2027 AHIP Moduel 3 Exam Questions and Correct Answers

2027 AHIP Moduel 3 gf gf gf




1. Mr. Livingston was still working when he first qualified for Medicare. At that ti
gf gf gf gf gf gf gf gf gf gf gf gf gf




me, he had employer group coverage that was creditable. During his initial Part
gf gf gf gf gf gf gf gf gf gf gf gf




D eligibility period, he decided not to enroll because he was satisfied with his
gf gf gf gf gf gf gf gf gf gf gf gf gf gf gf




drug coverage. It is now a year later, and Mr. Livingston has lost his employer g
gf gf gf gf gf gf gf gf gf gf gf gf gf gf gf




roup coverage within the last two weeks. How would you advise him?: Mr. Livingston s
gf gf gf gf gf gf gf gf gf gf gf gf gf gf




hould enroll in a Part D plan before he has a 63-day break in coverage to avoid a premium penalty.
gf gf gf gf gf gf gf gf gf gf gf gf gf gf gf gf gf gf gf




2. Who is most likely to benefit from the Medicare Prescription Payment Plan?-
gf gf gf gf gf gf gf gf gf gf gf




: Ryan, who suttered a heart attack at the beginning of the year requiring him to take an expensive brand name blood
gf gf gf gf gf gf gf gf gf gf gf gf gf gf gf gf gf gf gf gf gf



thinner on a daily basis, as well as an equally expensive injectable cholesterol medication on a bi-
gf gf gf gf gf gf gf gf gf gf gf gf gf gf gf gf




weekly basis for which he incurs high out-of-pocket costs.
gf gf gf gf gf gf gf gf




3. Mr. Wells gets by on a very small amount of fixed income. He has heard there
gf gf gf gf gf gf gf gf gf gf gf gf gf gf gf gf




may be extra help paying for Part D prescription drugs for Medicare beneficiari
gf gf gf gf gf gf gf gf gf gf gf gf




es with limited income. He wants to know whether he might qualify. What should yo
gf gf gf gf gf gf gf gf gf gf gf gf gf gf




u tell him?: The extra help is available to beneficiaries whose income and assets do not
gf gf gf gf gf gf gf gf gf gf gf gf gf gf gf




exceed the annual limits specified by the government.
gf gf gf gf gf gf gf




4. Mrs. Enriquez is one of your clients. She has read that there is a new program that
gf gf gf gf gf gf gf gf gf gf gf gf gf gf gf gf




may help her manage prescription drug costs. What do you tell her about the
gf gf gf gf gf gf gf gf gf gf gf gf g f gf gf




Medicare Prescription Payment Plan?: Part D enrollees can opt into the Medicare Prescription Pay
gf gf gf gf gf gf gf gf gf gf gf gf gf




ment Plan at the beginning of the plan year or any point during the year.
gf gf gf gf gf gf gf gf gf gf gf gf gf gf




5. Mr. Bravo complains to you that because he takes multiple expensive drugs, h
gf gf gf gf gf gf gf gf gf gf gf gf




e has trouble paying his cost sharing for his prescription drugs, particularly at t
gf gf gf gf gf gf gf gf gf gf gf gf gf




he beginning of the year during the deductible phase. He is happy with his plan
gf gf gf gf gf gf gf gf gf gf gf gf gf gf gf




and does not want to change. However, he said he had heard about a new progra
gf gf gf gf gf gf gf gf gf gf gf gf gf gf gf




m called the Medicare Prescription Payment Plan and asked whether it mig
g f g f g f g f g f g f g f g f g f gf gf




ht help. What do you tell him?: The Medicare Prescription Payment Plan helps spread out beneficiary
gf gf gf gf gf gf gf gf gf gf gf gf gf gf gf gf




cost-sharing payments but does not decrease the total amount owed. gf gf gf gf gf gf gf gf gf




6. Mrs. Yates is enrolled in a cost plan for her Medicare benefits. She has recentl
gf gf gf gf gf gf gf gf gf gf gf gf gf gf




y lost creditable coverage previously available through her husband's employer
gf gf gf gf gf gf gf gf gf




