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AHIP Module 5 Verified Solutions

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AHIP Module 5 Verified Solutions Initial Coverage Election Period (ICEP) What can Mrs. Reeves do during her ICEP? Answer: Enroll in a Medicare Advantage plan, but not enroll in a Medigap plan to supplement the benefits of the MA plan. Disenrollment from Employer Coverage What can Mr. Chen do if he decides to drop his employer-sponsored coverage? Answer: He can disenroll from his employer-sponsored coverage to elect a Medicare Advantage or Part D plan within 2 months of his disenrollment. Special Election Period (SEP) What should Mr. Rockwell do since he has lost creditable drug coverage? Answer: He is eligible for a SEP due to his involuntary loss of creditable drug coverage, which begins in June and ends on September 1. Part D Enrollment How does Mr. Johannsen's Part D low-income subsidy affect his ability to enroll or disenroll? Answer: He qualifies for a special election period and can enroll in or disenroll from a Part D plan once during that period. Change in Circumstances Can Mr. White change his Part D plan since he's now a dual eligible individual? Answer: No, once he's identified as a "potential at-risk" beneficiary, he cannot use the dual eligible SEP to change plans. Open Enrollment Period What advice would you give Mr. Roberts about his health coverage options after being discharged from a skilled nursing facility? Answer: His open enrollment period as an institutionalized individual will continue for two months after the month he moves out of the facility. Part D Initial Enrollment Period (IEP) What can Mr. Ziegler do during his IEP? Answer: He can make one Part D enrollment choice, including enrollment in a stand-alone Part D plan or an MA-PD plan. Enrollment Application Can Mr. Yoo give you an enrollment application on October 1 before the Annual Election Period begins? Answer: No, you must tell him you are not permitted to take the form. Special Election Period (SEP) What does it mean when Mr. Yoo's employer drops comprehensive creditable prescription drug coverage? Answer: It means he qualifies for a one-time opportunity to enroll in an MA-PD or Part D prescription drug plan. Medicare Advantage Plan Selection Should Agent Adams suggest completing the application with Mrs. Young before the start of the annual enrollment period (AEP)? Answer: No, this is not allowed by Medicare rules. Initial Coverage Election Period (ICEP) What action can you help Mr. Garrett take during his ICEP? Answer: He will have one opportunity to enroll in a Medicare Advantage plan. Change in Circumstances

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AHIP Module 5 Verified Solutions


Initial Coverage Election Period (ICEP)



What can Mrs. Reeves do during her ICEP?



Answer: Enroll in a Medicare Advantage plan, but not enroll in a Medigap plan to supplement the
benefits of the MA plan.



Disenrollment from Employer Coverage



What can Mr. Chen do if he decides to drop his employer-sponsored coverage?



Answer: He can disenroll from his employer-sponsored coverage to elect a Medicare Advantage or Part
D plan within 2 months of his disenrollment.



Special Election Period (SEP)



What should Mr. Rockwell do since he has lost creditable drug coverage?



Answer: He is eligible for a SEP due to his involuntary loss of creditable drug coverage, which begins in
June and ends on September 1.



Part D Enrollment



How does Mr. Johannsen's Part D low-income subsidy affect his ability to enroll or disenroll?



Answer: He qualifies for a special election period and can enroll in or disenroll from a Part D plan once
during that period.

, Change in Circumstances



Can Mr. White change his Part D plan since he's now a dual eligible individual?



Answer: No, once he's identified as a "potential at-risk" beneficiary, he cannot use the dual eligible SEP
to change plans.



Open Enrollment Period



What advice would you give Mr. Roberts about his health coverage options after being discharged from
a skilled nursing facility?



Answer: His open enrollment period as an institutionalized individual will continue for two months after
the month he moves out of the facility.



Part D Initial Enrollment Period (IEP)



What can Mr. Ziegler do during his IEP?



Answer: He can make one Part D enrollment choice, including enrollment in a stand-alone Part D plan or
an MA-PD plan.



Enrollment Application



Can Mr. Yoo give you an enrollment application on October 1 before the Annual Election Period begins?



Answer: No, you must tell him you are not permitted to take the form.



Special Election Period (SEP)

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