AHIP MODULE 5 RELIABLE STUDY MATERIAL WITH COMPLETE QUESTIONS AND CORRECT ANSWERS RATED A+
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AHIP MODULE 5
Institution
AHIP MODULE 5
AHIP MODULE 5 RELIABLE STUDY MATERIAL WITH COMPLETE QUESTIONS AND CORRECT ANSWERS RATED A+
You have come to Mrs. Midler's home for a sales presentation. At the beginning of the presentation, Mrs. Midler tells you that she has a copy of her medical records available because she thinks this will...
AHIP MODULE 5 RELIABLE STUDY
MATERIAL WITH COMPLETE QUESTIONS
AND CORRECT ANSWERS RATED A+
You have come to Mrs. Midler's home for a sales presentation. At
the beginning of the presentation, Mrs. Midler tells you that she
has a copy of her medical records available because she thinks
this will help you understand her needs. She suggests that you
will know which questions to ask her about her health status in
order to best assist her in selecting a plan. What should you do?
Correct Answer You can only ask Mrs. Midler questions about
conditions that affect eligibility, specifically, whether she has one
of the conditions that would qualify her for a special needs plan.
Mrs. Reeves is newly eligible to enroll in a Medicare Advantage
plan and her MA Initial Coverage Election Period (ICEP) has just
begun. Which of the following can she not do during the ICEP?
Correct Answer She can enroll in a Medigap plan to supplement
the benefits of the MA plan that she's also enrolling in.
Mr. White has Medicare Parts A and B with a Part D plan. Last
year, he received a notice that his plan sponsor identified him as
a "potential at-risk" beneficiary. This month, he started receiving
assistance from Medicaid. He wants to find a different Part D plan
that's more suitable to his current prescription drug needs. He
believes he's entitled to a SEP since he is now a dual eligible. Is
he able to change to a different Part D plan during a SEP for dual
eligible individuals? Correct Answer No. Once he is identified by
the plan sponsor as a "potential at-risk" beneficiary, he cannot
use the dual eligible SEP to change plans while this designation is
in place.
,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 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.
Mr. Ziegler is turning 65 next month and has asked you what he
can do, and when he must do it, with respect to enrolling in Part
D. What could you tell him? Correct Answer He is currently in the
Part D Initial Enrollment Period (IEP) and, during this time, he
may make one Part D enrollment choice, including enrollment in a
stand-alone Part D plan or an MA-PD plan.
Mrs. Parker likes to handle most of her business matters through
telephone calls. She currently is enrolled in Original Medicare
Parts A and B but has heard about a Medicare Advantage plan
offered by Senior Health from a neighbor. Mrs. Parker asks you
whether she can enroll in Senior Health's MA plan over the
telephone. What can you tell her?
I. Enrollment requests can only be made in face-to-face interviews
or by mail.
II. Telephone enrollment request calls must be recorded.
III. Telephonic enrollments must include all required elements
necessary to complete an enrollment.
IV. The signature element must be completed via certified mail.
Correct Answer II and III only
,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 election periods (SEPs)? Correct
Answer Mr. Rockwell is eligible for a SEP due to his involuntary
loss of creditable drug coverage; the SEP begins in June and
ends on September 1- two months after the loss of creditable
coverage.
Edna, Felix, George, and Harriet are Medicare beneficiaries.
Edna lives in an area that has suffered from major flooding that
has been declared a major disaster by both the Federal
government and her state. As a result of dealing with the flooding
issues and being evacuated from her home, Edna missed her
chance to enroll in MA during her Initial Coverage Election Period.
Felix lives in an area with a Medicare Advantage plan with a 4-
star rating that he would like to join. George dropped his Medigap
policy six months ago when he first enrolled in a Medicare
Advantage plan. He now wants to return to Original Medicare.
Harriet has recently developed diabetes and would like to enroll in
a Medicare Advantage plan that focuses on care for those with
that disease. Which, if any, of these individuals would qualify for a
special election period (SEP)? Correct Answer Edna would qualify
for a SEP because government officials have declared a major
disaster for her area and she did not enroll in MA during her ICEP
due to the emergency. George would qualify for an SEP because
he enrolled in Medicare Advantage (MA) plan for the first time and
would now like to return to Original Medicare within the first 12
months of his enrollment. Harriet would also qualify for a SEP to
enroll in a C-SNP because she has developed a chronic
, condition. Felix would not qualify for a SEP since he seeks to
enroll in a 4-star not a 5-star MA plan.
A client wants to give you an enrollment application on October 1
before 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? Correct Answer You
must tell him 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.
Mrs. Kumar would like her daughter, who lives in another state, to
meet with you during the Annual Election Period to help her
complete her enrollment in a Part D plan. She asked you when
she should have her daughter plan to visit. What could you tell
her? Correct Answer Her daughter should come in November.
Mr. Roberts is enrolled in an MA plan. He recently suffered
complications following hip replacement surgery. As a result, he
has spent the last three months in Resthaven, a skilled nursing
facility. Mr. Roberts is about to be discharged. What advice would
you give him regarding his health coverage options? Correct
Answer His open enrollment period as an institutionalized
individual will continue for two months after the month he moves
out of the facility.
Mrs. Goodman enrolled in an MA-PD plan during the Annual
Election Period. In mid-January of the following year, she wants to
switch back to Original Medicare and enroll in a stand-alone
prescription drug plan. What should you tell her? Correct Answer
During the MA Open Enrollment Period, from January 1 - March
31, she may disenroll from the MA-PD plan into Original Medicare
and also may add a stand-alone prescription drug plan.
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