AHIP 2025 MODULE 5 EXAM QUESTIONS AND
ANSWERS 100% CORRECT!!
, Mrs. Roswell is a new Medicare beneficiary who has just retired from retail work. She is
interested in selecting a Medicare Part D prescription drug plan. She takes several
medications and is concerned that she has not been able to identify a plan that covers
all of her medications. She does not want to make an abrupt change to new drugs that
would be covered and asks what she should do. What should you tell her? - ANSWER
Every Part D drug plan is required to cover a single one-month fill of her existing
medications sometime during a 90-day transition period.
What types of tools can Medicare Part D prescription drug plans use that affect the way
their enrollees can access medications? - ANSWER INCORRECT Part D plans do not
have to cover all medications. As a result, their formularies, or lists of covered drugs,
will vary from plan to plan. In addition, they can use cost containment techniques such
as tiered co-payments and prior authorization.
Mr. Hildalgo complains to you that because he takes multiple expensive drugs, he has
trouble paying his cost sharing for his prescription drugs, particularly at the beginning of
the year during the deductible phase. He is happy with his plan and does not want to
change. However, he said he had heard about a new program called the Medicare
Prescription Payment Plan and asked whether it might help. What do you tell him? -
ANSWER The Medicare Prescription Payment Plan helps spread out beneficiary cost-
sharing payments but does not decrease the total amount owed.
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? - ANSWER 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.
One of your clients, Lauren Nichols, has heard about a Medicare concept from one of
her neighbors called TrOOP. She asks you to explain it. What do you say? - ANSWER
Mr. and Mrs. Vaughn both take a specialized multivitamin prescription each day. Mr.
Vaughn takes a prescription to help to regrow his hair. They are anxious to have their
Medicare prescription drug plan cover these drug needs. What should you tell them? -
ANSWER d.
ANSWERS 100% CORRECT!!
, Mrs. Roswell is a new Medicare beneficiary who has just retired from retail work. She is
interested in selecting a Medicare Part D prescription drug plan. She takes several
medications and is concerned that she has not been able to identify a plan that covers
all of her medications. She does not want to make an abrupt change to new drugs that
would be covered and asks what she should do. What should you tell her? - ANSWER
Every Part D drug plan is required to cover a single one-month fill of her existing
medications sometime during a 90-day transition period.
What types of tools can Medicare Part D prescription drug plans use that affect the way
their enrollees can access medications? - ANSWER INCORRECT Part D plans do not
have to cover all medications. As a result, their formularies, or lists of covered drugs,
will vary from plan to plan. In addition, they can use cost containment techniques such
as tiered co-payments and prior authorization.
Mr. Hildalgo complains to you that because he takes multiple expensive drugs, he has
trouble paying his cost sharing for his prescription drugs, particularly at the beginning of
the year during the deductible phase. He is happy with his plan and does not want to
change. However, he said he had heard about a new program called the Medicare
Prescription Payment Plan and asked whether it might help. What do you tell him? -
ANSWER The Medicare Prescription Payment Plan helps spread out beneficiary cost-
sharing payments but does not decrease the total amount owed.
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? - ANSWER 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.
One of your clients, Lauren Nichols, has heard about a Medicare concept from one of
her neighbors called TrOOP. She asks you to explain it. What do you say? - ANSWER
Mr. and Mrs. Vaughn both take a specialized multivitamin prescription each day. Mr.
Vaughn takes a prescription to help to regrow his hair. They are anxious to have their
Medicare prescription drug plan cover these drug needs. What should you tell them? -
ANSWER d.
