AHIP 2024 Final Exam Questions and Answers
(Verified Answers)
1. Mrs. Chou likes a Private Fee-for-Service (PFFS) plan available in her area
that does not include drug coverage. She wants to enroll in the plan and enroll
in a stand-alone prescription drug plan. What should you tell her
ANS She couldenroll in a PFFS plan and a stand-alone Medicare prescription
drug plan.
2. Mrs. Roswell is a new Medicare beneficiary who has just retired from retail
work. She is interested in selecting a Medicare Part D prescription drug plan.
She takes a number of medications and is concerned that she has not been
able to identify a plan that covers all of her medications. She does not want
to make an abrupt change to new drugs that would be covered and asks what
she should do. What should you tell her
ANS Every Part D drug plan is required tocover a single one-month fill of her
existing medications sometime during a 90-daytransition period.
,3. Mr. Robinson was quite ill recently and forgot to pay his monthly premium
for his MA-PD plan. He is worried that he will lose his coverage now when
he needs it the most. He is certain his plan will disenroll him because that is
what happened to a friend of his in a similar type of plan. What can you tell
Mr. Robinson about his situation
ANS Plan sponsors have the option to do nothingwhen a plan member does not
pay their premiums or disenroll the member after agrace period and notice.
4. Mrs. Allen has a rare condition for which two different brand name drugs
are the only available treatment. She is concerned that since no generic
prescription drug is available and these drugs are very high cost, she will not
be able to find a Medicare Part D prescription drug plan that covers either
one of them. What should you tell her
ANS Medicare prescription drug plans are required to cover drugs in each
therapeutic category. She should be able to enroll in a Medicare prescription drug
plan that covers the medications she needs.
5. One of your clients, Lauren Nichols, has heard about a Medicare concept
from one of her neighbors called TrOOP. She asks you to explain it. What
do you say
ANS TrOOP stands for true out-of-pocket expenses that count toward the
Medicare Part D catastrophic limit and include not only expenses paid by a
beneficiary but also in some instances drug manufacturer discounts.
, 6. Mrs. Fiore is a retired federal worker with coverage under a Federal Employ-
ee Health Benefits (FEHB) plan that includes creditable drug coverage. She is
(Verified Answers)
1. Mrs. Chou likes a Private Fee-for-Service (PFFS) plan available in her area
that does not include drug coverage. She wants to enroll in the plan and enroll
in a stand-alone prescription drug plan. What should you tell her
ANS She couldenroll in a PFFS plan and a stand-alone Medicare prescription
drug plan.
2. Mrs. Roswell is a new Medicare beneficiary who has just retired from retail
work. She is interested in selecting a Medicare Part D prescription drug plan.
She takes a number of medications and is concerned that she has not been
able to identify a plan that covers all of her medications. She does not want
to make an abrupt change to new drugs that would be covered and asks what
she should do. What should you tell her
ANS Every Part D drug plan is required tocover a single one-month fill of her
existing medications sometime during a 90-daytransition period.
,3. Mr. Robinson was quite ill recently and forgot to pay his monthly premium
for his MA-PD plan. He is worried that he will lose his coverage now when
he needs it the most. He is certain his plan will disenroll him because that is
what happened to a friend of his in a similar type of plan. What can you tell
Mr. Robinson about his situation
ANS Plan sponsors have the option to do nothingwhen a plan member does not
pay their premiums or disenroll the member after agrace period and notice.
4. Mrs. Allen has a rare condition for which two different brand name drugs
are the only available treatment. She is concerned that since no generic
prescription drug is available and these drugs are very high cost, she will not
be able to find a Medicare Part D prescription drug plan that covers either
one of them. What should you tell her
ANS Medicare prescription drug plans are required to cover drugs in each
therapeutic category. She should be able to enroll in a Medicare prescription drug
plan that covers the medications she needs.
5. One of your clients, Lauren Nichols, has heard about a Medicare concept
from one of her neighbors called TrOOP. She asks you to explain it. What
do you say
ANS TrOOP stands for true out-of-pocket expenses that count toward the
Medicare Part D catastrophic limit and include not only expenses paid by a
beneficiary but also in some instances drug manufacturer discounts.
, 6. Mrs. Fiore is a retired federal worker with coverage under a Federal Employ-
ee Health Benefits (FEHB) plan that includes creditable drug coverage. She is
