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2025 AHIP Final 1 questions and answers 2015/2016
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2025 AHIP Final 11. Alice is enrolled in a MA-PD plan. She makes a permanent move across the country and
wonders what her options are for continuing MA-PD coverage. What would you say to
her in regard to a special enrollment period (SEP)? >ANS>She is likely to qualify for a
SEP. She can choose an effective date of up to three months after the month in
which the enrollment form is received by the new plan, but the effective date may
not be earlier than the date of her permanent move.
2. Mr. Lopez, who is fairly well-off financially, would like to enroll in a Medicare prescription
drug plan you represent and simply give you a check to cover his premiums for the entire
year. What should you tell him? >ANS>Enrollees should pay using automatic
withdrawal from a bank account or credit or debit card, direct monthly billing from
the plan, or deductions from their Social Security check.
3. Mrs. Albertson has been enrolled in a Medicare Part D plan for several years. She takes
several brand name drugs and is interested in learning about the Medicare Prescription
Payment Plan. What should you tell her? >ANS>Enrollees can opt out of the program
at any time. However, they will continue to be billed for any cost-sharing amounts
still owed.
4. Ms. Morris will turn 65 on June 10th. She has never previously qualified for Medicare.
She is entitled to Medicare Part A and intends to enroll in Part B. She wants to know if
she is eligible to enroll in a Medicare Advantage plan that includes prescription drug
coverage. What do you tell her? >ANS>Ms. Morris can enroll in an MA-PD plan now
since her initial election period (IEP) for Part D prescription drug coverage and
initial coverage period are occurring together beginning March 1st and ending
September 30th.
5. Richard is a licensed agent who represents Spartan Health Plan and its Medicare
Advantage (MA) plans. Richard has several clients who have recently come to him for
help who are in their initial coverage election period (ICEP) and are interested in
enrolling in one of Spartan Health Plan's MA plans. Alice will soon turn 65 and retire.
Alice has coverage through Spartan Health Plan offered by her employer. Bob had
health coverage through Spartan but dropped the coverage when he retired early to
travel overseas. Bob, who has just turned age 65, is now back in the United States.
Charlotte, who will turn 65 next month, has coverage through Athena Health plan - a
company Richard also represents. Who qualifies for the opt-in simplified enrollment
mechanism? >ANS>Alice and Charlotte because each of them currently have
health coverage and is in their initial coverage election period (ICEP).
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