Richard is a licensed agent who represents Spartan Health Plan and its Medicare Advantage (MA) plans. Richard has several clients who have recently come to him for help who are in their initial coverage election period (ICEP) and are interested in enrolling in one of Spartan Health Plan's MA plans....
2025 AHIP Final QUESTIONS &
SOLUTIONS!!!
Richard is a licensed agent who represents Spartan Health Plan and its Medicare Advantage (MA) plans.
Richard has several clients who have recently come to him for help who are in their initial coverage
election period (ICEP) and are interested in enrolling in one of Spartan Health Plan's MA plans. Alice will
soon turn 65 and retire. Alice has coverage through Spartan Health Plan offered by her employer. Bob
had health coverage through Spartan but dropped the coverage when he retired early to travel overseas.
Bob, who has just turned age 65, is now back in the United States. Charlotte, who will turn 65 next
month, has coverage through Athena Health plan - a company Richard also represents. Who qualifies for
the opt-in simplified enrollment mechanism? - ANSWER Alice and Charlotte because each of them
currently have health coverage and is in their initial coverage election period (ICEP).
Ms. Morris will turn 65 on June 10th. She has never previously qualified for Medicare. She is entitled to
Medicare Part A and intends to enroll in Part B. She wants to know if she is eligible to enroll in a
Medicare Advantage plan that includes prescription drug coverage. What do you tell her? - ANSWER Ms.
Morris can enroll in an MA-PD plan now since her initial election period (IEP) for Part D prescription drug
coverage and initial coverage period are occurring together beginning March 1st and ending September
30th.
Mr. Lopez, who is fairly well-off financially, would like to enroll in a Medicare prescription drug plan you
represent and simply give you a check to cover his premiums for the entire year. What should you tell
him? - ANSWER Enrollees should pay using automatic withdrawal from a bank account or credit or debit
card, direct monthly billing from the plan, or deductions from their Social Security check.
Alice is enrolled in a MA-PD plan. She makes a permanent move across the country and wonders what
her options are for continuing MA-PD coverage. What would you say to her in regard to a special
enrollment period (SEP)? - ANSWER She is likely to qualify for a SEP. She can choose an effective date of
up to three months after the month in which the enrollment form is received by the new plan, but the
effective date may not be earlier than the date of her permanent move.
Mrs. Albertson has been enrolled in a Medicare Part D plan for several years. She takes several brand
name drugs and is interested in learning about the Medicare Prescription Payment Plan. What should
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