AHIP 2025 MODULE 5 QUESTIONS WITH
VERIFIED ANSWERS
Mr. Liu turns 65 on June 19. He has never previously qualified for Medicare so his first Medicare eligibi
lity date will be June 1. Mr. Liu's ICEP and Part D IEP begin on March 1 and end on September 30. He
wants prescription drug coverage with his Part A and Part B benefits. What advice can you provide hi
m? - correct answer-He can enroll in a MA-PD as long as he enrolls in Part B and is entitled to Part A.
Mrs. Young is currently enrolled in Original Medicare (Parts A and B), but she has been working with A
gent 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 M
rs. Young complete the application together before she leaves. He will then submit the paper applicati
on before the start of the annual enrollment period (AEP). What would you say If you were advising A
gent Adams? - correct answer-
This is a bad idea. Agents are generally prohibited from soliciting or accepting an enrollment form bef
ore the start of the AEP.
Mr. Block is currently enrolled in a Medicare Advantage plan that includes drug coverage. He found a s
tand-
alone Medicare prescription drug plan in his area that offers better coverage than that available throu
gh his MA-
PD plan and in addition, has a low premium. It won't cost him much more and, because he has the m
eans to do so, he wishes to enroll in the stand-alone prescription drug plan in addition to his MA-
PD plan. What should you tell him? - correct answer-If Mr. Block enrolls in the stand-
alone Medicare prescription drug plan, he will be disenrolled from the Medicare Advantage plan.
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-
If the SEP is for MA coverage, he will generally have one opportunity to change his MA coverage.
Which of the following individuals has enrolled in a plan based on a fixed enrollment period? -
correct answer-
Ben enrolls in a Medicare Advantage plan during the Medicare Advantage Open Enrollment Period (M
A OEP).
Mr. Chen is enrolled in his employer's group health plan and will be retiring soon. He would like to kn
ow his options since he has decided to drop his retiree coverage and is eligible for Medicare. What sh
ould you tell him? - correct answer-Mr. Chen can disenroll from his employer-
, sponsored Lcoverage Lto Lelect La LMedicare LAdvantage Lor LPart LD Lplan Lwithin L2 Lmonths Lof Lhis
Ldisenrollmen L t.
Mrs. LPierce Lwould Llike Lto Lenroll Lin La LMedicare LCost Lplan Lthat Loffers LPart LD Lprescription Ldrug
Lcoverage. LShe Lcomes Lto Lyou Lfor Ladvice Labout Lwhen Lshe Lcan Lenroll Lin La Lplan Lyou Lhave
Lpreviously Ldiscussed. LWhat Lshould Lyou Ltell Lher? L- Lcorrect Lanswer-
Enrollment Lin LCost Lplans Loffering LPart LD Lcoverage Lis Lavailable Lonly Lduring Lenrollment Lperiods
Lunder Lthe LPart LD Lprogram, Land LCost Lplans Lmust Laccept Lenrollments Lduring Lthese Lperiods.
Mr. LRodriguez Lis Lcurrently Lenrolled Lin La LMA Lplan, Lbut Lhis Lplan Ldoesn't Lsufficiently Lcover Lhis
Lprescription Ldrug L needs. L He L is L interested L in L changing L plans L during L the L upcoming L MA L Open
L Enrollment L Period. L Wh Lat Lare Lhis Loptions Lduring Lthe LMA LOEP? L- Lcorrect Lanswer-He Lcan Lswitch
Lto La LMA-PD Lplan.
Mr. Land LMrs. LNunez Lattended Lone Lof Lyour Lsales Lpresentations. LThey've Lasked Lyou Lto Lcome Lto
Ltheir Lho Lme Lto Lclear Lup La Lfew Lquestions. LDuring Lthe Lpresentation, LMrs. LNunez Lfeels Ltired Land
Ltells Lyou Lthat Lher Lhusband Lcan Lfinish Lthings Lup. LShe Lgoes Lto Lbed. LAt Lthe Lend Lof Lyour
Ldiscussion, LMr. LNunez Lsays Lthat Lhe Lwants Lto Lenroll Lboth Lhimself Land Lhis Lwife. LWhat Lshould
Lyou Ldo? L- Lcorrect Lanswer-
As Llong Las Lshe Lcan Ldo Lso, Lonly LMrs. LNunez Lcan Lsign Lher Lenrollment Lform. LMrs. LNunez Lwill
Lhave Lto Lwake L up Lto Lsign Lher Lform Lor Ldo Lso Lat Lanother Ltime.
