MODULE 3 FINAL REVIEW QUESTIONS
AND ANSWERS WITH VERIFIED
SOLUTIONS 2024
All plans must cover at least the standard Part D coverage or its actuarial equivalent. Which of the
following statements best describes some of the costs a beneficiary would incur for prescription drugs
under the standard coverage? - ANSWER Standard Part D coverage would require payment of an annual
deductible, and once past the catastrophic coverage threshold, the beneficiary pays whichever is greater
of either the co-pays for generic and brand name drugs or coinsurance of 5%.
Mrs. Allen has a rare condition for which two different brand name drugs are the only available
treatment. She is concerned that since no generic prescription drug is available and these drugs are very
high cost, she will not be able to find a Medicare Part D prescription drug plan that covers either one of
them. What should you tell her? - ANSWER Medicare prescription drug plans are required to cover drugs
in each therapeutic category. She should be able to enroll in a Medicare prescription drug plan that
covers the medications she needs.
Mr. Torres has a small savings account. He would like to pay for his monthly Part D premiums with an
automatic monthly withdrawal from his savings account until it is exhausted, and then have his
premiums withheld from his Social Security check. What should you tell him? - ANSWER In general, he
must select a single Part D premium payment mechanism that will be used throughout the year.
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? - ANSWER
None of the costs of Mr. Wingate's other medications would currently count toward TrOOP but he may
wish to ask his plan for an exception to cover the prescription not on its formulary.
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? - ANSWER 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.
AND ANSWERS WITH VERIFIED
SOLUTIONS 2024
All plans must cover at least the standard Part D coverage or its actuarial equivalent. Which of the
following statements best describes some of the costs a beneficiary would incur for prescription drugs
under the standard coverage? - ANSWER Standard Part D coverage would require payment of an annual
deductible, and once past the catastrophic coverage threshold, the beneficiary pays whichever is greater
of either the co-pays for generic and brand name drugs or coinsurance of 5%.
Mrs. Allen has a rare condition for which two different brand name drugs are the only available
treatment. She is concerned that since no generic prescription drug is available and these drugs are very
high cost, she will not be able to find a Medicare Part D prescription drug plan that covers either one of
them. What should you tell her? - ANSWER Medicare prescription drug plans are required to cover drugs
in each therapeutic category. She should be able to enroll in a Medicare prescription drug plan that
covers the medications she needs.
Mr. Torres has a small savings account. He would like to pay for his monthly Part D premiums with an
automatic monthly withdrawal from his savings account until it is exhausted, and then have his
premiums withheld from his Social Security check. What should you tell him? - ANSWER In general, he
must select a single Part D premium payment mechanism that will be used throughout the year.
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? - ANSWER
None of the costs of Mr. Wingate's other medications would currently count toward TrOOP but he may
wish to ask his plan for an exception to cover the prescription not on its formulary.
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? - ANSWER 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.
