Exam (elaborations)
AHIP 2025 Exam Updated Qs & As| 100% Correct| Grade A (Verified Answers)
AHIP 2025 Exam Updated Qs & As| 100% Correct| Grade A (Verified Answers)
Q: 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...
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ahip 2025 exam updated qs as 100 correct grad
ms thomas has worked for many years and is turnin
ms claggett is sixty six 66 years old she has
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AHIPI2025IExamIUpdatedIQsI&IAs|I100%I
Correct|IGradeIAI(VerifiedIAnswers)
Q:IMs.IClaggettIisIsixty-
sixI(66)IyearsIold.ISheIhasIbeenIcoveredIunderIOriginalIMedicareIforItheIlastIsixIyearsIdueIto
IherIdisabilityIandIhasIneverIbeenIenrolledIinIaIMedicareIAdvantageIorIaIPartIDIplanIbefore.I
SheIwantsItoIenrollIinIaIPartIDIplan.ISheIknowsIthatIthereIisIsuchIaIthingIasItheI"PartIDIInitia
lIEnrollmentIPeriod"I(IEP)IandIhasIconcludedIthat,IsinceIsheIhasIneverIenrolledIinIsuchIaIplan
Ibefore,IsheIshouldIbeIeligibleItoIenrollIunderIthisIperiod.IWhatIshouldIyouItellIherIaboutIhow
ItheIPartIDIInitialIEnrollmentIPeriodIappliesItoIherIsituation?
Answer:
Ms.IClaggettIhasIhadItwoIIEPsIandImissedIthemIboth.ITheIfirstIoccurredIthreeImonthsIbeforeI
andIthreeImonthsIafterItheImonthIwhenIsheIwasIfirstIentitledItoIPartIAIORIenrolledIinIPartIB.
IBecauseIsheIwasIeligibleIforIMedicareIbeforeIageI65,IMs.IClaggettIhadIaIsecondIIEPIbasedIo
nIturningIageI65,IwhichIhasIalsoIexpired.
Q:IMr.IFordIenrolledIinIanIMA-onlyIplanIinImid-
NovemberIduringItheIAnnualIElectionIPeriodI(AEP).IOnIDecemberI1,IheIcallsIyouIupIandIsay
sIthatIheIhasIchangedIhisImindIandIwouldIlikeItoIenrollIinIaIMA-
PDIplan.IWhatIenrollmentIrulesIwouldIapplyIinIthisIcase?
Answer:
HeIcanImakeIasImanyIenrollmentIchangesIasIheIlikesIduringItheIAnnualIElectionIPeriodIandIt
heIlastIchoiceImadeIbeforeItheIendIofItheIperiodIwillIbeItheIeffectiveIoneIasIofIJanuaryI1.HeI
canImakeIasImanyIenrollmentIchangesIasIheIlikesIduringItheIAnnualIElectionIPeriodIandItheIl
astIchoiceImadeIbeforeItheIendIofItheIperiodIwillIbeItheIeffectiveIoneIasIofIJanuaryI1.
Q:IMr.IAndersonIisIaIveryIorganizedIindividualIandIhasIfilledIoutIandIbroughtItoIyouIanIenr
ollmentIformIonIOctoberI10IforIaInewIplanIavailableIonIJanuaryI1InextIyear.IHeIisIcurrentlyIe
nrolledIinIOriginalIMedicare.IWhatIshouldIyouIdo?
,Answer:
TellIMr.IAndersonIthatIyouIcannotIacceptIanyIenrollmentIformsIuntilItheIannualIelectionIperio
dIbegins.
Q:IMrs.ISchmidtIisImovingIandIaIfriendItoldIherIsheImightIqualifyIforIaI"specialIelectionIpe
riod"ItoIenrollIinIaInewIMedicareIAdvantageIplan.ISheIcontactedIyouItoIaskIwhatIaIspecialIel
ectionIperiodIis.IWhatIcouldIyouItellIher?
Answer:
ItIisIaIsingleIperiodIfromIJanuaryI1I-
IMarchI31,IcreatedIbyIstatute,IwhenIanyIMedicareIbeneficiaryIwhoIhasImovedIoutIofItheIareaI
ofItheirIMedicareIAdvantageIorIPartIDIplanIcanIadd,Idrop,IorIchangeItheirIMedicareIprescripti
onIdrugIcoverage.
