AHIP Module 5 2024

AHIP Module 5 2024 Willard works as a representative focused on the senior marketplace. What would be considered prohibited activity by Willard? Implying that only seniors can enroll in a Medicare Advantage plan when meeting with Mr. Hernandez, who is 58 but qualifies for Medicare because he is disabled. Medicare Advantage Enrollment What should you advise a client who is planning to turn 65 and wants to discuss Medicare Advantage plans with you? Answer: It's best to wait until October to discuss plan choices, as you can share plan benefits for the current year and any changes for the following year that may impact their choice. Special Election Period Can a client with a Part D low-income subsidy enroll or disenroll from a Part D plan? Answer: Yes, they qualify for a special election period and can enroll or disenroll from a Part D plan once during that period. Medicare Advantage Disenrollment What options are available to a client who has been admitted to a rehabilitation hospital outside their MA plan's service area? Answer: They may make an unlimited number of MA enrollment requests and disenroll from their current MA plan. Initial Coverage Election Period During the Initial Coverage Election Period (ICEP), what action can a client take? Answer: They will have one opportunity to enroll in a Medicare Advantage plan. Medical Records What should you do if a client offers to share their medical records with you during a sales presentation? Answer: You can only ask questions about conditions that affect eligibility, such as conditions that would qualify them for a special needs plan. Medigap Enrollment During the ICEP, what cannot a client do? Answer: They cannot enroll in a Medigap plan to supplement the benefits of the MA plan they're also enrolling in. Dual Eligible SEP Is a dual-eligible individual who is identified as "potential at-risk" eligible for a SEP to change Part D plans? Answer: No, once identified as "potential at-risk," they cannot use the dual eligible SEP to change plans while this designation is in place. Annual Enrollment Period If a client decides not to enroll in Original Medicare (Parts A and B) and Part D during the Annual Enrollment Period (AEP), can they still enroll in an MA plan? Answer: No, there is no opportunity for them to enroll in an MA plan during this time frame. Part D Enrollment Can a client who is turning 65 enroll in Part D during their Initial Enrollment Period (IEP)? Answer: Yes, they are currently in the IEP and can make one Part D enrollment choice, including enrollment in a stand-alone Part D plan or an MA-PD plan. Telephone Enrollment Can a client enroll in Senior Health's Medicare Advantage plan over the telephone? Answer: Yes, but telephone enrollment requests must be recorded, and telephonic enrollments must include all required elements necessary to complete an enrollment. Special Election Period What type of SEP applies when an employer cuts back on prescription drug benefits, making coverage non-creditable? Answer: A SEP due to involuntary loss of creditable coverage is available, which begins two months prior to the loss of creditable coverage and ends two months after the loss of creditable coverage. Mr. Wilcox has been enrolled in Lexington Private Fee-for-Service (PFFS) Medicare Advantage Health Plan (Lexington) for several years. Recently, Mr. Wilcox decided to spend time with his children who live in another state that is not in Lexington's service area. In the future, he may relocate near his children permanently. How does this move to another service area impact his PFFS MA coverage? Lexington can allow for Mr. Wilcox's continued enrollment for up to 12 months whether or not he is in a visitor/traveler (V/T) program since it is a PFFS plan. Mrs. Parker likes to handle most of her business matters through telephone calls. She currently is enrolled in Original Medicare Parts A and B but has heard about a Medicare Advantage plan offered by Senior Health from a neighbor. Mrs. Parker asks you whether she can enroll in Senior Health's MA plan over the telephone. What can tell her? I. Enrollment requests can only be made in face-to-face interviews or by mail. II. Telephone enrollment request calls must be recorded. III. Telephonic enrollments must include all required elements necessary to complete an enrollment. IV. The signature element must be completed via certified mail. II and III only