AHIP Mod V Exam Questions With Correct
Answers
1. Mr. Garcia was told he qualifies for a special election period (SEP), but he lost the paper that
explains what he could do during the SEP. What can you tell him? - ANS ✔ - If the SEP is for MA
coverage, he will generally have one opportunity to change his MA coverage.
2. Mrs. Young is currently enrolled in Original Medicare (Parts A and B), but she has been working
with Agent Neil Adams in the selection of a Medicare Advantage (MA) plan. It is mid-September,
and Mrs. Young is going on vacation. Agent Adams is considering suggesting that he and Mrs.
Young complete the application together before she leaves. He will then submit the paper
application before the start of the annual enrollment period (AEP). What would you say If you
were advising Agent Adams? - ANS ✔ - This is a bad idea. Agents are generally prohibited from
soliciting or accepting an enrollment form before the start of the AEP.
3. 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? - ANS ✔ - Tell Mr. Anderson that you cannot accept any
enrollment forms until the annual election period begins.
4. 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? - ANS ✔ - 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.
5. Mr. Chen is enrolled in his employer's group health plan and will be retiring soon. He would like
to know his options since he has decided to drop his retiree coverage and is eligible for
Medicare. What should you tell him? - ANS ✔ - Mr. Chen can disenroll from his employer-
sponsored coverage to elect a Medicare Advantage or Part D plan within 2 months of his
disenrollment.
6. Mr. Yoo's employer has recently dropped comprehensive creditable prescription drug coverage
that was offered to company retirees. The company told Mr. Yoo that, because he was affected
by this change, he would qualify for a special election period. Mr. Yoo contacted you to find out
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Answers
1. Mr. Garcia was told he qualifies for a special election period (SEP), but he lost the paper that
explains what he could do during the SEP. What can you tell him? - ANS ✔ - If the SEP is for MA
coverage, he will generally have one opportunity to change his MA coverage.
2. Mrs. Young is currently enrolled in Original Medicare (Parts A and B), but she has been working
with Agent Neil Adams in the selection of a Medicare Advantage (MA) plan. It is mid-September,
and Mrs. Young is going on vacation. Agent Adams is considering suggesting that he and Mrs.
Young complete the application together before she leaves. He will then submit the paper
application before the start of the annual enrollment period (AEP). What would you say If you
were advising Agent Adams? - ANS ✔ - This is a bad idea. Agents are generally prohibited from
soliciting or accepting an enrollment form before the start of the AEP.
3. 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? - ANS ✔ - Tell Mr. Anderson that you cannot accept any
enrollment forms until the annual election period begins.
4. 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? - ANS ✔ - 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.
5. Mr. Chen is enrolled in his employer's group health plan and will be retiring soon. He would like
to know his options since he has decided to drop his retiree coverage and is eligible for
Medicare. What should you tell him? - ANS ✔ - Mr. Chen can disenroll from his employer-
sponsored coverage to elect a Medicare Advantage or Part D plan within 2 months of his
disenrollment.
6. Mr. Yoo's employer has recently dropped comprehensive creditable prescription drug coverage
that was offered to company retirees. The company told Mr. Yoo that, because he was affected
by this change, he would qualify for a special election period. Mr. Yoo contacted you to find out
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