2025 AHIP Final
Alice is enrolled in a MA-PD plan. She makes a permanent move across the country
and wonders what her options are for continuing MA-PD coverage. What would you
say to her in regard to a special enrollment period (SEP)? - ANS-She is likely to
qualify for a SEP. She can choose an effective date of up to three months after the
month in which the enrollment form is received by the new plan, but the effective
date may not be earlier than the date of her permanent move.
\Mr. Lopez, who is fairly well-off financially, would like to enroll in a Medicare
prescription drug plan you represent and simply give you a check to cover his
premiums for the entire year. What should you tell him? - ANS-Enrollees should pay
using automatic withdrawal from a bank account or credit or debit card, direct
monthly billing from the plan, or deductions from their Social Security check.
\Mrs. Albertson has been enrolled in a Medicare Part D plan for several years. She
takes several brand name drugs and is interested in learning about the Medicare
Prescription Payment Plan. What should you tell her? - ANS-Enrollees can opt out of
the program at any time. However, they will continue to be billed for any cost-sharing
amounts still owed.
\Ms. Morris will turn 65 on June 10th. She has never previously qualified for
Medicare. She is entitled to Medicare Part A and intends to enroll in Part B. She
wants to know if she is eligible to enroll in a Medicare Advantage plan that includes
prescription drug coverage. What do you tell her? - ANS-Ms. Morris can enroll in an
MA-PD plan now since her initial election period (IEP) for Part D prescription drug
coverage and initial coverage period are occurring together beginning March 1st and
ending September 30th.
\Richard is a licensed agent who represents Spartan Health Plan and its Medicare
Advantage (MA) plans. Richard has several clients who have recently come to him
for help who are in their initial coverage election period (ICEP) and are interested in
enrolling in one of Spartan Health Plan's MA plans. Alice will soon turn 65 and retire.
Alice has coverage through Spartan Health Plan offered by her employer. Bob had
health coverage through Spartan but dropped the coverage when he retired early to
travel overseas. Bob, who has just turned age 65, is now back in the United States.
Charlotte, who will turn 65 next month, has coverage through Athena Health plan - a
company Richard also represents. Who qualifies for the opt-in simplified enrollment
mechanism? - ANS-Alice and Charlotte because each of them currently have health
coverage and is in their initial coverage election period (ICEP).
\
Alice is enrolled in a MA-PD plan. She makes a permanent move across the country
and wonders what her options are for continuing MA-PD coverage. What would you
say to her in regard to a special enrollment period (SEP)? - ANS-She is likely to
qualify for a SEP. She can choose an effective date of up to three months after the
month in which the enrollment form is received by the new plan, but the effective
date may not be earlier than the date of her permanent move.
\Mr. Lopez, who is fairly well-off financially, would like to enroll in a Medicare
prescription drug plan you represent and simply give you a check to cover his
premiums for the entire year. What should you tell him? - ANS-Enrollees should pay
using automatic withdrawal from a bank account or credit or debit card, direct
monthly billing from the plan, or deductions from their Social Security check.
\Mrs. Albertson has been enrolled in a Medicare Part D plan for several years. She
takes several brand name drugs and is interested in learning about the Medicare
Prescription Payment Plan. What should you tell her? - ANS-Enrollees can opt out of
the program at any time. However, they will continue to be billed for any cost-sharing
amounts still owed.
\Ms. Morris will turn 65 on June 10th. She has never previously qualified for
Medicare. She is entitled to Medicare Part A and intends to enroll in Part B. She
wants to know if she is eligible to enroll in a Medicare Advantage plan that includes
prescription drug coverage. What do you tell her? - ANS-Ms. Morris can enroll in an
MA-PD plan now since her initial election period (IEP) for Part D prescription drug
coverage and initial coverage period are occurring together beginning March 1st and
ending September 30th.
\Richard is a licensed agent who represents Spartan Health Plan and its Medicare
Advantage (MA) plans. Richard has several clients who have recently come to him
for help who are in their initial coverage election period (ICEP) and are interested in
enrolling in one of Spartan Health Plan's MA plans. Alice will soon turn 65 and retire.
Alice has coverage through Spartan Health Plan offered by her employer. Bob had
health coverage through Spartan but dropped the coverage when he retired early to
travel overseas. Bob, who has just turned age 65, is now back in the United States.
Charlotte, who will turn 65 next month, has coverage through Athena Health plan - a
company Richard also represents. Who qualifies for the opt-in simplified enrollment
mechanism? - ANS-Alice and Charlotte because each of them currently have health
coverage and is in their initial coverage election period (ICEP).
\
