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2021_AHIP_Module

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Exam of 37 pages for the course 2021 AHIP at 2021 AHIP (2021_AHIP_Module_)

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April 19, 2022
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Written in
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• Medicare Course Home
• Course (2021 Module 3: Part D)
• Transcript


Module 3 Final Review
Review of attempt 1

Started on Saturday, May 1, 2021, 12:56 PM
Complete Saturday, May 1, 2021, 01:20 PM
d on
Time 24 mins 21 secs
taken
Marks 19/20
Grade 95 out of a maximum of 100 (95%)
Feedback You have completed this Knowledge Check. To
proceed, please return to the training dashboard and
select the next available section.

,Question
1
Marks: 1
Mr. Wingate is a newly enrolled Medicare Part D beneficiary and one of
your clients. In addition to drugs on his plan’s formulary he takes several
other medications. These include a prescription drug not on his plan’s
formulary, over-the-counter medications for colds and allergies, vitamins,
and drugs from an Internet-based Canadian pharmacy to promote hair
growth and reduce joint swelling. His neighbor recently told him about a
concept called TrOOP and he asks you if any of his other medications
could count toward TrOOP should he ever reach the Part D catastrophic
limit. What should you say?
Choose one answer.
a. The cost of the prescription
drugs that are not on his plan’s
formulary as well as the cost of
the drug(s) to reduce joint
swelling from the Canadian
pharmacy will count toward
TrOOP but the other
medications in question will not
count toward TrOOP.
b. None of the costs of Mr. Correct: None of the costs of Mr.
Wingate’s other medications Wingate’s other medications would
would currently count toward currently count toward TrOOP but
TrOOP but he may wish to ask he may wish to ask his plan for an
his plan for an exception to exception to cover the prescription
cover the prescription not on not on its formulary. If he receives
its formulary. an exception under which the plan
covers the drug, it could count
toward TrOOP.

, c. The cost of all medications
bought within the United
States not covered by his plan
would count toward TrOOP.
The cost of the Canadian
bought medications would not
count toward TrOOP.
d. The cost of the prescription
drug that is not on his plan’s
formulary will count toward
TrOOP but the other
medications in question will not
count toward TrOOP.
Source: Module 3, Slide – True Out-of-Pocket Counts? (TrOOP): What
Counts, Slide - True Out-of-Pocket Costs (TrOOP): What is Excluded?
Correct
Marks for this submission: 1/1.
Question
2
Marks: 1
Mr. Shapiro gets by on a very small amount of fixed income. He has
heard there may be extra help paying for Part D prescription drugs for
Medicare beneficiaries with limited income. He wants to know whether
he might qualify. What should you tell him?
Choose one answer.
a. The extra help is available
only to Medicare
beneficiaries who are
enrolled in Medicaid. He
should apply for coverage
under his state’s Medicaid
program to access the extra
help with his drug costs.

, b. The government pays a
per-beneficiary dollar
amount to the Medicare Part
D prescription drug plans, to
offset premiums for their low-
income enrollees in
accordance with the plan’s
set criteria. Mr. Shapiro
should check with his plan to
see if he qualifies.
c. He must apply for the
extra help at the same time
he applies for enrollment in a
Part D plan. If he missed this
opportunity, he will not be
able to apply for the extra
help again until the next
annual enrollment period.
d. The extra help is available Correct: If a beneficiary has limited
to beneficiaries whose income and resources, they may
income and assets do not qualify for a low-income subsidy (LIS)
exceed annual limits to cover all or part of the Part D plan
specified by the government. premium and cost-sharing.
Beneficiary income may not exceed
150 percent of the Federal Poverty
Level (FPL). Assets may not exceed
a limited amount also specified by the
government.
Source: Module 3, Slide - Help for Individuals with Limited Income and
Limited Resources and Slide - Encourage Individuals with Limited
Income/Resources to Apply to the State Medicaid Office
Correct
Marks for this submission: 1/1.
Question
3
Marks: 1

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