2024 AHIP Module 5
Questions and
Answers with Certified Solutions Rated A+
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?
- ANSWER -Tell 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? - ANSWER -He 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? - ANSWER -Mary
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? - ANSWER -He 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? - ANSWER -You 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? - ANSWER
-She 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
Questions and
Answers with Certified Solutions Rated A+
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?
- ANSWER -Tell 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? - ANSWER -He 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? - ANSWER -Mary
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? - ANSWER -He 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? - ANSWER -You 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? - ANSWER
-She 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
