024 AHIP Module 5 Actual Questions and Verified Answers ( Included ) 100% Correct

AHIP 2024 Module 5 1. A client wants to give you an enrollment application on October 1 before the beginning of the Annual Election Period because he is leaving on vacation for two weeks and does not want to forget about turning it in. What should you tell him?: Answer You must tell him you are not permitted to take the form. If he sends the form directly to the plan, the plan will process the enrollment on the day the Annual Election Period begins. Correct. If a beneficiary sends an unsolicited AEP paper enrollment request to the plan on or after October 1 but before the Annual Election Period begins, the plan will process the application beginning on the first day of the election period (October 15). 2. Mr. Johannsen is entitled to Medicare Part A and Part B. He gains the Part D low-income subsidy. How does that affect his ability to enroll or disenroll in a Part D plan?: Answer He qualifies for a special election period and can enroll in or disenroll from a Part D plan once during that period. Correct. Because he is entitled to Medicare Part A and Part B and has a change in his low income subsidy status, he is eligible for a special election period. During the SEP, he can enroll in or disenroll from a Part D plan once. 3. You are visiting with Mr. Tully 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?: Answer Mr. Tully'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. Correct: CMS will permit someone to sign on behalf of a beneficiary if they are a legal representative or individual authorized under state law, such as a court -appointed legal guardian, someone with a durable power of attorney for health care decisions, or someone authorized to make health care decisions under state surrogate consent laws. 4. Torie Jones is a new marketing representative. Torie asks you for advice as to what topics must be discussed with a Medicare beneficiary prior to enrollment in a Medicare Advantage (MA -PD) plan. What should you say?: Answer Torie, there are many required questions and topics regarding beneficiary needs to be discussed prior to enrollment in an MA plan. These include information regarding primary care providers and specialists whether they are in the plan network, whether or not a beneficiary's current prescriptions are covered as well as premiums, bene - fits, and costs of health care services. Correct: CMS requires a series of questions and topics regarding beneficiary needs to be fully discussed before an enrollment. Questions and topics to be discussed include information regarding whether the beneficiary's primary care providers and specialists are in the plan network, whether or not a beneficiary's current prescriptions are covered and their costs, as well as premiums, benefits, and cost of health care services. Other required topics include whether or not the beneficiary's current pharmacy is in the plan's network and the beneficiary's specific health care needs. 5. Mrs. Kumar would like her daughter, who lives in another state, to meet with you during the Annual Election Period to help her complete her enrollment in a Part D plan. She asked you when she should have her daughter plan to visit. What could you tell her?: Answer Her daughter should come in November. Correct. She can enroll in a Part D plan during the Annual Election Period (AEP), which takes place from October 15 to December 7. 6. Mr. Garrett has just entered his MA Initial Coverage Election Period (ICEP). What action could you help him take during this time?: Answer He will have one opportunity to enroll in a Medicare Advantage plan. Correct: During the ICEP, he is permitted to make one enrollment choice. Once the enrollment is effective, the ICEP is used. However, individuals choosing a MA plan during their ICEP have a MA-OEP following their election through the last day of the 3rd month of entitlement.