Which L of L the L following Lindividuals L are L likely Lto L qualify L for L a Lspecial Lelection L period L (SEP) L for
Leither La L M LA Land/or LPart LD Ldue Lto La Lchange Lof Lresidence?I. LEdward L(enrolled Lin LMA Land LPart
LD) Lmoves Lto La Lnew L home Lwithin Lthe Lsame Lneighborhood Lin Lhis Lexisting Lplan's Lservice Larea.II.
LFiona L(enrolled Lin LMANand LPa L rt LD) Lmoves Lcross-
country Lto Lan Larea Loutside Lher Lexisting Lplan's Lservice Larea.III. LGilbert Lmoves Linto La Lplan Lservice
Larea Lw Lhere L there L is L now L a L Part L D L plan L available L to L him L from L a L service L area L where L no
L Part L D L plan L was L availabl
e.IV. LHenry Lmakes La Lpermanent Lmove Lto La Lnew Lstate Lproviding Lhim Lwith Lnew LMA Land LPart LD
Loptions. L- Lcorrect Lanswer-II, LIII, Land LIV Lonly.
Mr. LWendt Lsuffers Lfrom Ldiabetes Lwhich Lhas Lgotten Lprogressively Lworse Lduring Lthe Llast Lyear. LHe
Lis Lcurre Lntly L enrolled L in L Original L Medicare L (Parts L A L and L B) L and L a L Part L D L prescription L drug
L plan L and L did L not L enro Lll Lin La LMedicare LAdvantage L(MA) Lplan Lduring Lthe Llast Lannual Lopen
Lenrollment Lperiod L(AEP) Lwhich Lhas Lj Lust Lclosed. LMr. LWendt Lhas Lheard Lcertain LMA Lplans Lmight
Lprovide Lhim Lwith Lmore Lspecialized Lcoverage Lf Lor Lhis Ldiabetes Land Lwants Lto Lknow Lif Lhe Lmust
Lwait Luntil Lthe Lnext Lannual Lopen Lenrollment Lperiod L(AEP) Lbefore Lenrolling Lin Lsuch La Lplan. LWhat
Lshould Lyou Ltell Lhim? L- Lcorrect Lanswer-
If Lthere Lis La Lspecial Lneeds Lplan L(SNP) Lin LMr. LWendt's Larea Lthat Lspecializes Lin Lcaring Lfor
Lindividuals Lwith Ldiabetes, Lhe Lmay Lenroll Lin Lthe LSNP Lat Lany Ltime Lunder La Lspecial Lelection
Lperiod L(SEP).
VERIFIED ANSWERS
Mr. Liu turns 65 on June 19. He has never previously qualified for Medicare so his first Medicare eligibi
lity date will be June 1. Mr. Liu's ICEP and Part D IEP begin on March 1 and end on September 30. He
wants prescription drug coverage with his Part A and Part B benefits. What advice can you provide hi
m? - correct answer-He can enroll in a MA-PD as long as he enrolls in Part B and is entitled to Part A.
Mrs. Young is currently enrolled in Original Medicare (Parts A and B), but she has been working with A
gent 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 M
rs. Young complete the application together before she leaves. He will then submit the paper applicati
on before the start of the annual enrollment period (AEP). What would you say If you were advising A
gent Adams? - correct answer-
This is a bad idea. Agents are generally prohibited from soliciting or accepting an enrollment form bef
ore the start of the AEP.
Mr. Block is currently enrolled in a Medicare Advantage plan that includes drug coverage. He found a s
tand-
alone Medicare prescription drug plan in his area that offers better coverage than that available throu
gh his MA-
PD plan and in addition, has a low premium. It won't cost him much more and, because he has the m
eans to do so, he wishes to enroll in the stand-alone prescription drug plan in addition to his MA-
PD plan. What should you tell him? - correct answer-If Mr. Block enrolls in the stand-
alone Medicare prescription drug plan, he will be disenrolled from the Medicare Advantage plan.
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-
If the SEP is for MA coverage, he will generally have one opportunity to change his MA coverage.
Which of the following individuals has enrolled in a plan based on a fixed enrollment period? -
correct answer-
Ben enrolls in a Medicare Advantage plan during the Medicare Advantage Open Enrollment Period (M
A OEP).
Mr. Chen is enrolled in his employer's group health plan and will be retiring soon. He would like to kn
ow his options since he has decided to drop his retiree coverage and is eligible for Medicare. What sh
ould you tell him? - correct answer-Mr. Chen can disenroll from his employer-
, sponsored Lcoverage Lto Lelect La LMedicare LAdvantage Lor LPart LD Lplan Lwithin L2 Lmonths Lof Lhis
Ldisenrollmen L t.
