AHIP Medicare Module 5
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? - ANS She can enroll in a Medigap plan to
supplement the benefits of the MA plan that she's also enrolling in.
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? - ANS Mary may make an unlimited number of MA enrollment
requests and may disenroll from her current MA plan.
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? - ANS
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.
When Myra first became eligible for Medicare, she enrolled in Original Medicare
(Parts A and B). She is now 67 and will turn 68 on July 1. She would now like to
enroll in a Medicare Advantage (MA) plan and approaches you about her options.
What advice would you give her? - ANS She should remain in Original Medicare
until the annual election period running from October 15 to December 7, during
which she can select an MA 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. - ANS I & III only
You are doing a sales presentation for Mrs. Pearson. You know that Medicare
marketing guidelines prohibit certain types of statements. Apply those guidelines
to the following statements and identify which would be prohibited."
a. If you're not in very good health, you will probably do better with a different
product."
b."A Private Fee-for-Service plan is not the same as a Medigap supplemental
policy."
c."How are you this morning, Mrs. Pearson?"
d."Are you interested in a Medicare supplement plan or a Medicare health plan?" -
ANS If you're not in very good health, you will probably do better with a different
product."
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? - ANS 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. 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? - ANS Her daughter should come in November.
You are visiting with Mr. Tully and his daughter at her request. He has advanced
Alzheimer's and is incapable of understanding the implications of choosing a
Medicare Advantage or prescription drug plan. Can his daughter fill out the
enrollment form and sign it for him? - ANS Mr. Tully's daughter can do so only, if
she is authorized under state law as a court-appointed legal guardian, has a
durable power of attorney for health care decisions, or is authorized under state
surrogate consent laws to make health decisions.
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? -
ANS During the MA Open Enrollment Period, from January 1 - March 31, she may
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