AHIP Module 5 2023 Questions and
Correct Answers
Willard works as a representative focused on the senior marketplace. What would be considered
prohibited activity by Willard? - correct Answers:Implying that only seniors can enroll in a Medicare
Advantage plan when meeting with Mr. Hernandez, who is 58 but qualifies for Medicare because he is
disabled.
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 certain MA plans 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 Answers: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 election period (SEP)
Ms. Thomas has worked for many years and is turning 68 in June. She is eligible for Medicare Part A and
did not enroll for Part B when first eligible because she has insurance through her employer - Coffee
Brew, Inc. She also did not enroll in Part D because she had creditable coverage. She would like to retire
in June and enroll in a Medicare Advantage plan. She has been informed that her group coverage will
end on her retirement effective date. How would you advise Ms. Thomas? - correct Answers:Ms. Thomas
can enroll in Part B without a late penalty at any time she is still covered by her employer group and 8
months after her last month of employer group coverage without a penalty. However, because she wants
to enroll in a MA plan after retirement, she should make sure her Part B coverage is effective in time to
use the Medicare Advantage/Part D special election period for individuals changing from employer group
coverage to enroll in a MA plan or MA-PD. The SEP begins while she has employer group coverage and
will last until 2 months after the month after the month her employer coverage ends. If she wants Part D
coverage she should enroll in an MA-PD or a PDP (depending on how she decides to receive her Part A
and B benefits) during this time.
Mrs. Johnson calls to tell you she has not received her new plan ID card yet, but she needs to see a
doctor. What can she expect to receive from the plan after the plan has received her enrollment form? -
correct Answers:Evidence of plan membership, information on how to obtain services, and the effective
date of coverage.
Correct Answers
Willard works as a representative focused on the senior marketplace. What would be considered
prohibited activity by Willard? - correct Answers:Implying that only seniors can enroll in a Medicare
Advantage plan when meeting with Mr. Hernandez, who is 58 but qualifies for Medicare because he is
disabled.
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 certain MA plans 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 Answers: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 election period (SEP)
Ms. Thomas has worked for many years and is turning 68 in June. She is eligible for Medicare Part A and
did not enroll for Part B when first eligible because she has insurance through her employer - Coffee
Brew, Inc. She also did not enroll in Part D because she had creditable coverage. She would like to retire
in June and enroll in a Medicare Advantage plan. She has been informed that her group coverage will
end on her retirement effective date. How would you advise Ms. Thomas? - correct Answers:Ms. Thomas
can enroll in Part B without a late penalty at any time she is still covered by her employer group and 8
months after her last month of employer group coverage without a penalty. However, because she wants
to enroll in a MA plan after retirement, she should make sure her Part B coverage is effective in time to
use the Medicare Advantage/Part D special election period for individuals changing from employer group
coverage to enroll in a MA plan or MA-PD. The SEP begins while she has employer group coverage and
will last until 2 months after the month after the month her employer coverage ends. If she wants Part D
coverage she should enroll in an MA-PD or a PDP (depending on how she decides to receive her Part A
and B benefits) during this time.
Mrs. Johnson calls to tell you she has not received her new plan ID card yet, but she needs to see a
doctor. What can she expect to receive from the plan after the plan has received her enrollment form? -
correct Answers:Evidence of plan membership, information on how to obtain services, and the effective
date of coverage.