Mrs. LPierce Lwould Llike Lto Lenroll Lin La LMedicare LCost Lplan Lthat Loffers LPart LD Lprescription Ldrug
Lcoverage. LShe Lcomes Lto Lyou Lfor Ladvice Labout Lwhen Lshe Lcan Lenroll Lin La Lplan Lyou Lhave
Lpreviously Ldiscussed. LWhat Lshould Lyou Ltell Lher? L- Lcorrect Lanswer-
Enrollment Lin LCost Lplans Loffering LPart LD Lcoverage Lis Lavailable Lonly Lduring Lenrollment Lperiods
Lunder Lthe LPart LD Lprogram, Land LCost Lplans Lmust Laccept Lenrollments Lduring Lthese Lperiods.
Mr. LRodriguez Lis Lcurrently Lenrolled Lin La LMA Lplan, Lbut Lhis Lplan Ldoesn't Lsufficiently Lcover Lhis
Lprescription Ldrug L needs. L He L is L interested L in L changing L plans L during L the L upcoming L MA L Open
L Enrollment L Period. L Wh Lat Lare Lhis Loptions Lduring Lthe LMA LOEP? L- Lcorrect Lanswer-He Lcan Lswitch
Lto La LMA-PD Lplan.
Mr. Land LMrs. LNunez Lattended Lone Lof Lyour Lsales Lpresentations. LThey've Lasked Lyou Lto Lcome Lto
Ltheir Lho Lme Lto Lclear Lup La Lfew Lquestions. LDuring Lthe Lpresentation, LMrs. LNunez Lfeels Ltired Land
Ltells Lyou Lthat Lher Lhusband Lcan Lfinish Lthings Lup. LShe Lgoes Lto Lbed. LAt Lthe Lend Lof Lyour
Ldiscussion, LMr. LNunez Lsays Lthat Lhe Lwants Lto Lenroll Lboth Lhimself Land Lhis Lwife. LWhat Lshould
Lyou Ldo? L- Lcorrect Lanswer-
As Llong Las Lshe Lcan Ldo Lso, Lonly LMrs. LNunez Lcan Lsign Lher Lenrollment Lform. LMrs. LNunez Lwill
Lhave Lto Lwake L up Lto Lsign Lher Lform Lor Ldo Lso Lat Lanother Ltime.
Which L of L the L following Lindividuals L are L likely Lto L qualify L for L a Lspecial Lelection L period L (SEP) L for
Leither La L M LA Land/or LPart LD Ldue Lto La Lchange Lof Lresidence?I. LEdward L(enrolled Lin LMA Land LPart
LD) Lmoves Lto La Lnew L home Lwithin Lthe Lsame Lneighborhood Lin Lhis Lexisting Lplan's Lservice Larea.II.
LFiona L(enrolled Lin LMANand LPa L rt LD) Lmoves Lcross-
country Lto Lan Larea Loutside Lher Lexisting Lplan's Lservice Larea.III. LGilbert Lmoves Linto La Lplan Lservice
Larea Lw Lhere L there L is L now L a L Part L D L plan L available L to L him L from L a L service L area L where L no
L Part L D L plan L was L availabl
e.IV. LHenry Lmakes La Lpermanent Lmove Lto La Lnew Lstate Lproviding Lhim Lwith Lnew LMA Land LPart LD
Loptions. L- Lcorrect Lanswer-II, LIII, Land LIV Lonly.
Mr. LWendt Lsuffers Lfrom Ldiabetes Lwhich Lhas Lgotten Lprogressively Lworse Lduring Lthe Llast Lyear. LHe
Lis Lcurre Lntly L enrolled L in L Original L Medicare L (Parts L A L and L B) L and L a L Part L D L prescription L drug
L plan L and L did L not L enro Lll Lin La LMedicare LAdvantage L(MA) Lplan Lduring Lthe Llast Lannual Lopen
Lenrollment Lperiod L(AEP) Lwhich Lhas Lj Lust Lclosed. LMr. LWendt Lhas Lheard Lcertain LMA Lplans Lmight
Lprovide Lhim Lwith Lmore Lspecialized Lcoverage Lf Lor Lhis Ldiabetes Land Lwants Lto Lknow Lif Lhe Lmust
Lwait Luntil Lthe Lnext Lannual Lopen Lenrollment Lperiod L(AEP) Lbefore Lenrolling Lin Lsuch La Lplan. LWhat
Lshould Lyou Ltell Lhim? L- Lcorrect Lanswer-
If Lthere Lis La Lspecial Lneeds Lplan L(SNP) Lin LMr. LWendt's Larea Lthat Lspecializes Lin Lcaring Lfor
Lindividuals Lwith Ldiabetes, Lhe Lmay Lenroll Lin Lthe LSNP Lat Lany Ltime Lunder La Lspecial Lelection
Lperiod L(SEP).
