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AHIP MODULE 5 2026 | COMPREHENSIVE Q&A
FOR GUARANTEED SUCCESS
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-answer-Mr. 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. Hamilton likes to handle most of her business matters through telephone
calls. She is currently enrolled in Original Medicare Parts A and B but has heard
about a Medicare Advantage plan offered by Senior Health from a neighbor. Mrs.
Hamilton asks you whether she can enroll in Senior Health's MA plan over the
telephone. What can you tell her?
I. Enrollment requests can only be made in face-to-face interviews or by mail.
II. Telephone enrollment request calls must be recorded.
III. Telephonic enrollments must include all required elements necessary to
complete an enrollment.
IV. The signature element must be completed via certified mail.-correct-answer-II
and III only
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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-answer-You 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. Solomon 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. Solomon is about to be discharged.
What advice would you give him regarding his health coverage options?-correct-
answer-His open enrollment period as an institutionalized individual will continue
for two months after the month he moves out of the facility.
Mr. White has been enrolled in the Lexington Private Fee-for-Service (PFFS)
Medicare Advantage Health Plan (Lexington) for several years. Recently, Mr. White
decided to spend time with his children who live in another state that is not in
Lexington's service area. In the future, he may relocate near his children
permanently. How does this move to another service area impact his PFFS MA
coverage?-correct-answer-Lexington can allow for Mr. White's continued
enrollment for up to 12 months whether or not he is in a visitor/traveler (V/T)
program since it is a PFFS plan.
AHIP MODULE 5 2026 | COMPREHENSIVE Q&A
FOR GUARANTEED SUCCESS
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-answer-Mr. 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. Hamilton likes to handle most of her business matters through telephone
calls. She is currently enrolled in Original Medicare Parts A and B but has heard
about a Medicare Advantage plan offered by Senior Health from a neighbor. Mrs.
Hamilton asks you whether she can enroll in Senior Health's MA plan over the
telephone. What can you tell her?
I. Enrollment requests can only be made in face-to-face interviews or by mail.
II. Telephone enrollment request calls must be recorded.
III. Telephonic enrollments must include all required elements necessary to
complete an enrollment.
IV. The signature element must be completed via certified mail.-correct-answer-II
and III only
, 2|Page
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-answer-You 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. Solomon 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. Solomon is about to be discharged.
What advice would you give him regarding his health coverage options?-correct-
answer-His open enrollment period as an institutionalized individual will continue
for two months after the month he moves out of the facility.
Mr. White has been enrolled in the Lexington Private Fee-for-Service (PFFS)
Medicare Advantage Health Plan (Lexington) for several years. Recently, Mr. White
decided to spend time with his children who live in another state that is not in
Lexington's service area. In the future, he may relocate near his children
permanently. How does this move to another service area impact his PFFS MA
coverage?-correct-answer-Lexington can allow for Mr. White's continued
enrollment for up to 12 months whether or not he is in a visitor/traveler (V/T)
program since it is a PFFS plan.
