AHIP MODULE 5 EXAM 2024 WITH QUESTIONS
& CORRECT ANSWERS GRADED A+
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.
Mrs. Roberts has Original Medicare and would like to enroll in a Private Fee-for-
Service (PFFS) plan. All types of PFFS plans are available in her area. Which
options could Mrs. Roberts consider before selecting a PFFS plan? - ANSWER-A
Medicare Advantage Prescription Drug (MA-PD) PFFS plan that combines
medical benefits and Part D prescription drug coverage, a PFFS plan offering only
medical benefits, or a PFFS plan in combination with a stand-alone prescription
drug plan.
Mrs. Lenard is enrolled in a Medicare Cost plan. Recently the cost plan announced
its intention to end its cost contract and transition to a Medicare Advantage (MA)
Mrs. Lenard received a letter indicating that unless she chooses another plan or
opts out she will be automatically enrolled in the new Medicare Advantage plan
operated by an organization affiliated with her cost plan. What does this mean? -
ANSWER-If Mrs. Lenard wants to enroll in a Medicare Advantage plan affiliated
with her cost plan effective January 1, she should do nothing and she will be
automatically enrolled. If she does not want to enroll in that MA plan, she should
choose another plan or otherwise opt out of the automatic enrollment.
,Which of the following individuals is most likely to be eligible to enroll in a
Medicare Advantage or Part D Plan? - ANSWER-Jose, a grandfather who was
granted asylum and has worked in the United States for many years.
Mr. Sanchez is entitled to Part A but has not enrolled in Part B because he has
coverage through an employer plan. If he wants to enroll in a Medicare Advantage
plan, what will he have to do? - ANSWER-He will have to enroll in Part B.
Mrs. Kumar would like her daughter, who lives in another state, to meet with you
during the Annual Election Period to help her complete her enrollment in a Part D
plan. She asked you when she should have her daughter plan to visit. What could
you tell her? - ANSWER-Her daughter should come in November.
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? -
ANSWER-His open enrollment period as an institutionalized individual will
continue for two months after the month he moves out of the facility.
Mrs. Disraeli is enrolled in Original Medicare (Parts A and B) and a standalone
Part D prescription drug plan. She has recently developed diabetes and has suffered
from heart disease for several years. She has also recently learned that her area is
served by a SNP for individuals suffering from such a combination of chronic
diseases (C-SNP). Mrs. Disraeli is concerned however, that she will have few
rights or protections if she enrolls in a C-SNP. How would you respond? -
ANSWER-Enrollees in SNPs must have access to provider networks that include
enough doctors, specialists, and hospitals to provide all covered services necessary
to meet enrollee needs within reasonable travel time.
, Mr. Garrett has just entered his MA Initial Coverage Election Period (ICEP). What
action could you help him take during this time? - ANSWER-He will have one
opportunity to enroll in a Medicare Advantage plan.
Mrs. Young is currently enrolled in Original Medicare (Parts A and B), but she has
been working with Agent Neil Adams in the selection of a Medicare Advantage
(MA) plan. It is mid-September, and Mrs. Young is going on vacation. Agent
Adams is considering suggesting that he and Mrs. Young complete the application
together before she leaves. He will then submit the paper application prior to the
start of the annual enrollment period (AEP). What would you say If you were
advising Agent Adams? - ANSWER-This is a bad idea. Agents are generally
prohibited from soliciting or accepting an enrollment form prior to the start of the
AEP.
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? - 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.
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? - ANSWER-II and III only
Ms. O'Donnell learned about a new MA-PD plan that her neighbor suggested and
that you represent. She plans to switch from her old MA HMO plan to the new
MA-PD plan during the Annual Election Period. However, she wants to make sure
she does not end up paying premiums for two plans. What can you tell her? -
ANSWER-She only needs to enroll in the new MA-PD plan and she will
automatically be disenrolled from her old MA plan.
& CORRECT ANSWERS GRADED A+
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.
Mrs. Roberts has Original Medicare and would like to enroll in a Private Fee-for-
Service (PFFS) plan. All types of PFFS plans are available in her area. Which
options could Mrs. Roberts consider before selecting a PFFS plan? - ANSWER-A
Medicare Advantage Prescription Drug (MA-PD) PFFS plan that combines
medical benefits and Part D prescription drug coverage, a PFFS plan offering only
medical benefits, or a PFFS plan in combination with a stand-alone prescription
drug plan.
Mrs. Lenard is enrolled in a Medicare Cost plan. Recently the cost plan announced
its intention to end its cost contract and transition to a Medicare Advantage (MA)
Mrs. Lenard received a letter indicating that unless she chooses another plan or
opts out she will be automatically enrolled in the new Medicare Advantage plan
operated by an organization affiliated with her cost plan. What does this mean? -
ANSWER-If Mrs. Lenard wants to enroll in a Medicare Advantage plan affiliated
with her cost plan effective January 1, she should do nothing and she will be
automatically enrolled. If she does not want to enroll in that MA plan, she should
choose another plan or otherwise opt out of the automatic enrollment.
,Which of the following individuals is most likely to be eligible to enroll in a
Medicare Advantage or Part D Plan? - ANSWER-Jose, a grandfather who was
granted asylum and has worked in the United States for many years.
Mr. Sanchez is entitled to Part A but has not enrolled in Part B because he has
coverage through an employer plan. If he wants to enroll in a Medicare Advantage
plan, what will he have to do? - ANSWER-He will have to enroll in Part B.
Mrs. Kumar would like her daughter, who lives in another state, to meet with you
during the Annual Election Period to help her complete her enrollment in a Part D
plan. She asked you when she should have her daughter plan to visit. What could
you tell her? - ANSWER-Her daughter should come in November.
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? -
ANSWER-His open enrollment period as an institutionalized individual will
continue for two months after the month he moves out of the facility.
Mrs. Disraeli is enrolled in Original Medicare (Parts A and B) and a standalone
Part D prescription drug plan. She has recently developed diabetes and has suffered
from heart disease for several years. She has also recently learned that her area is
served by a SNP for individuals suffering from such a combination of chronic
diseases (C-SNP). Mrs. Disraeli is concerned however, that she will have few
rights or protections if she enrolls in a C-SNP. How would you respond? -
ANSWER-Enrollees in SNPs must have access to provider networks that include
enough doctors, specialists, and hospitals to provide all covered services necessary
to meet enrollee needs within reasonable travel time.
, Mr. Garrett has just entered his MA Initial Coverage Election Period (ICEP). What
action could you help him take during this time? - ANSWER-He will have one
opportunity to enroll in a Medicare Advantage plan.
Mrs. Young is currently enrolled in Original Medicare (Parts A and B), but she has
been working with Agent Neil Adams in the selection of a Medicare Advantage
(MA) plan. It is mid-September, and Mrs. Young is going on vacation. Agent
Adams is considering suggesting that he and Mrs. Young complete the application
together before she leaves. He will then submit the paper application prior to the
start of the annual enrollment period (AEP). What would you say If you were
advising Agent Adams? - ANSWER-This is a bad idea. Agents are generally
prohibited from soliciting or accepting an enrollment form prior to the start of the
AEP.
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? - 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.
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? - ANSWER-II and III only
Ms. O'Donnell learned about a new MA-PD plan that her neighbor suggested and
that you represent. She plans to switch from her old MA HMO plan to the new
MA-PD plan during the Annual Election Period. However, she wants to make sure
she does not end up paying premiums for two plans. What can you tell her? -
ANSWER-She only needs to enroll in the new MA-PD plan and she will
automatically be disenrolled from her old MA plan.
