2025 AHIP Final Exam BEST STUDYING
MATERIAL WITH VERIFIED ANSWERS
LATEST VERSION UPDATE 2024-2025 WITH
100+ QUESTIONS
Mr. Chen is enrolled in his employer's group health plan and will be retiring soon.
He would like to know his options since he has decided to drop his retiree
coverage and is eligible for Medicare. What should you tell him?
- ANSWER Mr. Chen can disenroll from his employer-sponsored coverage to elect a
Medicare Advantage or Part D plan within 2 months of his disenrollment.
Mr. Liu turns 65 on June 19. He has never previously qualified for Medicare so his
first Medicare eligibility date will be June 1. Mr. Liu's ICEP and Part D IEP begin on
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?
- ANSWER He can enroll in a MA-PD as long as he enrolls in Part B and is entitled
to Part A.
Mr. and Mrs. Nunez attended one of your sales presentations. They've asked you
to come to their home to clear up a few questions. During the presentation, Mrs.
Nunez feels tired and tells you that her husband can finish things up. She goes to
bed. At the end of your discussion, Mr. Nunez says that he wants to enroll both
himself and his wife. What should you do?
- ANSWER As long as she can do so, only Mrs. Nunez can sign her enrollment form.
Mrs. Nunez will have to wake up to sign her form or do so at another time.
,Mr. Anderson is a very organized individual and has filled out and brought to you
an enrollment form on October 10 for a new plan available on January 1 next year.
He is currently enrolled in Original Medicare. What should you do?
- ANSWER Tell Mr. Anderson that you cannot accept any enrollment forms until
the annual election period begins.
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 in a MA-PD plan. What enrollment rules would apply
in this case?
- ANSWER He can make as many enrollment changes as he likes during the Annual
Election Period and the last choice made before the end of the period will be the
effective one as of January 1.
Mrs. Pierce would like to enroll in a Medicare Cost plan that offers Part D
prescription drug coverage. She comes to you for advice about when she can
enroll in a plan you have previously discussed. What should you tell her? -
ANSWER Enrollment in Cost plans offering Part D coverage is available only during
enrollment periods under the Part D program, and Cost plans must accept
enrollments during these periods.
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?
- ANSWER He can switch to a MA-PD plan.
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?
, - ANSWER She is eligible for a special election period (SEP) 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. Block is currently enrolled in a Medicare Advantage plan that includes drug
coverage. He found a stand-alone Medicare prescription drug plan in his area that
offers better coverage than that available through his MA-PD plan and in addition,
has a low premium. It won't cost him much more and, because he has the means
to do so, he wishes to enroll in the stand-alone prescription drug plan in addition
to his MA-PD plan. What should you tell him?
- ANSWER If Mr. Block enrolls in the stand-alone Medicare prescription drug plan,
he will be disenrolled from the Medicare Advantage plan.
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 certain MA plans 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?
- ANSWER 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 election period (SEP).
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?
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