Mrs. Parker likes to handle most of her business matters through telephone calls. She currently is enrolled in Original Medicare Parts A and B but has heard about a Medicare Advantage plan offered by Senior Health from a neighbor. Mrs. Parker asks you whether she can enroll in Senior Health's MA pl...
mrs parker likes to handle most of her business matters through telephone calls she currently is enrolled in original medicare parts
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AHIP 2023 Module 5 | with 100% Correct Answers
Mrs. Parker likes to handle most of her business matters through telephone calls. She currently is
enrolled in Original Medicare Parts A and B but has heard about a Medicare Advantage plan offered by
Senior Health from a neighbor. Mrs. Parker asks you whether she can enroll in Senior Health's MA plan
over the telephone. What can tell her?
I. Enrollment requests can only be made in face-to-face interviews or by mail.
II. Telephone enrollment request calls must be recorded.
III. Telephonic enrollments must include all required elements necessary to complete an enrollment.
IV. The signature element must be completed via certified mail. Correct Answer: II and III only
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. 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. 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. Fitzgerald is selling his home to permanently move into a retirement facility near his daughter in a
neighboring state before the Annual Election Period. He has a stand-alone prescription drug plan and
has learned it is not available where he is moving. He doesn't know what he should do. What can you
tell him? Correct Answer: Because he is moving outside of the service area, the plan must automatically
disenroll him. He will have a special election period to select a new 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
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