AHIP Module 5 EXAM 2024 [100% PASS]
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Mr. White has Medicare Parts A and B with a Part D plan. Last year, he received a notice that his
plan
... [Show More] 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? *Ans* No. 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.
Mr. Ziegler is turning 65 next month and has asked you what he can do, and when he must do it,
with respect to enrolling in Part D. What
could you tell him? *Ans* He is currently in the Part D Initial Enrollment Period (IEP) and,
during this time, he may make one Part D enrollment choice, including enrollment in a standalone Part D plan or an MA-PD
plan.
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)? *Ans* 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.
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? *Ans* He qualifies for a special election period and can enroll
in or disenroll from a Part D plan once during that period.
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? *Ans* Tell 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.
Torie Jones is a new marketing representative. Torie asks you for advice as to what topi [Show Less]