AHIP Module 5 QUESTIONS &
ANSWERS(RATED A)
Mrs. Reeves is newly eligible to enroll in a Medicare Advantage plan and her MA Initial Coverage Election
Period (ICEP) has just begun. Which of the following can she not do during the ICEP? - ANSWER She can
enroll in a Medigap plan to supplement the benefits of the MA plan that she's also enrolling in.
Mr. Chen is enrolled in his employer's group health plan and will be retiring soon. He would like to know
his options since he has decided to drop his retiree coverage and is eligible for Medicare. What should
you tell him? - ANSWER Mr. Chen can disenroll from his employer-sponsored coverage to elect a
Medicare Advantage or Part D plan within 2 months of his disenrollment.
Mr. Rockwell, age 67, is enrolled in Medicare Part A, but because he continues to work and is covered by
an employer health plan, he has not enrolled in Part B or Part D. He receives a notice on June 1 that his
employer is cutting back on prescription drug benefits and that as of July 1 his coverage will no longer be
creditable. He has come to you for advice. What advice would you give Mr. Rockwell about special
election periods (SEPs)? - ANSWER Mr. Rockwell is eligible for a SEP due to his involuntary loss of
creditable drug coverage; the SEP begins in June and ends on September 1- two months after the loss of
creditable coverage
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 b.
He qualifies for a special election period and can enroll in or disenroll from a Part D plan once during that
period.
Mr. White has Medicare Parts A and B with a Part D plan. Last year, he received a notice that his plan
sponsor identified him as a "potential at-risk" beneficiary. This month, he started receiving assistance
from Medicaid. He wants to find a different Part D plan that's more suitable to his current prescription
drug needs. He believes he's entitled to a SEP since he is now a dual eligible. Is he able to change to a
different Part D plan during a SEP for dual eligible individuals? - ANSWER No. Once he is identified by the
plan sponsor as a "potential at-risk" beneficiary, he cannot use the dual eligible SEP to change plans
while this designation is in place.
ANSWERS(RATED A)
Mrs. Reeves is newly eligible to enroll in a Medicare Advantage plan and her MA Initial Coverage Election
Period (ICEP) has just begun. Which of the following can she not do during the ICEP? - ANSWER She can
enroll in a Medigap plan to supplement the benefits of the MA plan that she's also enrolling in.
Mr. Chen is enrolled in his employer's group health plan and will be retiring soon. He would like to know
his options since he has decided to drop his retiree coverage and is eligible for Medicare. What should
you tell him? - ANSWER Mr. Chen can disenroll from his employer-sponsored coverage to elect a
Medicare Advantage or Part D plan within 2 months of his disenrollment.
Mr. Rockwell, age 67, is enrolled in Medicare Part A, but because he continues to work and is covered by
an employer health plan, he has not enrolled in Part B or Part D. He receives a notice on June 1 that his
employer is cutting back on prescription drug benefits and that as of July 1 his coverage will no longer be
creditable. He has come to you for advice. What advice would you give Mr. Rockwell about special
election periods (SEPs)? - ANSWER Mr. Rockwell is eligible for a SEP due to his involuntary loss of
creditable drug coverage; the SEP begins in June and ends on September 1- two months after the loss of
creditable coverage
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 b.
He qualifies for a special election period and can enroll in or disenroll from a Part D plan once during that
period.
Mr. White has Medicare Parts A and B with a Part D plan. Last year, he received a notice that his plan
sponsor identified him as a "potential at-risk" beneficiary. This month, he started receiving assistance
from Medicaid. He wants to find a different Part D plan that's more suitable to his current prescription
drug needs. He believes he's entitled to a SEP since he is now a dual eligible. Is he able to change to a
different Part D plan during a SEP for dual eligible individuals? - ANSWER No. Once he is identified by the
plan sponsor as a "potential at-risk" beneficiary, he cannot use the dual eligible SEP to change plans
while this designation is in place.
