AHIP Module 2 Verified Answers

AHIP Module 2 Verified Answers Question 1: When inviting new Medicare beneficiaries to a marketing event, what is important to keep in mind? a. You can request RSVPs and also require contact information b. You may request RSVPs, but you are not permitted to require contact information c. You can only invite Medicare beneficiaries with specific health conditions d. You cannot invite Medicare beneficiaries at all Correct answer: b. You may request RSVPs, but you are not permitted to require contact information Question 2: Where might Mr. Wu, who has limited financial resources but failed to qualify for the Part D low-income subsidy, turn for help with his prescription drug costs? a. He should apply for a different Part D plan b. He may still qualify for help in paying Part D costs through his State Pharmaceutical Assistance Program c. He should try to negotiate a lower price with his pharmacy d. He should consider enrolling in a Medicare Advantage plan Correct answer: b. He may still qualify for help in paying Part D costs through his State Pharmaceutical Assistance Program Question 3: Which type of SNP is likely to be most appropriate for Daniel, who has chronic bronchitis? a. C-SNP b. Dual-Eligible SNP c. Institutional SNP d. Cost SNP Correct answer: a. C-SNP Question 4: How much can Dr. Brennan charge Mary Rodgers, who sees him for treatment under a PFFS plan? a. Any amount she agrees to pay b. Up to the cost sharing specified in the PFFS plan's terms and condition of payment, which may include balance billing up to 15% of the Medicare rate c. Up to the Medicare rate d. Only if she has other insurance coverage Correct answer: b. Up to the cost sharing specified in the PFFS plan's terms and condition of payment, which may include balance billing up to 15% of the Medicare rate Which of the following steps may a Part D sponsor adopt for beneficiaries who are at risk of misusing or abusing frequently abused drugs? I. Identifying at risk individuals by using criteria that includes the number of opioid prescriptions the beneficiary has and the number of prescribers who have written those prescriptions. II. Locking an at-risk beneficiary into one pharmacy. III. Locking an at-risk beneficiary into one prescriber. IV. Increasing deductibles and copays for at-risk beneficiaries. ️I, II and III only Under what conditions can a Medicare prescription drug plan reduce its coverage for a given drug during the first 60 days of the year? ️When a formulary change is in response to a drug's removal from the market. What types of tools can Medicare Part D prescription drug plans use that affect the way their enrollees can access medications? ️Part D plans do not have to cover all medications. As a result, their formularies, or lists of covered drugs, will vary from plan to plan. In addition, they can use cost containment techniques such as tiered co-payments and prior authorization. Mr. Rice has coverage for medical services and medications through his employer's retiree plan. He is considering switching to a Medicare prescription drug plan because his retiree plan does not cover two important medications. What should he consider before making a change? ️If Mr. Rice drops his drug coverage through the retiree plan, he may not be able to get it back and he also may lose his medical health coverage.