2024 AHIP paper 6
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?
- answerTell 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? - answerHe 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? - answerMary 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? - answerHe 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? - answerYou 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? -
answerShe 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 D plan during a SEP for dual eligible individuals? - answerNo. Once he is identified by the
plan sponsor as a "potential at-risk" beneficiary, he cannot use the dual eligible SEP to change plans
while this designation is in place.
Ms. Gonzales decided to remain in Original Medicare (Parts A and B) and Part D during the Annual
Enrollment Period (AEP). At the beginning of January, her neighbor told her about the Medicare
Advantage (MA) plan he selected. He also told her there was an open enrollment period that she might
be able to use to enroll in a MA plan. Ms. Gonzales comes to you for advice shortly after speaking to her
neighbor. What should you tell her? - answerThere is a MA Open Enrollment Period (OEP) that takes
place between January 1 and March 31, but Ms. Gonzales cannot use it because eligibility to use the OEP
is available only to MA enrollees.
Mr. Ziegler is turning 65 next month and has asked you what he can do, and when he must do it, with
respect to enrolling in Part D. What could you tell him? - answerHe is currently in the Part D Initial
Enrollment Period (IEP) and, during this time, he may make one Part D enrollment choice, including
enrollment in a stand-alone Part D plan or an MA-PD 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 you 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. - answerII and III only
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?
- answerTell 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? - answerHe 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? - answerMary 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? - answerHe 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? - answerYou 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? -
answerShe 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 D plan during a SEP for dual eligible individuals? - answerNo. Once he is identified by the
plan sponsor as a "potential at-risk" beneficiary, he cannot use the dual eligible SEP to change plans
while this designation is in place.
Ms. Gonzales decided to remain in Original Medicare (Parts A and B) and Part D during the Annual
Enrollment Period (AEP). At the beginning of January, her neighbor told her about the Medicare
Advantage (MA) plan he selected. He also told her there was an open enrollment period that she might
be able to use to enroll in a MA plan. Ms. Gonzales comes to you for advice shortly after speaking to her
neighbor. What should you tell her? - answerThere is a MA Open Enrollment Period (OEP) that takes
place between January 1 and March 31, but Ms. Gonzales cannot use it because eligibility to use the OEP
is available only to MA enrollees.
Mr. Ziegler is turning 65 next month and has asked you what he can do, and when he must do it, with
respect to enrolling in Part D. What could you tell him? - answerHe is currently in the Part D Initial
Enrollment Period (IEP) and, during this time, he may make one Part D enrollment choice, including
enrollment in a stand-alone Part D plan or an MA-PD 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 you 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. - answerII and III only
