AHIP 2025/2026 MODULE 5
Mr. Liu turns 65 on June 19. He has never previously qualified for Medicare so his first
Medicare eligibility 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 him? - 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 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? - ANSWER-This
is a bad idea. Agents are generally prohibited from soliciting or accepting an enrollment
form before the start of the AEP.
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? - ANSWER-As long as she can 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.
Which of the following individuals are likely to qualify for a special election period (SEP)
for either a MA and/or 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 to a new state providing him with
new MA and Part D options. - ANSWER-II, III, and IV only.
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? - ANSWER-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).
Mr. Liu turns 65 on June 19. He has never previously qualified for Medicare so his first
Medicare eligibility 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 him? - 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 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? - ANSWER-This
is a bad idea. Agents are generally prohibited from soliciting or accepting an enrollment
form before the start of the AEP.
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? - ANSWER-As long as she can 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.
Which of the following individuals are likely to qualify for a special election period (SEP)
for either a MA and/or 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 to a new state providing him with
new MA and Part D options. - ANSWER-II, III, and IV only.
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? - ANSWER-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).
