2025/2026 AHIP MODULE 5 WITH
CORRECT
Mrs. Margolis contacts you in August because she will become eligible for Medicare for
the first time in November. She would like to meet and discuss plan choices with you.
What advice should you give her? - ANSWER-Tell her to wait until October to discuss
plan choices with you so that you can share plan benefits for the current year as well as
any changes for the following year that may impact her choice.
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.
Mary Samuels recently suffered a stroke while visiting her daughter and grandchildren.
As a result, Mary has been admitted to a rehabilitation hospital where she is expected to
reside for several months. The rehabilitation hospital is located outside the geographic
area served by her current Medicare Advantage (MA) plan. What options are available
to Mary regarding her health plan coverage? - ANSWER-Mary may make an unlimited
number of MA enrollment requests and may disenroll from her current MA plan.
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.
You have come to Mrs. Midler's home for a sales presentation. At the beginning of the
presentation, Mrs. Midler tells you that she has a copy of her medical records available
because she thinks this will help you understand her needs. She suggests that you will
know which questions to ask her about her health status in order to best assist her in
selecting a plan. What should you do? - ANSWER-You can only ask Mrs. Midler
questions about conditions that affect eligibility, specifically, whether she has one of the
conditions that would qualify her for a special needs plan.
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. 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
CORRECT
Mrs. Margolis contacts you in August because she will become eligible for Medicare for
the first time in November. She would like to meet and discuss plan choices with you.
What advice should you give her? - ANSWER-Tell her to wait until October to discuss
plan choices with you so that you can share plan benefits for the current year as well as
any changes for the following year that may impact her choice.
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.
Mary Samuels recently suffered a stroke while visiting her daughter and grandchildren.
As a result, Mary has been admitted to a rehabilitation hospital where she is expected to
reside for several months. The rehabilitation hospital is located outside the geographic
area served by her current Medicare Advantage (MA) plan. What options are available
to Mary regarding her health plan coverage? - ANSWER-Mary may make an unlimited
number of MA enrollment requests and may disenroll from her current MA plan.
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.
You have come to Mrs. Midler's home for a sales presentation. At the beginning of the
presentation, Mrs. Midler tells you that she has a copy of her medical records available
because she thinks this will help you understand her needs. She suggests that you will
know which questions to ask her about her health status in order to best assist her in
selecting a plan. What should you do? - ANSWER-You can only ask Mrs. Midler
questions about conditions that affect eligibility, specifically, whether she has one of the
conditions that would qualify her for a special needs plan.
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. 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
