AHIP 2025 module 5
Mr. Liu turns 65 on June 19. He has never previously qualified for Medicare so his first Medicare
eligibility date will be June 1. Mr. Liu's ICEP and Part D IEP begin on March 1 and end on September 30.
He wants prescription drug coverage with his Part A and Part B benefits. What advice can you provide
him? - ANS He can enroll in a MA-PD as long as he enrolls in Part B and is entitled to Part A.
Mrs. Young is currently enrolled in Original Medicare (Parts A and B), but she has been working with
Agent Neil Adams in the selection of a Medicare Advantage (MA) plan. It is mid-September, and Mrs.
Young is going on vacation. Agent Adams is considering suggesting that he and Mrs. Young complete the
application together before she leaves. He will then submit the paper application before the start of the
annual enrollment period (AEP). What would you say If you were advising Agent Adams? - ANS This is a
bad idea. Agents are generally prohibited from soliciting or accepting an enrollment form before the
start of the AEP.
Mr. Block is currently enrolled in a Medicare Advantage plan that includes drug coverage. He found a
stand-alone Medicare prescription drug plan in his area that offers better coverage than that available
through his MA-PD plan and in addition, has a low premium. It won't cost him much more and, because
he has the means to do so, he wishes to enroll in the stand-alone prescription drug plan in addition to
his MA-PD plan. What should you tell him? - ANS If Mr. Block enrolls in the stand-alone Medicare
prescription drug plan, he will be disenrolled from the Medicare Advantage plan.
Mr. Garcia was told he qualifies for a special election period (SEP), but he lost the paper that explains
what he could do during the SEP. What can you tell him? - ANS If the SEP is for MA coverage, he will
generally have one opportunity to change his MA coverage.
Which of the following individuals has enrolled in a plan based on a fixed enrollment period? - ANS Ben
enrolls in a Medicare Advantage plan during the Medicare Advantage Open Enrollment Period (MA
OEP).
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? - ANS 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. Liu turns 65 on June 19. He has never previously qualified for Medicare so his first Medicare
eligibility date will be June 1. Mr. Liu's ICEP and Part D IEP begin on March 1 and end on September 30.
He wants prescription drug coverage with his Part A and Part B benefits. What advice can you provide
him? - ANS He can enroll in a MA-PD as long as he enrolls in Part B and is entitled to Part A.
Mrs. Young is currently enrolled in Original Medicare (Parts A and B), but she has been working with
Agent Neil Adams in the selection of a Medicare Advantage (MA) plan. It is mid-September, and Mrs.
Young is going on vacation. Agent Adams is considering suggesting that he and Mrs. Young complete the
application together before she leaves. He will then submit the paper application before the start of the
annual enrollment period (AEP). What would you say If you were advising Agent Adams? - ANS This is a
bad idea. Agents are generally prohibited from soliciting or accepting an enrollment form before the
start of the AEP.
Mr. Block is currently enrolled in a Medicare Advantage plan that includes drug coverage. He found a
stand-alone Medicare prescription drug plan in his area that offers better coverage than that available
through his MA-PD plan and in addition, has a low premium. It won't cost him much more and, because
he has the means to do so, he wishes to enroll in the stand-alone prescription drug plan in addition to
his MA-PD plan. What should you tell him? - ANS If Mr. Block enrolls in the stand-alone Medicare
prescription drug plan, he will be disenrolled from the Medicare Advantage plan.
Mr. Garcia was told he qualifies for a special election period (SEP), but he lost the paper that explains
what he could do during the SEP. What can you tell him? - ANS If the SEP is for MA coverage, he will
generally have one opportunity to change his MA coverage.
Which of the following individuals has enrolled in a plan based on a fixed enrollment period? - ANS Ben
enrolls in a Medicare Advantage plan during the Medicare Advantage Open Enrollment Period (MA
OEP).
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? - ANS Mr. Chen can disenroll from his employer-sponsored coverage to elect a Medicare
Advantage or Part D plan within 2 months of his disenrollment.
