AHIP 2025 MODULE 3 QUESTIONS WITH 100% VERIFIED ANSWERS

AHIP 2025 MODULE 3 QUESTIONS WITH 100% VERIFIED
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ANSWERS.


1) Mr. Carlini has heard that Medicare prescription drug plans are only offered
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through private companies under a program known as Medicare Advantage (MA),
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not by the government. He likes Original Medicare and does not want to sign up
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for an MA product, but he also wants prescription drug coverage. What should
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you tell him? - Correct Answer-b. Mr. Carlini can stay with Original Medicare and
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also enroll in a Medicare prescription drug plan through a private company that
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has contracted with the government to provide only such drug coverage to
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eligible Medicare beneficiaries.
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2) Mrs. Mulcahy is concerned that she may not qualify for enrollment in a Medicare
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prescription drug plan because, although she is entitled to Part A, she is not
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enrolled under Medicare Part B. What should you tell her? - Correct Answer-d.
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Everyone who is entitled to Part A or enrolled under Part B is eligible to enroll in
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a Medicare prescription drug plan. As long as Mrs. Mulcahy is entitled to Part A,
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she does not need to enroll under Part B before enrolling in a prescription drug
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plan.

3) Mrs. Lopez is enrolled in a Medicare Advantage cost plan. She has recently lost
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creditable coverage previously available through her husband's employer. She is
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interested in enrolling in a Medicare Part D prescription drug plan (PDP). What
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should you tell her? - Correct Answer-a. If a Part D benefit is offered through her
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plan, she may choose in enroll in that plan or a standalone PDP.
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4) Which of the following statements about Medicare Part D are correct?
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I. Part D plans must enroll any eligible beneficiary who applies regardless
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of health status except in limited circumstances.
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II. Private fee-for-service (PFFS) plans are not required to use a pharmacy
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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.
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IV. Beneficiaries enrolled in a MA-PPO may obtain Part D benefits through _ _ _ _ _ _ _ _ _ _ _




a standalone PDP or through their plan. - Correct Answer-b. I, II, and III
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only
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5) All plans must cover at least the standard Part D coverage or its actuarial
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equivalent. What costs would a beneficiary incur for prescription drugs in 2019
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under the standard coverage? - Correct Answer-c. Standard Part D coverage
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would require payment of an annual deductible, 25% cost-sharing up to the
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coverage gap, a portion of costs for both generics and brand-name drugs in the
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coverage gap, and co-pays or co-insurance after the coverage gap.
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6) Mrs. Andrews was preparing a budget for next year because she takes quite a few
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prescription drugs, she will reach the coverage gap, and wants to be sure she has
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enough money set aside for those months. She received assistance calculating her
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projected expenses from her daughter who is a pharmacist, but she doesn't think
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the calculations are correct because her out-of-pocket expenses would be lower
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than last year. She calls to ask if you can help. What might you tell her? - Correct
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Answer-d. It would not be unusual for her costs to be a bit less because the
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Bipartisan Budget Act of 2018 moved up the date for closing the so-called "donut
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hole" for brand name drugs to 2019.
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7) Mr. Jacob understands that there is a standard Medicare Part D prescription drug
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benefit, but when he looks at information on various plans available in his area, he
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sees a wide range in what they charge for deductibles, premiums and cost sharing.
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How can you explain this to him? - Correct Answer-a. Medicare Part D drug plans
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_may have different benefit structures, but on average, they must all be at least as
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good as the standard model established by the government.
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8) Ms. Edwards is enrolled in a Medicare Advantage plan that includes prescription
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drug plan (PDP) coverage. She is traveling and wishes to fill two of her
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prescriptions that she has lost. How would you advise her? - Correct Answer-d. _ _ _ _ _ _ _ _ _ _ _ _ _




She may fill prescriptions for covered drugs at non-network pharmacies, but likely
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at a higher cost than paid at an in-network pharmacy.
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