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2024 AHIP MEDICARE MODULE 5 EXAM WITH CORRECT ANSWERS
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2024 AHIP MEDICARE MODULE 5 EXAM WITH CORRECT ANSWERS
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2024 AHIP MEDICARE MODULE 5EXAM WITH CORRECT ANSWERS
Mrs. Reeves is newly eligible to enroll in a Medicare Advantage plan and her
MA Initial Coverage Election Period (ICEP) has just begun. Which of the
following can she not do during the ICEP? - CORRECT-ANSWERSShe can
enroll in a Medigap plan to supplement the benefits of the MA plan that she's
also enrolling in.
Mr. White has Medicare Parts A and B with a Part D plan. Last year, he
received a notice that his plan sponsor identified him as a "potential at-risk"
beneficiary. This month, he started receiving assistance from Medicaid. He
wants to find a different Part D plan that's more suitable to his current
prescription drug needs. He believes he's entitled to a SEP since he is now a
dual eligible. Is he able to change to a different Part D plan during a SEP for
dual eligible individuals? - CORRECT-ANSWERSNo. Once he is identified by
the plan sponsor as a "potential at-risk" beneficiary, he cannot use the dual
eligible SEP to change plans while this designation is in place.
Edna, Felix, George, and Harriet are Medicare beneficiaries. Edna lives in an
area that has suffered from major flooding that has been declared a major
disaster by both the Federal government and her state. As a result of dealing
with the flooding issues and being evacuated from her home, Edna missed
her chance to enroll in MA during her Initial Coverage Election Period. Felix
lives in an area with a Medicare Advantage plan with a 4-star rating that he
would like to join. George dropped his Medigap policy six months ago when
he first enrolled in a Medicare Advantage plan. He now wants to return to
Original Medicare. Harriet has recently developed diabetes and would like to
enroll in a Medicare Advantage plan that focuses on care for those with that
disease. Which, if any, of these individuals would qualify for a special
election period (SEP)? - CORRECT-ANSWERSEdna would qualify for a SEP
because government officials have declared a major disaster for her area
and she did not enroll in MA during her ICEP due to the emergency. George
would qualify for an SEP because he enrolled in Medicare Advantage (MA)
plan for the first time and would now like to return to Original Medicare
within the first 12 months of his enrollment. Harriet would also qualify for a
SEP to enroll in a C-SNP because she has developed a chronic condition. Felix
would not qualify for a SEP since he seeks to enroll in a 4-star not a 5-star MA
plan.
, Mr. Roberts is enrolled in an MA plan. He recently suffered complications
following hip replacement surgery. As a result, he has spent the last three
months in Resthaven, a skilled nursing facility. Mr. Roberts is about to be
discharged. What advice would you give him regarding his health coverage
options? - CORRECT-ANSWERSHis open enrollment period as an
institutionalized individual will continue for two months after the month he
moves out of the facility.
A client wants to give you an enrollment application on October 1 before 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-ANSWERSYou 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.
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 election periods (SEPs)? -
CORRECT-ANSWERSMr. Rockwell is eligible for a SEP due to his involuntary
loss of creditable drug coverage; the SEP begins in June and ends on
September 1- two months after the loss of creditable coverage.
Mrs. Margolis contacts you in August because she will become eligible for
Medicare for the first time in November. She would like to meet and discuss
plan choices with you. What advice should you give her? - CORRECT-
ANSWERSTell her to wait until October to discuss plan choices with you so
that you can share plan benefits for the current year as well as any changes
for the following year that may impact her choice.
Mr. Johannsen is entitled to Medicare Part A and Part B. He gains the Part D
low-income subsidy. How does that affect his ability to enroll or disenroll in a
Part D plan? - CORRECT-ANSWERSHe qualifies for a special election period
and can enroll in or disenroll from a Part D plan once during that period.
Torie Jones is a new marketing representative. Torie asks you for advice as to
what topics must be discussed with a Medicare beneficiary prior to
enrollment in a Medicare Advantage (MA-PD) plan. What should you say? -
CORRECT-ANSWERSTorie, there are many required questions and topics
regarding beneficiary needs to be discussed prior to enrollment in an MA
plan. These include information regarding primary care providers and
specialists whether they are in the plan network, whether or not a
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