2024 AHIP Module 5
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? - ANSTell 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? - ANSHe 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? - ANSMary 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? - ANSHe 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? - ANSYou 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? - ANSShe 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?
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? - ANSTell 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? - ANSHe 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? - ANSMary 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? - ANSHe 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? - ANSYou 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? - ANSShe 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?