Q:IMr.IYoo'sIemployerIhasIrecentlyIdroppedIcomprehensiveIcreditableIprescriptionIdrugIcov
erageIthatIwasIofferedItoIcompanyIretirees.ITheIcompanyItoldIMr.IYooIthat,IbecauseIheIwasIa
ffectedIbyIthisIchange,IheIwouldIqualifyIforIaIspecialIelectionIperiod.IMr.IYooIcontactedIyouIt
oIfindIoutImoreIaboutIwhatIthisImeans.IWhatIcanIyouItellIhim?
Answer:
ItImeansIthatIheIqualifiesIforIaIone-timeIopportunityItoIenrollIinIanIMA-
PDIorIPartIDIprescriptionIdrugIplan.
Q:IMs.IThomasIhasIworkedIforImanyIyearsIandIisIturningI68IinIJune.ISheIisIeligibleIforIMe
dicareIPartIAIandIdidInotIenrollIforIPartIBIwhenIfirstIeligibleIbecauseIsheIhasIinsuranceIthrou
ghIherIemployerI-
ICoffeeIBrew,IInc.ISheIalsoIdidInotIenrollIinIPartIDIbecauseIsheIhadIcreditableIcoverage.ISheI
wouldIlikeItoIretireIinIJuneIandIenrollIinIaIMedicareIAdvantageIplan.ISheIhasIbeenIinformedIt
hatIherIgroupIcoverageIwillIendIonIherIretirementIeffectiveIdate.IHowIwouldIyouIadviseIMs.I
Thomas?
, Answer:
Ms.IThomasIcanIenrollIinIPartIBIwithoutIaIlateIpenaltyIatIanyItimeIsheIisIstillIcoveredIbyIherI
employerIgroupIandI8ImonthsIafterIherIlastImonthIofIemployerIgroupIcoverageIwithoutIaIpena
lty.IHowever,IbecauseIsheIwantsItoIenrollIinIaIMAIplanIafterIretirement,IsheIshouldImakeIsure
IherIPartIBIcoverageIisIeffectiveIinItimeItoIuseItheIMedicareIAdvantage/PartIDIspecialIelectio
nIperiodIforIindividualsIchangingIfromIemployerIgroupIcoverageItoIenrollIinIaIMAIplanIorIM
A-
PD.ITheISEPIbeginsIwhileIsheIhasIemployerIgroupIcoverageIandIwillIlastIuntilI2ImonthsIafter
ItheImonthIafterItheImonthIherIemployerIcoverageIends.IIfIsheIwantsIPartIDIcoverageIsheIsho
uldIenrollIinIanIMA-
PDIorIaIPDPI(dependingIonIhowIsheIdecidesItoIreceiveIherIPartIAIandIBIbenefits)IduringIthis
Itime.
Q:IMs.ILeeIisIenrolledIinIanIMA-
PDIplanIbutIwillIbeImovingIoutIofItheIplan'sIserviceIareaInextImonth.ISheIisIworriedIthatIsheI
willInotIbeIableItoIenrollIinIanotherIplanIavailableIinIherInewIresidenceIuntilItheIAnnualIElect
ionIPeriod.IWhatIshouldIyouItellIher?
Answer:
SheIisIeligibleIforIaIspecialIelectionIperiodI(SEP)IthatIbeginsIeitherItheImonthIbeforeIherIper
manentImove,IifItheIplanIisInotifiedIinIadvance,IorItheImonthIsheIprovidesInoticeIofItheImove
,IandIthisIperiodItypicallyIlastsIanIadditionalItwoImonths.
Q:IMrs.IKendrickIisIinIgoodIhealth,IhasIworkedIforImanyIyears,IandIisIsixImonthsIawayIfro
mIturningI65.ISheIwantsItoIknowIwhatIsheIwillIhaveItoIdoItoIenrollIinIaIMedicareIAdvantage
I(MA)IplanIasIsoonIasIpossible.IWhatIcouldIyouItellIher?
Answer:
SheImayIenrollIinIanIMAIplanIbeginningIthreeImonthsIimmediatelyIbeforeIherIfirstIentitlemen
tItoIbothIMedicareIPartIAIandIPartIB.
Q:INextIweekIyouIwillIbeIparticipatingIinIyourIfirstI"educationalIevent"IforIprospectiveIenro
llees.IToIbeIsureIthatIyouIdoInotIviolateIanyIofItheIapplicableIguidelines,IinIwhatIactivitiesIsh
ouldIyouIplanItoIengage?