AHIP Module 3 test with correct answers
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? - CORRECT ANSWERS-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
Mr. and Mrs. Vaughn both take a specialized multivitamin prescription each day. Mr.
Vaughn takes a prescription for helping to regrow his hair. They are anxious to have
their Medicare prescription drug plan cover these drug needs. What should you tell
them? - CORRECT ANSWERS-b. Medicare prescription drug plans are not permitted to
cover the prescription medications the Vaughns are interested in under Part D
coverage, however, plans may cover them as supplemental benefits and the Vaughn's
could look into that possibility. Correct
Mr. Bickford did not quite qualify for the extra help low-income subsidy under the
Medicare Part D Prescription Drug program and he is wondering if there is any other
option he has for obtaining help with his considerable drug costs. What should you tell
him? - CORRECT ANSWERS-a. 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. Correct
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? -
CORRECT ANSWERS-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
, Mr. Hutchinson has drug coverage through his former employer's retiree plan. He is
concerned about the Part D premium penalty if he does not enroll in a Medicare
prescription drug plan, but does not want to purchase extra coverage that he will not
need. What should you tell him? - CORRECT ANSWERS-b. If the drug coverage he
has is not expected to pay, on average, at least as much as Medicare's standard Part D
coverage expects to pay, then he will need to enroll in Medicare Part D during his initial
eligibility period to avoid the late enrollment penalty. Correct
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? - CORRECT ANSWERS-a. 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. Correct
Mr. Katz reached the Part D coverage gap in August last year. His prescriptions have
not changed, he is keeping the same Part D plan and the benefits, cost-sharing, and
coverage of his drugs are all the same as last year. He asked what to expect for this
year about his out-of-pocket costs. What could you tell him? - CORRECT ANSWERS-d.
Because he reached the coverage gap last year, he will probably reach it again this
year close to the same time. Correct
Mr. Rice has coverage for medical services and medications through his employer's
retiree plan. He is considering switching to a Medicare prescription drug plan because
his retiree plan does not cover two important medications. What should he consider
before making a change? - CORRECT ANSWERS-c. If Mr. Rice drops his drug
coverage through the retiree plan, he may not be able to get it back and he also may
lose his medical health coverage. Correct
Mr. Shapiro gets by on a very small 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? - CORRECT
ANSWERS-b. The extra help is available to beneficiaries whose income and assets do
not exceed annual limits specified by the government. Correct
Mr. Shultz was still working when he first qualified for Medicare. At that time, he had
employer group coverage that was creditable. During his initial Part D eligibility period,
he decided not to enroll because he was satisfied with his drug coverage. It is now a
year later and Mr. Shultz has lost his employer group coverage. How would you advise
him? - CORRECT ANSWERS-b. Mr. Schultz should enroll in a Part D plan before he
has a 63-day break in coverage in order to avoid a premium penalty. Correct
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
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? - CORRECT ANSWERS-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
Mr. and Mrs. Vaughn both take a specialized multivitamin prescription each day. Mr.
Vaughn takes a prescription for helping to regrow his hair. They are anxious to have
their Medicare prescription drug plan cover these drug needs. What should you tell
them? - CORRECT ANSWERS-b. Medicare prescription drug plans are not permitted to
cover the prescription medications the Vaughns are interested in under Part D
coverage, however, plans may cover them as supplemental benefits and the Vaughn's
could look into that possibility. Correct
Mr. Bickford did not quite qualify for the extra help low-income subsidy under the
Medicare Part D Prescription Drug program and he is wondering if there is any other
option he has for obtaining help with his considerable drug costs. What should you tell
him? - CORRECT ANSWERS-a. 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. Correct
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? -
CORRECT ANSWERS-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
, Mr. Hutchinson has drug coverage through his former employer's retiree plan. He is
concerned about the Part D premium penalty if he does not enroll in a Medicare
prescription drug plan, but does not want to purchase extra coverage that he will not
need. What should you tell him? - CORRECT ANSWERS-b. If the drug coverage he
has is not expected to pay, on average, at least as much as Medicare's standard Part D
coverage expects to pay, then he will need to enroll in Medicare Part D during his initial
eligibility period to avoid the late enrollment penalty. Correct
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? - CORRECT ANSWERS-a. 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. Correct
Mr. Katz reached the Part D coverage gap in August last year. His prescriptions have
not changed, he is keeping the same Part D plan and the benefits, cost-sharing, and
coverage of his drugs are all the same as last year. He asked what to expect for this
year about his out-of-pocket costs. What could you tell him? - CORRECT ANSWERS-d.
Because he reached the coverage gap last year, he will probably reach it again this
year close to the same time. Correct
Mr. Rice has coverage for medical services and medications through his employer's
retiree plan. He is considering switching to a Medicare prescription drug plan because
his retiree plan does not cover two important medications. What should he consider
before making a change? - CORRECT ANSWERS-c. If Mr. Rice drops his drug
coverage through the retiree plan, he may not be able to get it back and he also may
lose his medical health coverage. Correct
Mr. Shapiro gets by on a very small 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? - CORRECT
ANSWERS-b. The extra help is available to beneficiaries whose income and assets do
not exceed annual limits specified by the government. Correct
Mr. Shultz was still working when he first qualified for Medicare. At that time, he had
employer group coverage that was creditable. During his initial Part D eligibility period,
he decided not to enroll because he was satisfied with his drug coverage. It is now a
year later and Mr. Shultz has lost his employer group coverage. How would you advise
him? - CORRECT ANSWERS-b. Mr. Schultz should enroll in a Part D plan before he
has a 63-day break in coverage in order to avoid a premium penalty. Correct
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
