AHIP FINAL EXAM | QUESTIONS
AND 100% CORRECT ANSWERS |
COMPLETE STUDY GUIDE GRADED
A+ |2024/2025 GUIDE
Mrs. Jenkins is enrolled in both Part A and Part B of Medicare. She has
recently also become eligible for Medicaid and would like to enroll in a
MA-PD plan. Since this is her first experience with Medicare Advantage,
she is concerned that she will be locked into a plan and unable to make
any coverage changes for at least a year if not longer. What should you
tell her?
- Correct Answer - Since Mrs. Jenkins has Medicare Part A and Part B
and receives Medicaid, she has a special election period (SEP) that will
allow her to enroll or disenroll from an MA or MA-PD plan during the first
9 months of each calendar year.
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 Answer - He can switch to a MA-PD plan.
,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 into a MA-PD plan. What
enrollment rules would apply in this case?
- Correct Answer - He can make as many enrollment changes as he
likes during the Annual Election Period and the last choice made prior to
the end of the period will be the effective one as of January 1.
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 Answer - Ms. 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.
Mr. Liu turns 65 on June 19. He has never previously qualified for
Medicare so his first Medicare eligibility date will be by June 1. Mr. Liu's
ICEP and Part D IEP begin 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 Answer - He can enroll in a MA-PD as long as he enrolls in Part
B and is entitled to Part A.
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 Answer - Ms. 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. O'Donnell learned about a new MA-PD plan that her neighbor
suggested and that you represent. She plans to switch from her old MA
HMO plan to the new MA-PD plan during the Annual Election Period.
However, she wants to make sure she does not end up paying premiums
for two plans. What can you tell her?
- Correct Answer - She only needs to enroll in the new MA-PD plan and
she will automatically be disenrolled from her old MA plan.
You work for Caring Health, a Medicare Advantage (MA) plan sponsor.
Recently, Mrs. Garcia has completed an enrollment application for a plan
offered by Caring Health, which is waiting for a reply from CMS
indicating whether or not Mrs. Garcia's enrollment has been accepted.
Once CMS replies, how long does Caring Health have to notify Mrs.
Garcia that her enrollment has been accepted and in what format?
- Correct Answer - The plan has 10 calendar days to notify Mrs. Garcia
in writing.
Mrs. Kendrick is in good health, has worked for many years and is six
months away from turning 65. She wants to know what she will have to
do to enroll in a Medicare Advantage (MA) plan as soon as possible.
What could you tell her?
- Correct Answer - She may enroll in an MA plan beginning three months
immediately before her first entitlement to both Medicare Part A and Part
B.
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