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.
Mrs. Pierce would like to enroll in a Medicare Cost plan that offers Part D prescription drug
coverage. She comes to you for advice about when she can enroll in a plan you have previously
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.
Mrs. Pierce would like to enroll in a Medicare Cost plan that offers Part D prescription drug
coverage. She comes to you for advice about when she can enroll in a plan you have previously
