AHIP Module 3 Verified Solutions
Question 1: Why do Medicare Part D plans vary in terms of their coverage and costs?
Answer: Medicare Part D plans may have different benefit structures, but on average, they must cover
all medications to the same level as the standard model established by the government.
Question 2: What tools do Medicare Part D plans use to affect access to medications?
Answer: Part D plans can use cost containment techniques such as tiered co-payments and prior
authorization, and their formularies will vary from plan to plan.
Question 3: What can Mrs. Edwards do if she needs to fill her prescriptions while traveling?
Answer: She may fill prescriptions at non-network pharmacies, but likely at a higher cost than at an in-
network pharmacy.
Question 4: Can Mrs. Mulcahy enroll in a Medicare prescription drug plan despite not being enrolled
under Medicare Part B?
Answer: Yes, an individual who is entitled to Part A or enrolled under Part B is eligible to enroll in a
Medicare prescription drug plan. Mrs. Mulcahy does not need to enroll under Part B before enrolling in
a prescription drug plan.
Question 5: What should Mr. Hutchinson do about enrolling in a Medicare prescription drug plan?
Answer: If his employer retiree plan does not expect to pay at least as much as Medicare's standard Part
D coverage expects to pay, he will need to enroll in Medicare Part D during his initial eligibility period to
avoid the late enrollment penalty.
Question 6: Which statements about Medicare Part D are correct?
Question 1: Why do Medicare Part D plans vary in terms of their coverage and costs?
Answer: Medicare Part D plans may have different benefit structures, but on average, they must cover
all medications to the same level as the standard model established by the government.
Question 2: What tools do Medicare Part D plans use to affect access to medications?
Answer: Part D plans can use cost containment techniques such as tiered co-payments and prior
authorization, and their formularies will vary from plan to plan.
Question 3: What can Mrs. Edwards do if she needs to fill her prescriptions while traveling?
Answer: She may fill prescriptions at non-network pharmacies, but likely at a higher cost than at an in-
network pharmacy.
Question 4: Can Mrs. Mulcahy enroll in a Medicare prescription drug plan despite not being enrolled
under Medicare Part B?
Answer: Yes, an individual who is entitled to Part A or enrolled under Part B is eligible to enroll in a
Medicare prescription drug plan. Mrs. Mulcahy does not need to enroll under Part B before enrolling in
a prescription drug plan.
Question 5: What should Mr. Hutchinson do about enrolling in a Medicare prescription drug plan?
Answer: If his employer retiree plan does not expect to pay at least as much as Medicare's standard Part
D coverage expects to pay, he will need to enroll in Medicare Part D during his initial eligibility period to
avoid the late enrollment penalty.
Question 6: Which statements about Medicare Part D are correct?
