America’s Health Insurance Plans (AHIP) 5 Practice Test

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If a beneficiary enrolls in a stand-alone PDP after already enrolling in an MA plan with drug coverage, what is the effect on the MA plan?

You will be disenrolled from the MA plan. You will keep both plans with no changes. You will be automatically enrolled in a new MA plan. You will continue with MA-PD and add the PDP.

Correct Answer:

You will be disenrolled from the MA plan.

Explanation:

Enrolling in a stand-alone prescription drug plan while you’re in a Medicare Advantage plan that already includes drug coverage means you can’t keep both drug coverages. The MA plan and its drug benefit are designed to be a single package, so adding a separate PDP creates duplicate drug coverage. Because of this, your enrollment in the MA plan ends; you’re disenrolled from the MA-PD, leaving you with Original Medicare for medical coverage and the PDP for drugs (or you’d switch plans during another enrollment period). The other options aren’t allowed because you can’t maintain two separate prescription drug coverages at the same time.

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