. She is interested in enrolling in a Medicare Part D prescription drug plan (PDP). W
gf gf gf gf gf gf gf gf gf gf gf gf gf gf gf




hat should you tell her?: If a Part D benefit is ottered through her plan she may choose to enroll in that
gf gf gf gf gf gf gf gf gf gf gf gf gf gf gf gf gf gf gf gf gf gf




plan or a standalone PDP. gf gf gf gf




1gf/gf6

, 2027 AHIP Moduel 3 gf gf gf




7. Mr. Rudd, a fairly prosperous individual, first became eligible for Part D on De
gf gf gf gf gf gf gf gf gf gf gf gf gf




cember 1, 2025 after working many years and contributing to the Medicare prog
gf gf gf gf gf gf gf gf gf gf gf gf




ram.-
Although he did not have creditable drug coverage, he did not sign up for Part
gf gf gf gf gf gf gf gf gf gf gf gf gf gf gf gf




D when he was first eligible because at that time he did not rely on any prescrip
gf gf gf gf gf gf gf gf gf gf gf gf gf gf gf gf




tion drugs. Recently, Mr. Rudd learned that he needed to take several expensiv
gf gf gf gf gf gf gf gf gf gf gf gf




e drugs to stay healthy. Therefore, he wishes to obtain drug coverage during th
gf gf gf gf gf gf gf gf gf gf gf gf gf




e Annual Election Period to be effective on January 1, 2027. Will Mr. Rudd be s
gf gf gf gf gf gf gf gf g f gf gf gf gf gf gf




ubject to a late enrollment penalty and if so, how much?: Mr.Rudd will have to pay a penalty
gf gf gf gf gf gf gf gf gf gf gf gf gf gf gf gf gf gf




of 13 percent of the national average premium, representing a 1 percent penalty for every month he did not have credit
gf gf gf gf gf gf gf gf gf gf gf gf gf gf gf gf gf gf gf gf




able coverage after becoming eligible for Part D. This penalty will remain in ettect for as long as he has Medicare prescri
gf gf gf gf gf gf gf gf gf gf gf gf gf gf gf gf gf gf gf gf gf




ption drug coverage. gf gf




8. Mr. Willis did not quite qualify for the extra help low-
gf gf gf gf gf gf gf gf gf gf




income subsidy under the Medicare Part D Prescription Drug program, and he i
gf gf gf gf gf gf gf gf gf gf gf gf




s wondering if there is any other option he has for obtaining help with his consid
gf gf gf gf gf gf gf gf gf gf gf gf gf gf gf




erable drug costs. What should you tell him?: He could check with the manufacturers of his medicati
gf gf gf g f g f g f g f g f gf gf gf gf gf gf gf gf




ons to see if they otter an assistance program to help people with limited means obtain the medications they need. Alt
gf gf gf gf gf gf gf gf gf gf gf gf gf gf gf gf gf gf gf gf



ernatively, he could gf gf




check to see whether his state has a pharmacy assistance program to help him with his expenses.
gf gf gf gf gf gf gf gf gf gf gf gf gf gf gf gf




9. Mr. Peters understands that there is a standard Medicare Part D prescription d
gf gf gf gf gf gf gf gf gf gf gf gf




rug benefit, but when he looks at information on various plans available in his
gf gf gf gf gf gf gf gf gf gf gf gf gf gf




area, he sees a wide range in what they charge for deductibles, premiums, and c
gf gf gf gf gf gf gf gf gf gf gf gf gf gf




ost-
sharing. How can you explain this to him?: Medicare Part D drug plans may have ditterent benefit
gf gf gf gf gf gf gf gf gf gf gf gf gf gf gf gf gf




structures, but on average, they must all be at least as good as the standard model established by the government.
gf gf gf gf gf gf gf gf gf gf gf gf gf gf gf gf gf gf gf




10. Mrs. Huang is a retired federal worker with coverage under a Federal Employ
gf gf gf gf gf gf gf gf gf gf gf gf




ee Health Benefits (FEHB) plan that includes creditable drug coverage. She will s
gf gf gf gf gf gf gf gf gf gf gf gf




oon turn 65 and become Medicare-
gf gf gf gf gf




eligible for the first time. What issues might she consider concerning whether t
gf gf gf gf gf gf gf gf gf gf gf gf




o enroll in a Medicare pre-
gf gf gf gf gf




scription drug plan?: She could compare the coverage to see if the Medicare Part D plan otters better benef
gf gf gf gf gf gf gf gf gf gf gf gf gf gf gf gf gf gf




its and coverage than the FEHB plan for the specific medications she needs and whether any additional benefits
gf gf gf gf gf gf gf gf gf gf gf gf gf gf gf gf gf




2gf/gf6