AHIP - Module 5
Question 1
A client wants to give you an enrollment application on October 1 prior to the
beginning of the Annual Election Period because he is leaving on vacation for two
weeks and does not want to forget about turning it in. What should you tell him?
a) Accept the form and hold it until the Annual Election Period begins
b) Accept the form and submit it immediately
c) You are not permitted to take the form. If he sends the form directly to the plan,
the plan will process the enrollment on the day the Annual Election Period begins
d) Tell him to mail it to you while on vacation
Answer: c
Question 2
If Mr. Johannsen gains the Part D low-income subsidy, how does that affect his
ability to enroll or disenroll in a Part D plan?
a) He can enroll in or disenroll from a Part D plan at any time and the subsidy will
apply to the plan he chooses
b) He qualifies for a special enrollment period and can enroll in or disenroll from a
Part D plan and the subsidy will apply to the plan he chooses
c) He must wait until the Annual Election Period
d) He loses his enrollment flexibility
Answer: a or b (both marked correct in source)
Question 3
Mary Samuels recently suffered a stroke while visiting her daughter and
grandchildren. As a result, Mary has been admitted to a rehabilitation hospital where
she is expected to reside for several months. The rehabilitation hospital is located
outside the geographic area served by her current Medicare Advantage (MA) plan.
What options are available to Mary regarding her health plan coverage?
,a) Mary may make an unlimited number of MA enrollment requests and may
disenroll from her current MA plan
b) She must keep her current plan
c) She can only change during the Annual Election Period
d) She must switch to Original Medicare only
Answer: a
Question 4
Mr. and Mrs. Nunez attended one of your sales presentations. They've asked you to
come to their home to clear up a few questions. During the presentation, Mrs. Nunez
feels tired and tells you that her husband can finish things up. She goes to bed. At
the end of your discussion, Mr. Nunez says that he wants to enroll both himself and
his wife. What should you do?
a) Allow Mr. Nunez to sign for both of them
b) Sign the form yourself on her behalf
c) Complete the enrollment without her signature
d) As long as she is able to do so, only Mrs. Nunez can sign her enrollment form.
Mrs. Nunez will have to wake up to sign her form or do so at another time
Answer: d
Question 5
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 January 1 next year. He is
currently enrolled in Original Medicare. What should you do?
a) Tell Mr. Anderson that you cannot accept any enrollment forms until the annual
election period begins
b) Accept the form and hold it
c) Submit the form immediately
d) Tell him to mail it to the plan directly
Answer: a
, Question 6
Mr. Barker had surgery recently and expected that he would have certain services
and items covered by the plan with minimal out-of-pocket costs because his MA-PD
coverage has been very good. However, when he received the bill, he was surprised
to see large charges in excess of his maximum out-of-pocket limit that included a
number of services and items he thought would be fully covered. He called you to
ask what he could do? What could you tell him?
a) There is nothing he can do
b) He must pay the full amount
c) He should switch plans immediately
d) You can offer to review the plan's appeal process to help him ask the plan to
review the coverage decision
Answer: d
Question 7
Mr. Block is currently enrolled in a Medicare Advantage plan that includes drug
coverage. He found a stand-alone Medicare prescription drug plan in his area that
offers better coverage than that available through his MA-PD plan and in addition
has a low premium. It won't cost him much more and, because he has the means 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?
a) He can enroll in both plans
b) He must drop his MA plan first
c) If Mr. Block enrolls in the stand-alone Medicare prescription drug plan, he will be
disenrolled from the Medicare Advantage plan
d) This is not allowed under any circumstances
Answer: c
Question 8
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?
Question 1
A client wants to give you an enrollment application on October 1 prior to the
beginning of the Annual Election Period because he is leaving on vacation for two
weeks and does not want to forget about turning it in. What should you tell him?
a) Accept the form and hold it until the Annual Election Period begins
b) Accept the form and submit it immediately
c) You are not permitted to take the form. If he sends the form directly to the plan,
the plan will process the enrollment on the day the Annual Election Period begins
d) Tell him to mail it to you while on vacation
Answer: c
Question 2
If Mr. Johannsen gains the Part D low-income subsidy, how does that affect his
ability to enroll or disenroll in a Part D plan?
a) He can enroll in or disenroll from a Part D plan at any time and the subsidy will
apply to the plan he chooses
b) He qualifies for a special enrollment period and can enroll in or disenroll from a
Part D plan and the subsidy will apply to the plan he chooses
c) He must wait until the Annual Election Period
d) He loses his enrollment flexibility
Answer: a or b (both marked correct in source)
Question 3
Mary Samuels recently suffered a stroke while visiting her daughter and
grandchildren. As a result, Mary has been admitted to a rehabilitation hospital where
she is expected to reside for several months. The rehabilitation hospital is located
outside the geographic area served by her current Medicare Advantage (MA) plan.
What options are available to Mary regarding her health plan coverage?
,a) Mary may make an unlimited number of MA enrollment requests and may
disenroll from her current MA plan
b) She must keep her current plan
c) She can only change during the Annual Election Period
d) She must switch to Original Medicare only
Answer: a
Question 4
Mr. and Mrs. Nunez attended one of your sales presentations. They've asked you to
come to their home to clear up a few questions. During the presentation, Mrs. Nunez
feels tired and tells you that her husband can finish things up. She goes to bed. At
the end of your discussion, Mr. Nunez says that he wants to enroll both himself and
his wife. What should you do?
a) Allow Mr. Nunez to sign for both of them
b) Sign the form yourself on her behalf
c) Complete the enrollment without her signature
d) As long as she is able to do so, only Mrs. Nunez can sign her enrollment form.
Mrs. Nunez will have to wake up to sign her form or do so at another time
Answer: d
Question 5
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 January 1 next year. He is
currently enrolled in Original Medicare. What should you do?
a) Tell Mr. Anderson that you cannot accept any enrollment forms until the annual
election period begins
b) Accept the form and hold it
c) Submit the form immediately
d) Tell him to mail it to the plan directly
Answer: a
, Question 6
Mr. Barker had surgery recently and expected that he would have certain services
and items covered by the plan with minimal out-of-pocket costs because his MA-PD
coverage has been very good. However, when he received the bill, he was surprised
to see large charges in excess of his maximum out-of-pocket limit that included a
number of services and items he thought would be fully covered. He called you to
ask what he could do? What could you tell him?
a) There is nothing he can do
b) He must pay the full amount
c) He should switch plans immediately
d) You can offer to review the plan's appeal process to help him ask the plan to
review the coverage decision
Answer: d
Question 7
Mr. Block is currently enrolled in a Medicare Advantage plan that includes drug
coverage. He found a stand-alone Medicare prescription drug plan in his area that
offers better coverage than that available through his MA-PD plan and in addition
has a low premium. It won't cost him much more and, because he has the means 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?
a) He can enroll in both plans
b) He must drop his MA plan first
c) If Mr. Block enrolls in the stand-alone Medicare prescription drug plan, he will be
disenrolled from the Medicare Advantage plan
d) This is not allowed under any circumstances
Answer: c
Question 8
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?
