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2024 AHIP FINAL EXAM WITH ANSWERS
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2024 AHIP FINAL EXAM WITH ANSWERS
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2024 AHIP FINAL EXAM WITHANSWERS
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. - CORRECT-ANSWERSII, III, and IV only.
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? -
CORRECT-ANSWERSMr. Chen can disenroll from his employer-sponsored
coverage to elect a Medicare Advantage or Part D plan within 2 months of his
disenrollment.
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? - CORRECT-ANSWERSHe can enroll in a MA-PD as long as he enrolls in
Part B and is entitled to Part A.
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? -
CORRECT-ANSWERSAs 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.
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 on January 1
next year. He is currently enrolled in Original Medicare. What should you do?
,- CORRECT-ANSWERSTell Mr. Anderson that you cannot accept any
enrollment forms until the annual election period begins.
Mr. Ford enrolled in an MA-only plan in mid-November during the Annual
Election Period (AEP). On December 1, he calls you up and says that he has
changed his mind and would like to enroll in a MA-PD plan. What enrollment
rules would apply in this case? - CORRECT-ANSWERSHe can make as many
enrollment changes as he likes during the Annual Election Period and the last
choice made before the end of the period will be the effective one as of
January 1.
Mrs. Pierce would like to enroll in a Medicare Cost plan that offers Part D
prescription drug coverage. She comes to you for advice about when she can
enroll in a plan you have previously discussed. What should you tell her? -
CORRECT-ANSWERSEnrollment in Cost plans offering Part D coverage is
available only during enrollment periods under the Part D program, and Cost
plans must accept enrollments during these periods.
Mr. Rodriguez is currently enrolled in a MA plan, but his plan doesn't
sufficiently cover his prescription drug needs. He is interested in changing
plans during the upcoming MA Open Enrollment Period. What are his options
during the MA OEP? - CORRECT-ANSWERSHe can switch to a MA-PD plan.
Ms. Lee is enrolled in an MA-PD plan but will be moving out of the plan's
service area next month. She is worried that she will not be able to enroll in
another plan available in her new residence until the Annual Election Period.
What should you tell her? - CORRECT-ANSWERSShe is eligible for a special
election period (SEP) that begins either the month before her permanent
move, if the plan is notified in advance, or the month she provides notice of
the move, and this period typically lasts an additional two months.
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? - CORRECT-ANSWERSIf Mr. Block enrolls in the stand-alone Medicare
prescription drug plan, he will be disenrolled from the Medicare Advantage
plan.
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-ANSWERSIf
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. Yoo's employer has recently dropped comprehensive creditable
prescription drug coverage that was offered to company retirees. The
company told Mr. Yoo that, because he was affected by this change, he
would qualify for a special election period. Mr. Yoo contacted you to find out
more about what this means. What can you tell him? - CORRECT-ANSWERSIt
means that he qualifies for a one-time opportunity to enroll in an MA-PD or
Part D prescription drug plan.
Ms. Claggett is sixty-six (66) years old. She has been covered under Original
Medicare for the last six years due to her disability and has never been
enrolled in a Medicare Advantage or a Part D plan before. She wants to enroll
in a Part D plan. She knows that there is such a thing as the "Part D Initial
Enrollment Period" (IEP) and has concluded that, since she has never
enrolled in such a plan before, she should be eligible to enroll under this
period. What should you tell her about how the Part D Initial Enrollment
Period applies to her situation? - CORRECT-ANSWERSMs. Claggett has had
two IEPs and missed them both. The first occurred three months before and
three months after the month when she was first entitled to Part A OR
enrolled in Part B. Because she was eligible for Medicare before age 65, Ms.
Claggett had a second IEP based on turning age 65, which has also expired.
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-ANSWERSMs. 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.
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