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AHIP Module 5 2025 | Comprehensive
Q&A For Certification Success
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 prior the
start of the annual enrollment period (AEP). What would you say If you were
advising Agent Adams? -correct-answer-c. This is a bad idea. Agents are generally
prohibited from soliciting or accepting an enrollment form prior to the start of the
AEP. Correct
Ms. Gonzales decided to remain in Original Medicare (Parts A and B) and Part D
during the Annual Enrollment Period (AEP). At the beginning of January, her
neighbor told her about the Medicare Advantage (MA) plan he selected. He also
told her there was an open enrollment period that she might be able to use to
enroll in a MA plan. Ms. Gonzales comes to you for advice shortly after speaking
to her neighbor. What should you tell her? -correct-answer-d. There is a MA Open
Enrollment Period (OEP) that takes place between January 1 and March 31, but
Ms. Gonzales cannot use it because eligibility to use the OEP is available only to
MA enrollees. Correct
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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? -correct-answer-d.
It is a time 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. Correct
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? -
correct-answer-b. If the SEP is for MA coverage, he will generally have one
opportunity to change his MA coverage. Correct
Mr. Wendt suffers from diabetes which has gotten progressively worse during the
last year. He is currently enrolled in Original Medicare (Parts A and B) and a Part D
prescription drug plan and did not enroll in a Medicare Advantage (MA) plan
during the last annual open enrollment period (AEP) which has just closed. Mr.
Wendt has heard that there are certain MA plans that might provide him with
more specialized coverage for his diabetes and wants to know if he must wait until
the next annual open enrollment period (AEP) before enrolling in such a plan.
What should you tell him? -correct-answer-c. If there is a special needs plan (SNP)
in Mr. Wendt's area that specializes in caring for individuals with diabetes, he may
enroll in the SNP at any time under a special enrollment period (SEP). Correct
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Which of the following individuals are likely to qualify for a special enrollment
period (SEP) for both MA and Part D due to a change of residence?
I. Edward (enrolled in MA and Part D) moves to a new home within the same
neighborhood in his existing plan's service area.
II. Fiona (enrolled in MA and Part D) moves cross-country to an area outside her
existing plan's service area.
III. Gilbert moves into a plan service area where there is now a Part D plan
available to him from a service area where no Part D plan was available.
IV. Henry makes a permanent move providing him with new MA and Part D
options. -correct-answer-d. II, III, and IV only Correct
Mr. Rockwell, age 67, is enrolled in Medicare Part A, but because he continues to
work and is covered by an employer health plan, he has not enrolled in Part B or
Part D. He receives a notice on June 1 that his employer is cutting back on
prescription drug benefits and that as of July 1 his coverage will no longer be
creditable. He has come to you for advice. What advice would you give Mr.
Rockwell about special enrollment periods (SEPs)? -correct-answer-d. Mr.
Rockwell is eligible for a SEP due to his involuntary loss of creditable drug
coverage; the SEP begins in June and ends September 1 - two months after the
loss of creditable coverage. Correct
Ms. Lee is enrolled in an MA-PD plan, but will be moving out of the plan's service
area next month. She is worried that she will not be able to enroll in another plan
available in her new residence until the Annual Election Period. What should you
AHIP Module 5 2025 | Comprehensive
Q&A For Certification Success
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 prior the
start of the annual enrollment period (AEP). What would you say If you were
advising Agent Adams? -correct-answer-c. This is a bad idea. Agents are generally
prohibited from soliciting or accepting an enrollment form prior to the start of the
AEP. Correct
Ms. Gonzales decided to remain in Original Medicare (Parts A and B) and Part D
during the Annual Enrollment Period (AEP). At the beginning of January, her
neighbor told her about the Medicare Advantage (MA) plan he selected. He also
told her there was an open enrollment period that she might be able to use to
enroll in a MA plan. Ms. Gonzales comes to you for advice shortly after speaking
to her neighbor. What should you tell her? -correct-answer-d. There is a MA Open
Enrollment Period (OEP) that takes place between January 1 and March 31, but
Ms. Gonzales cannot use it because eligibility to use the OEP is available only to
MA enrollees. Correct
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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? -correct-answer-d.
It is a time 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. Correct
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? -
correct-answer-b. If the SEP is for MA coverage, he will generally have one
opportunity to change his MA coverage. Correct
Mr. Wendt suffers from diabetes which has gotten progressively worse during the
last year. He is currently enrolled in Original Medicare (Parts A and B) and a Part D
prescription drug plan and did not enroll in a Medicare Advantage (MA) plan
during the last annual open enrollment period (AEP) which has just closed. Mr.
Wendt has heard that there are certain MA plans that might provide him with
more specialized coverage for his diabetes and wants to know if he must wait until
the next annual open enrollment period (AEP) before enrolling in such a plan.
What should you tell him? -correct-answer-c. If there is a special needs plan (SNP)
in Mr. Wendt's area that specializes in caring for individuals with diabetes, he may
enroll in the SNP at any time under a special enrollment period (SEP). Correct
, 3|Page
Which of the following individuals are likely to qualify for a special enrollment
period (SEP) for both MA and Part D due to a change of residence?
I. Edward (enrolled in MA and Part D) moves to a new home within the same
neighborhood in his existing plan's service area.
II. Fiona (enrolled in MA and Part D) moves cross-country to an area outside her
existing plan's service area.
III. Gilbert moves into a plan service area where there is now a Part D plan
available to him from a service area where no Part D plan was available.
IV. Henry makes a permanent move providing him with new MA and Part D
options. -correct-answer-d. II, III, and IV only Correct
Mr. Rockwell, age 67, is enrolled in Medicare Part A, but because he continues to
work and is covered by an employer health plan, he has not enrolled in Part B or
Part D. He receives a notice on June 1 that his employer is cutting back on
prescription drug benefits and that as of July 1 his coverage will no longer be
creditable. He has come to you for advice. What advice would you give Mr.
Rockwell about special enrollment periods (SEPs)? -correct-answer-d. Mr.
Rockwell is eligible for a SEP due to his involuntary loss of creditable drug
coverage; the SEP begins in June and ends September 1 - two months after the
loss of creditable coverage. Correct
Ms. Lee is enrolled in an MA-PD plan, but will be moving out of the plan's service
area next month. She is worried that she will not be able to enroll in another plan
available in her new residence until the Annual Election Period. What should you
