AHIP MODULE 5
Enrollment Guidance (MA/Part D)
Question Answer
MA - eligible if person is entitled to Part A AND
Memory Check: Who is eligible to enroll
enrolled in Part B Part D - eligible if person is
in MA or Part D plans?
entitled to Part A AND/OR enrolled in Part B
What is the plan called where employer
obtains approval from Medicare to enroll
EGWP
Part B only retirees, even if the retirees
are not entitled to Part A?
What is the medical condition that
previously made the person with it
ESRD - ends 01/01/21
ineligible to receive MA benefits? When
does that restriction end?
What extra benefit should a bene look
out for when selecting/changing their "visitor/traveler benefit" - Temporary Exception
MA plan if they think they might be to Involuntary Disenrollment When an Enrollee
spending 6 months or more outside their Moves from the Service Area
service area?
True or False: there is no scenario where
False - in certain cases CMS will allow
CMS will allow an abbreviated
abbreviated enrollment forms (usually its a
enrollment form because nothing can be
form to switch a plan, not a new account app)
missed no matter what.
True or False: a persons eligibility to True
enroll in a stand alone PDP depends on
, AHIP MODULE 5
Enrollment Guidance (MA/Part D)
how they receive their medical benefits?
In order to be enrolled in a stand-alone 1) Original (FFS) Medicare 2) PFFS (does not
PDP, the person must be enrolled in one include Part D coverage) 3) MSA 4) 1876 Cost
of the following: Plan 5) MA EGWPS (if PDP is also an EGWPS)
True or False: there is a MA PFFS
exception (at plan level) where a person True, its more of a clarification of the rule that
enrolled in a MA PFFS that does not says if a person is eligible to enroll in a PDP if
cover Part D may enroll in a stand alone they are enrolled in a "PFFS plan that does not
PDP, even if the same MA org offers a include Rx coverage"
PFFS
bene must receive their medicare Rx benefit
For benes enrolled in a "coordinated
through the "coordinated care plan" (some
care plan", what is the rule about where
exceptions for Employer/Union retiree group
the bene holds their Rx coverage?
plans)
What option(s) do benes in a "1876 Cost
through the 1876 cost plan or from a
Plan" have for receiving their Rx
"freestanding Rx plan"
coverage?
Memory Check: The period between
AEP
October 15 - December 7 is called?
Memory Check: The period between
MA-OEP (OEP)
January 1 - March 31 is called?
What are the four periods of enrollment IEP (bene first eligible for Medicare) MA New
Enrollment Guidance (MA/Part D)
Question Answer
MA - eligible if person is entitled to Part A AND
Memory Check: Who is eligible to enroll
enrolled in Part B Part D - eligible if person is
in MA or Part D plans?
entitled to Part A AND/OR enrolled in Part B
What is the plan called where employer
obtains approval from Medicare to enroll
EGWP
Part B only retirees, even if the retirees
are not entitled to Part A?
What is the medical condition that
previously made the person with it
ESRD - ends 01/01/21
ineligible to receive MA benefits? When
does that restriction end?
What extra benefit should a bene look
out for when selecting/changing their "visitor/traveler benefit" - Temporary Exception
MA plan if they think they might be to Involuntary Disenrollment When an Enrollee
spending 6 months or more outside their Moves from the Service Area
service area?
True or False: there is no scenario where
False - in certain cases CMS will allow
CMS will allow an abbreviated
abbreviated enrollment forms (usually its a
enrollment form because nothing can be
form to switch a plan, not a new account app)
missed no matter what.
True or False: a persons eligibility to True
enroll in a stand alone PDP depends on
, AHIP MODULE 5
Enrollment Guidance (MA/Part D)
how they receive their medical benefits?
In order to be enrolled in a stand-alone 1) Original (FFS) Medicare 2) PFFS (does not
PDP, the person must be enrolled in one include Part D coverage) 3) MSA 4) 1876 Cost
of the following: Plan 5) MA EGWPS (if PDP is also an EGWPS)
True or False: there is a MA PFFS
exception (at plan level) where a person True, its more of a clarification of the rule that
enrolled in a MA PFFS that does not says if a person is eligible to enroll in a PDP if
cover Part D may enroll in a stand alone they are enrolled in a "PFFS plan that does not
PDP, even if the same MA org offers a include Rx coverage"
PFFS
bene must receive their medicare Rx benefit
For benes enrolled in a "coordinated
through the "coordinated care plan" (some
care plan", what is the rule about where
exceptions for Employer/Union retiree group
the bene holds their Rx coverage?
plans)
What option(s) do benes in a "1876 Cost
through the 1876 cost plan or from a
Plan" have for receiving their Rx
"freestanding Rx plan"
coverage?
Memory Check: The period between
AEP
October 15 - December 7 is called?
Memory Check: The period between
MA-OEP (OEP)
January 1 - March 31 is called?
What are the four periods of enrollment IEP (bene first eligible for Medicare) MA New
