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? - answers✔✔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)? - answers✔✔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.
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? - answers✔✔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.
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