Enrollment Periods Quiz 1

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| By Angie Nelson
A
Angie Nelson
Community Contributor
Quizzes Created: 3 | Total Attempts: 728
Questions: 15 | Attempts: 299

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Enrollment Periods Quiz 1 - Quiz


Questions and Answers
  • 1. 

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  • 2. 

    ________ plans have guarantee issue periods that allow customers to enroll without underwriting?

    Explanation
    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.

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  • 3. 

     ______ plans are MAPD, MA only, PFFS and PDP plans that have enrollment periods that allow a customer to enroll into, drop or switch plans.

    Explanation
    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.

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  • 4. 

    Using the wrong enrollment period can cause a customer's plan to issue too early.

    • A.

      True

    • B.

      False

    Correct Answer
    A. True
    Explanation
    This can cause their group coverage to end before the transition and even effect their funding qualification.

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  • 5. 

    What is the top reason or reasons why an application is denied?

    • A.

      Using the wrong enrollment reason.

    • B.

      Enrolling someone outside of the proper enrollment period.

    • C.

      It is critical to understand the correct enrollment period.

    • D.

      All of the above.

    • E.

      None of the above.

    Correct Answer
    D. All of the above.
    Explanation
    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.

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  • 6. 

    The Annual Enrollment Period (AEP) is Oct 15 -Dec 15.

    • A.

      True

    • B.

      False

    Correct Answer
    B. False
    Explanation
    (AEP) is Oct 15 - Dec 7

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  • 7. 

    Action is needed if the beneficiary wants to keep their existing plan.

    • A.

      True

    • B.

      False

    Correct Answer
    B. False
    Explanation
    No action is needed if the beneficiary would like to keep their existing plan into the following year.

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  • 8. 

    Which of the following is true about a customer with Original Medicare or currently enrolled in a MA or PDP who is enrolling during the AEP?

    • A.

      Has an effective date for their new plan of January 1.

    • B.

      The last election made is the one that will go into effect.

    • C.

      May add, drop or switch coverage.

    • D.

      No limit to the number of elections.

    • E.

      All of the above.

    • F.

      None of the above.

    Correct Answer
    E. All of the above.
    Explanation
    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.

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  • 9. 

    AEP rules do not apply to Medigap plans?

    • A.

      True

    • B.

      False

    Correct Answer
    A. True
    Explanation
    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.

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  • 10. 

    A beneficiary without creditable Part D coverage may be subject to a 1% penalty for each month they went without coverage.

    • A.

      True

    • B.

      False

    Correct Answer
    A. True
    Explanation
    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.

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  • 11. 

    A member can attempt to switch their Medigap plan anytime during the year, but may not have Guaranteed Issue rights.

    • A.

      True

    • B.

      False

    Correct Answer
    A. True
    Explanation
    AEP rules do not apply to Medigap plans.

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  • 12. 

    When a plan is ending it's contract with Medicare, or Medicare is ending its contract with my plan is?

    • A.

      Annual Disenrollment Period (ADP) January 1 - February 14

    • B.

      Annual Enrollment Period (AEP) October 15 - December 7

    • C.

      End of Coverage (EOC) December 8 - February 29

    • D.

      Initial Coverage Election Period (ICEP)

    Correct Answer
    C. End of Coverage (EOC) December 8 - February 29
    Explanation
    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.

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  • 13. 

    Choose the best answer or answers that define the Initial Coverage Election Period (ICEP).

    • A.

      Is 7 months long includes the month a retiree turns age 65. Starts 3 months Before turning 65 and Ends 3 months After turning 65.

    • B.

      May enroll in a MA and/or PDP.

    • C.

      A customer is turning 65 or "Aging-in" to Medicare.

    • D.

      All of the above.

    • E.

      None of the above.

    Correct Answer
    D. All of the above.
    Explanation
    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.

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  • 14. 

    If the beneficiary's birthday falls on the 1st of the month, their plan effective date will be the 1st of the following month.

    • A.

      True

    • B.

      False

    Correct Answer
    B. False
    Explanation
    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.

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  • 15. 

    During the Annual Disenrollment Period (ADP) Jan 1 - Feb 14.  Medicare Advantage members will not be allowed to disenroll from their MA plan back into traditional Medicare.

    • A.

      True

    • B.

      False

    Correct Answer
    B. False
    Explanation
    During ADP MA members will be allowed to disenroll from their MA plan back into traditional Medicare.

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  • 16. 

    During the Annual Disenrollment Period (ADP) Jan 1 - Feb 14. 

    • A.

      ADP does not allow a switch from MA-PD to MA-PD or PDP to PDP.

    • B.

      Members will be allowed to select a new standalone PDP when they leave a MA or MA-PD.

    • C.

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

    • D.

      All of the above.

    • E.

      None of the above.

    Correct Answer
    D. All of the above.
    Explanation
    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.

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