AHIP Module 5 2023 Exam/ Questions &
Answers Updated 2025
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
ANSWERS-She may enroll in an MA plan beginning three months immediately before
her first entitlement to both Medicare Part A and Part B.
Which of the following individuals has enrolled in a plan based on a fixed enrollment
period? - CORRECT ANSWERS-Ben, who enrolls in a Medicare Advantage plan during
the Medicare Advantage Open Enrollment Period (MA OEP).
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? - CORRECT ANSWERS-
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. - CORRECT
ANSWERS-II and III only
You work for Caring Health, a Medicare Advantage (MA) plan sponsor. Recently, Mrs.
Garcia has completed an enrollment application for a plan offered by Caring Health,
which is waiting for a reply from CMS indicating whether or not Mrs. Garcia's enrollment
has been accepted. Once CMS replies, how long does Caring Health have to notify Mrs.
Garcia that her enrollment has been accepted and in what format? - CORRECT
ANSWERS-The plan has 10 calendar days to notify Mrs. Garcia in writing.
Mr. Robinson was quite ill recently and forgot to pay his monthly premium for his MA-PD
plan. He is worried that he will lose his coverage now when he needs it the most. He is
certain his plan will disenroll him because that is what happened to a friend of his in a
similar type of plan. What can you tell Mr. Robinson about his situation? - CORRECT
Answers Updated 2025
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
ANSWERS-She may enroll in an MA plan beginning three months immediately before
her first entitlement to both Medicare Part A and Part B.
Which of the following individuals has enrolled in a plan based on a fixed enrollment
period? - CORRECT ANSWERS-Ben, who enrolls in a Medicare Advantage plan during
the Medicare Advantage Open Enrollment Period (MA OEP).
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? - CORRECT ANSWERS-
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. - CORRECT
ANSWERS-II and III only
You work for Caring Health, a Medicare Advantage (MA) plan sponsor. Recently, Mrs.
Garcia has completed an enrollment application for a plan offered by Caring Health,
which is waiting for a reply from CMS indicating whether or not Mrs. Garcia's enrollment
has been accepted. Once CMS replies, how long does Caring Health have to notify Mrs.
Garcia that her enrollment has been accepted and in what format? - CORRECT
ANSWERS-The plan has 10 calendar days to notify Mrs. Garcia in writing.
Mr. Robinson was quite ill recently and forgot to pay his monthly premium for his MA-PD
plan. He is worried that he will lose his coverage now when he needs it the most. He is
certain his plan will disenroll him because that is what happened to a friend of his in a
similar type of plan. What can you tell Mr. Robinson about his situation? - CORRECT
