AHIP Module 3
2022/2023
1.Mr. Carlini has heard that Medicare prescription drug plans are only
offered through private companies under a program known as Medicare
Advantage (MA), not by the government. He likes Original Medicare and
does not want to sign up for an MA product, but he also wants prescription
drug coverage. What should you tell him?: b. Mr. Carlini can stay with
Original Medicare and also enroll in a Medicare prescription drug plan
through a private company that has contracted with the government
to provide only such drug coverage to eligible Medicare beneficiaries.
Correct
2. Mrs. Mulcahy is concerned that she may not qualify for enrollment in a
Medicare prescription drug plan because, although she is entitled to Part
A, she is not enrolled under Medicare Part B. What should you tell her?: d.
Everyone who is entitled to Part A or enrolled under Part B is eligible to
enroll in a Medicare prescription drug plan. As long as Mrs. Mulcahy is
entitled to Part A, she does not need to enroll under Part B before
enrolling in a prescription drug plan. Correct
3. Mrs. Lopez is enrolled in a Medicare Advantage cost plan. She has recently
lost creditable coverage previously available through her husband's
employ- er. She is interested in enrolling in a Medicare Part D prescription
drug plan (PDP). What should you tell her?: a. If a Part D benefit is offered
through her plan she may choose in enroll in that plan or a standalone
PDP. Correct
4. Which of the following statements about Medicare Part D are correct?
1/5
, I. Part D plans must enroll any eligible beneficiary who applies regardless
of health status except in limited circumstances.
II. Private fee-for-service (PFFS) plans are not required to use a
pharmacy network but may choose to have one.
III. Beneficiaries enrolled in a MA-Medical Savings Account (MSA) plan
may only obtain Part D benefits through a standalone PDP.
IV. Beneficiaries enrolled in a MA-PPO may obtain Part D benefits through
a standalone PDP or through their plan.: b. I, II, and III only Correct
5. All plans must cover at least the standard Part D coverage or its
actuarial equivalent. What costs would a beneficiary incur for prescription
drugs in 2019 under the standard coverage?: c. Standard Part D coverage
would require payment of an annual deductible, 25% cost-sharing up
to the coverage gap, a portion of costs for both generics and brand-
name drugs in the coverage gap, and co-pays or co-insurance after
the coverage gap. Correct
2/5
2022/2023
1.Mr. Carlini has heard that Medicare prescription drug plans are only
offered through private companies under a program known as Medicare
Advantage (MA), not by the government. He likes Original Medicare and
does not want to sign up for an MA product, but he also wants prescription
drug coverage. What should you tell him?: b. Mr. Carlini can stay with
Original Medicare and also enroll in a Medicare prescription drug plan
through a private company that has contracted with the government
to provide only such drug coverage to eligible Medicare beneficiaries.
Correct
2. Mrs. Mulcahy is concerned that she may not qualify for enrollment in a
Medicare prescription drug plan because, although she is entitled to Part
A, she is not enrolled under Medicare Part B. What should you tell her?: d.
Everyone who is entitled to Part A or enrolled under Part B is eligible to
enroll in a Medicare prescription drug plan. As long as Mrs. Mulcahy is
entitled to Part A, she does not need to enroll under Part B before
enrolling in a prescription drug plan. Correct
3. Mrs. Lopez is enrolled in a Medicare Advantage cost plan. She has recently
lost creditable coverage previously available through her husband's
employ- er. She is interested in enrolling in a Medicare Part D prescription
drug plan (PDP). What should you tell her?: a. If a Part D benefit is offered
through her plan she may choose in enroll in that plan or a standalone
PDP. Correct
4. Which of the following statements about Medicare Part D are correct?
1/5
, I. Part D plans must enroll any eligible beneficiary who applies regardless
of health status except in limited circumstances.
II. Private fee-for-service (PFFS) plans are not required to use a
pharmacy network but may choose to have one.
III. Beneficiaries enrolled in a MA-Medical Savings Account (MSA) plan
may only obtain Part D benefits through a standalone PDP.
IV. Beneficiaries enrolled in a MA-PPO may obtain Part D benefits through
a standalone PDP or through their plan.: b. I, II, and III only Correct
5. All plans must cover at least the standard Part D coverage or its
actuarial equivalent. What costs would a beneficiary incur for prescription
drugs in 2019 under the standard coverage?: c. Standard Part D coverage
would require payment of an annual deductible, 25% cost-sharing up
to the coverage gap, a portion of costs for both generics and brand-
name drugs in the coverage gap, and co-pays or co-insurance after
the coverage gap. Correct
2/5
