AHIP 2022 Comprehensive SolutionsWITH
MULTIPLE QUESTIONS AND THE CORRECT
ANSWERS EXAMS
FROM THE BEST INSTITUTIONS ACROSS THE
GLOBE
A client wants to give you an enrollment application on October 1 prior to 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 ans- -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. 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 ans- -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.
Mrs. Young is currently enrolled in Original Medicare (Parts A and B), but she has been working
with Agent Neil Adams in the selection of a Medicare Advantage (MA) plan. It is mid-September,
and Mrs. Young is going on vacation. Agent Adams is considering suggesting that he and Mrs.
Young complete the application together before she leaves. He will then submit the paper
application prior the start of the annual enrollment period (AEP). What would you say If you
were advising Agent Adams? - -correct ans- -This is a bad idea. Agents are generally prohibited
from soliciting or accepting an enrollment form prior to the start of the AEP.
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 ans- -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.
,Mrs. Schmidt is moving and a friend told her she might qualify for a "Special Election Period" to
enroll in a new Medicare Advantage plan. She contacted you to ask what a Special Election
Period is. What could you tell her? - -correct ans- -It is a time period, outside of the Annual
Election Period, when a Medicare beneficiary can select a new or different Medicare Advantage
and/or Part D prescription drug plan. Typically the Special Election Period is beneficiary specific
and results from events, such as when the beneficiary moves outside of the service area.
Mr. Garcia was told he qualifies for a Special Election Period (SEP), but he lost the paper that
explains what he could do during the SEP. What can you tell him? - -correct ans- -If the SEP is for
MA coverage, he will generally have one opportunity to change his MA coverage.
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 that there are certain MA plans that 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 ans- -If 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 enrollment period (SEP).
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 ans- -II, III, and IV 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 enrollment periods (SEPs)? - -correct ans- -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.
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 ans- -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.
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 ans- -It means that he qualifies
for a one-time opportunity to enroll into an MA-PD or Part D prescription drug plan.
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 ans- -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.
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 ans- -He can enroll in or disenroll from a Part D plan at any
time and the subsidy will apply to the plan he chooses.
Mrs. Ridgeway enrolled in Original Medicare and Medigap coverage following her retirements
several years ago. Four months ago, Mrs. Ridgeway dropped her Medigap policy to enroll in a
Medicare Advantage (MA) plan for the first time. Unfortunately, Mrs. Ridgeway has found that
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