AHIP Module 5 questions and 100%
Verified correct answers
Mr. Ford enrolled in an MA-only plan in mid-November during the Annual Election
Period (AEP). On December 1, he calls you up and says that he has changed his mind
and would like to enroll in a MA-PD plan. What enrollment rules would apply in this
case? - Correct Answer He can make as many enrollment changes as he likes during
the Annual Election Period and the last choice made before the end of the period will be
the effective one as of January 1.
Mrs. Schmidt is moving and a friend told her she might qualify for a "special election
period" to enroll in a new Medicare Advantage plan. She contacted you to ask what a
special election period is. What could you tell her? - Correct Answer It is a period,
outside of the Annual Election Period, when a Medicare beneficiary can select a new or
different Medicare Advantage and/or Part D prescription drug plan. Typically, the special
election period is beneficiary specific and results from events, such as when the
beneficiary moves outside of the service area.
Mr. Anderson is a very organized individual and has filled out and brought to you an
enrollment form on October 10 for a new plan available on January 1 next year. He is
currently enrolled in Original Medicare. What should you do? - Correct Answer Tell Mr.
Anderson that you cannot accept any enrollment forms until the annual election period
begins.
Ms. Claggett is sixty-six (66) years old. She has been covered under Original Medicare
for the last six years due to her disability and has never been enrolled in a Medicare
Advantage or a Part D plan before. She wants to enroll in a Part D plan. She knows that
there is such a thing as the "Part D Initial Enrollment Period" (IEP) and has concluded
that, since she has never enrolled in such a plan before, she should be eligible to enroll
under this period. What should you tell her about how the Part D Initial Enrollment
Period applies to her situation? - Correct Answer Ms. Claggett has had two IEPs and
missed them both. The first occurred three months before and three months after the
month when she was first entitled to Part A OR enrolled in Part B. Because she was
eligible for Medicare before age 65, Ms. Claggett had a second IEP based on turning
age 65, which has also expired.
Mrs. Kendrick is in good health, has worked for many years, and is six months away
from turning 65. She wants to know what she will have to do to enroll in a Medicare
Advantage (MA) plan as soon as possible. What could you tell her? - Correct Answer
She may enroll in an MA plan beginning three months immediately before her first
entitlement to both Medicare Part A and Part B.
Ms. Thomas has worked for many years and is turning 68 in June. She is eligible for
Medicare Part A and did not enroll for Part B when first eligible because she has
insurance through her employer - Coffee Brew, Inc. She also did not enroll in Part D
because she had creditable coverage. She would like to retire in June and enroll in a
Medicare Advantage plan. She has been informed that her group coverage will end on
her retirement effective date. How would you advise Ms. Thomas? - Correct Answer Ms.
Thomas can enroll in Part B without a late penalty at any time she is still covered by her
Verified correct answers
Mr. Ford enrolled in an MA-only plan in mid-November during the Annual Election
Period (AEP). On December 1, he calls you up and says that he has changed his mind
and would like to enroll in a MA-PD plan. What enrollment rules would apply in this
case? - Correct Answer He can make as many enrollment changes as he likes during
the Annual Election Period and the last choice made before the end of the period will be
the effective one as of January 1.
Mrs. Schmidt is moving and a friend told her she might qualify for a "special election
period" to enroll in a new Medicare Advantage plan. She contacted you to ask what a
special election period is. What could you tell her? - Correct Answer It is a period,
outside of the Annual Election Period, when a Medicare beneficiary can select a new or
different Medicare Advantage and/or Part D prescription drug plan. Typically, the special
election period is beneficiary specific and results from events, such as when the
beneficiary moves outside of the service area.
Mr. Anderson is a very organized individual and has filled out and brought to you an
enrollment form on October 10 for a new plan available on January 1 next year. He is
currently enrolled in Original Medicare. What should you do? - Correct Answer Tell Mr.
Anderson that you cannot accept any enrollment forms until the annual election period
begins.
Ms. Claggett is sixty-six (66) years old. She has been covered under Original Medicare
for the last six years due to her disability and has never been enrolled in a Medicare
Advantage or a Part D plan before. She wants to enroll in a Part D plan. She knows that
there is such a thing as the "Part D Initial Enrollment Period" (IEP) and has concluded
that, since she has never enrolled in such a plan before, she should be eligible to enroll
under this period. What should you tell her about how the Part D Initial Enrollment
Period applies to her situation? - Correct Answer Ms. Claggett has had two IEPs and
missed them both. The first occurred three months before and three months after the
month when she was first entitled to Part A OR enrolled in Part B. Because she was
eligible for Medicare before age 65, Ms. Claggett had a second IEP based on turning
age 65, which has also expired.
Mrs. Kendrick is in good health, has worked for many years, and is six months away
from turning 65. She wants to know what she will have to do to enroll in a Medicare
Advantage (MA) plan as soon as possible. What could you tell her? - Correct Answer
She may enroll in an MA plan beginning three months immediately before her first
entitlement to both Medicare Part A and Part B.
Ms. Thomas has worked for many years and is turning 68 in June. She is eligible for
Medicare Part A and did not enroll for Part B when first eligible because she has
insurance through her employer - Coffee Brew, Inc. She also did not enroll in Part D
because she had creditable coverage. She would like to retire in June and enroll in a
Medicare Advantage plan. She has been informed that her group coverage will end on
her retirement effective date. How would you advise Ms. Thomas? - Correct Answer Ms.
Thomas can enroll in Part B without a late penalty at any time she is still covered by her
