Which of the following individuals are likely to qualify for a special enrollment
period (SEP) for both MA and 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 providing him with new MA and Part D
options. - Correct Answer-d. II, III, and IV only Correct
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 enrollment periods (SEPs)? - Correct Answer-d. Mr.
Rockwell is eligible for a SEP due to his involuntary loss of creditable drug
coverage; the SEP begins in June and ends September 1 - two months after the
loss of creditable coverage. Correct
, 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 Answer-c. She is eligible for a Special Election Period 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. Correct
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 Answer-d. It means that he qualifies for a one-
time opportunity to enroll into an MA-PD or Part D prescription drug plan. Correct
Mrs. Schneider has Original Medicare Parts A and B and has just qualified for her
state's Medicaid program, so the state is now paying her Part B premium. Will
gaining eligibility for this program affect her ability to enroll in a Medicare
Advantage or Medicare Prescription Drug plan? - Correct Answer-b. Yes.
Qualifying for this state program gives Mrs. Schneider access to a Special Election
Period that allows her to make changes to her MA and/or Part D enrollment at
any time. Correct
If Mr. Johannsen gains the Part D low-income subsidy, how does that affect his
ability to enroll or disenroll in a Part D plan? - Correct Answer-b. He can enroll in
or disenroll from a Part D plan at any time and the subsidy will apply to the plan
he chooses. Correct
Mrs. Walters is entitled to Part A and has medical coverage without drug
coverage through an employer retiree plan. She is not enrolled in Part B. Since the
employer plan does not cover prescription drugs, she wants to enroll in a
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