CEC Post-Enrollment and Renewals 2

Question 1

A beneficiary enrolled in a Medicare Advantage plan wants to add dental coverage mid-year. What should the enrollment counselor advise?

Accepted Answer

They must wait for the Annual Enrollment Period to switch to a plan with dental benefits

Answer

Medicare Advantage plan changes, including adding benefits like dental, generally require waiting for the Annual Enrollment Period (October 15–December 7) unless a qualifying SEP event occurs.

Question 2

Which of the following is a valid reason for a Medicare beneficiary to qualify for a Special Enrollment Period after initial enrollment?

Accepted Answer

The beneficiary moved to a new address outside their plan's service area

Answer

Moving out of a plan's service area is a qualifying life event that triggers a Special Enrollment Period, allowing the beneficiary to change plans.

Question 3

During the Medicare Advantage Open Enrollment Period (January 1–March 31), what changes can a beneficiary make?

Accepted Answer

Switch from one Medicare Advantage plan to another MA plan or return to Original Medicare

Answer

The MA Open Enrollment Period allows beneficiaries already enrolled in a Medicare Advantage plan to switch to another MA plan or return to Original Medicare once.

Question 4

A client enrolled in a PDP (Prescription Drug Plan) notices their medication is no longer covered after the plan's Annual Notice of Change. What is the best next step?

Accepted Answer

Review the Annual Notice of Change and use the AEP to switch to a plan covering the medication

Answer

The Annual Notice of Change alerts beneficiaries to plan changes, and the Annual Enrollment Period (Oct 15–Dec 7) is the time to switch to a better-fitting plan for the new year.

Question 5

What document must Medicare Advantage and Part D plans send to enrollees each September?

Accepted Answer

Annual Notice of Change (ANOC)

Answer

Plans must send the Annual Notice of Change (ANOC) by September 30 each year, informing members of any changes taking effect on January 1.

(CEC) Certified Enrollment Counselor Practice Test

(CEC) Certified Enrollment Counselor Practice Test

CEC Post-Enrollment and Renewals 2