Enrollment Periods Quiz 1

(AEP) is Oct 15 - Dec 7

No action is needed if the beneficiary would like to keep their existing plan into the following year.

The top reason or reasons why an application is denied include using the wrong enrollment reason and enrolling someone outside of the proper enrollment period. It is critical to understand the correct enrollment period to avoid application denial. Therefore, the correct answer is "All of the above" as all the mentioned reasons contribute to the denial of an application.

The correct answer is End of Coverage (EOC) December 8 - February 29. This is the period when a plan is ending its contract with Medicare or when Medicare is ending its contract with a plan. During this time, individuals have the opportunity to find a new Medicare plan or make changes to their existing coverage.

Medigap plans have guarantee issue periods that allow customers to enroll without underwriting. During these periods, insurance companies are required to offer Medigap policies to individuals who are 65 or older and have Medicare Part B. Underwriting, which involves assessing an individual's health status and medical history, is not required during guarantee issue periods. This ensures that individuals with pre-existing conditions or health issues can still obtain coverage. Medigap plans provide additional coverage to fill the gaps in Original Medicare, such as deductibles, copayments, and coinsurance.

A customer with Original Medicare or currently enrolled in a MA or PDP who is enrolling during the AEP has an effective date for their new plan of January 1. They can make multiple elections during this period, and the last election made is the one that will go into effect. They have the flexibility to add, drop, or switch coverage based on their needs. Therefore, all of the statements mentioned in the options are true.

This can cause their group coverage to end before the transition and even effect their funding qualification.

AEP rules do not apply to Medigap plans.

The Initial Coverage Election Period (ICEP) refers to the time period when a customer is turning 65 or "Aging-in" to Medicare. During this period, which is 7 months long and includes the month a retiree turns age 65, the customer can enroll in a Medicare Advantage (MA) plan and/or a Prescription Drug Plan (PDP). The ICEP starts 3 months before the customer turns 65 and ends 3 months after turning 65. Therefore, the correct answer is "All of the above" as all the statements provided define the Initial Coverage Election Period.

A beneficiary without creditable Part D coverage may be subject to a 1% penalty for each month they went without coverage. This means that if a beneficiary does not have a prescription drug plan that is at least as good as Medicare's standard prescription drug coverage, they may have to pay a penalty if they decide to enroll in a Part D plan later on. The penalty is calculated by multiplying 1% of the national base beneficiary premium by the number of full, uncovered months the beneficiary was eligible for Part D but did not have creditable coverage.

CMS stands for the Centers for Medicare and Medicaid Services. It is the federal agency responsible for administering the Medicare program and overseeing the Medicaid program. The statement is referring to different types of Medicare Advantage and prescription drug plans that fall under the jurisdiction of CMS. These plans have specific enrollment periods during which customers can enroll, drop, or switch plans.

If a customer's birthday is April 1st. Their effective date will be March 1st. Their effective date will be the 1st of the previous month.

Medigap plans are supplemental insurance policies that help cover the costs that Original Medicare does not cover. These plans are regulated by federal and state laws, not by the Affordable Care Act (ACA) or the AEP (Annual Election Period) rules. Therefore, the AEP rules, which apply to Medicare Advantage and Medicare Part D plans, do not apply to Medigap plans. Hence, the statement "AEP rules do not apply to Medigap plans" is true.

During ADP MA members will be allowed to disenroll from their MA plan back into traditional Medicare.

During the Annual Disenrollment Period (ADP) from January 1st to February 14th, several options are available for members. ADP does not allow switching from MA-PD to MA-PD or PDP to PDP. However, members are allowed to select a new standalone PDP when they leave an MA or MA-PD plan. Additionally, during ADP, MA members can disenroll from their MA plan and switch back to traditional Medicare. Therefore, all of the above statements are correct.