AHIP Final Exam2024/25; Questions with
Complete Solutions
Mr. Jacob understands that there is a standard Medicare Part D
prescription drug benefit, but when he looks at information on various
plans available in his area, he sees a wide range in what they charge for
deductibles, premiums and cost sharing. How can you explain this to him?
Medicare Part D drug plans may have different benefit structures, but on
average, they must all be at least as good as the standard model established
by the government.
Mrs. West wears glasses and dentures and has enjoyed considerable pain
relief from arthritis through acupuncture. She is concerned about whether
or not Medicare will cover these items and services. What should you tell
her?
Medicare does not cover acupuncture, or, in general, glasses or dentures.
Mr. Bickford did not quite qualify for the extra help low-income subsidy
under the Medicare Part D Prescription Drug program and he is
, AHIP Final Exam2024/25; Questions with
Complete Solutions
wondering if there is any other option he has for obtaining help with his
considerable drug costs. What should you tell him?
He could check with the manufacturers of his medications to see if they
offer an assistance program to help people with limited means obtain the
medications they need. Alternatively, he could check to see whether his
state has a pharmacy assistance program to help him with his expenses.
Since 2004 Ms. Eisenberg has had a Medigap plan that provides some
drug coverage. She has received a letter from her Medigap carrier
informing her that her drug coverage is not “creditable.” She wants to
know what this means. What should you tell her?
The letter is to inform her that the drug coverage offered through her
Medigap plan does not offer drug coverage that is at least comparable to
that provided under the Medicare Part D prescription drug program. If she
does not have such creditable coverage during periods when she is eligible
, AHIP Final Exam2024/25; Questions with
Complete Solutions
for the Part D program, she will face a premium penalty if she enrolls in
a Part D plan at a later date.
Mr. Lombardi is interested in a Medicare Advantage (MA) PPO plan that
you represent. It is one of three plans operated by the same organization
in Mr. Lombardi’s area. The MA PPO plan does not include drug
coverage, but the other two plans do. Mr. Lombardi likes the PPO plan
that does not include drug coverage and intends to obtain his drug
coverage through a stand-alone Medicare prescription drug plan. What
should you tell him about this situation?
He could enroll in one of the MA plans that include prescription drug
coverage or a Medigap plan and a stand-alone prescription drug plan, but
he cannot enroll in the MA-only PPO plan and a stand-alone prescription
drug plan.
Mr. Torres has a small savings account. He would like to pay for his
Complete Solutions
Mr. Jacob understands that there is a standard Medicare Part D
prescription drug benefit, but when he looks at information on various
plans available in his area, he sees a wide range in what they charge for
deductibles, premiums and cost sharing. How can you explain this to him?
Medicare Part D drug plans may have different benefit structures, but on
average, they must all be at least as good as the standard model established
by the government.
Mrs. West wears glasses and dentures and has enjoyed considerable pain
relief from arthritis through acupuncture. She is concerned about whether
or not Medicare will cover these items and services. What should you tell
her?
Medicare does not cover acupuncture, or, in general, glasses or dentures.
Mr. Bickford did not quite qualify for the extra help low-income subsidy
under the Medicare Part D Prescription Drug program and he is
, AHIP Final Exam2024/25; Questions with
Complete Solutions
wondering if there is any other option he has for obtaining help with his
considerable drug costs. What should you tell him?
He could check with the manufacturers of his medications to see if they
offer an assistance program to help people with limited means obtain the
medications they need. Alternatively, he could check to see whether his
state has a pharmacy assistance program to help him with his expenses.
Since 2004 Ms. Eisenberg has had a Medigap plan that provides some
drug coverage. She has received a letter from her Medigap carrier
informing her that her drug coverage is not “creditable.” She wants to
know what this means. What should you tell her?
The letter is to inform her that the drug coverage offered through her
Medigap plan does not offer drug coverage that is at least comparable to
that provided under the Medicare Part D prescription drug program. If she
does not have such creditable coverage during periods when she is eligible
, AHIP Final Exam2024/25; Questions with
Complete Solutions
for the Part D program, she will face a premium penalty if she enrolls in
a Part D plan at a later date.
Mr. Lombardi is interested in a Medicare Advantage (MA) PPO plan that
you represent. It is one of three plans operated by the same organization
in Mr. Lombardi’s area. The MA PPO plan does not include drug
coverage, but the other two plans do. Mr. Lombardi likes the PPO plan
that does not include drug coverage and intends to obtain his drug
coverage through a stand-alone Medicare prescription drug plan. What
should you tell him about this situation?
He could enroll in one of the MA plans that include prescription drug
coverage or a Medigap plan and a stand-alone prescription drug plan, but
he cannot enroll in the MA-only PPO plan and a stand-alone prescription
drug plan.
Mr. Torres has a small savings account. He would like to pay for his
