AHIP 2026 Final Exam | Questions with Verified Answers| Graded A+ | 100% Correct.

AHIP 2026 Final Exam | Questions with Verified
Answers| Graded A+ | 100% Correct.


Question:

Mrs. Castro has just turned 65, is in excellent health and has a relatively
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high income. She uses no medications and sees no reason to spend
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money on a Medicare prescription drug plan if she does not need the
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coverage. She currently does not have creditable coverage. What could
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you tell her about the implications of such a decision??
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Answer:

If she does not sign up for a Medicare prescription drug plan as soon as
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she is eligible to do so, and if she does sign up at a later date, her
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premium will be permanently increased by 1% of the national average
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premium for every month that she was not covered.
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Question:
Mr. Chen was still working when he first qualified for Medicare. At that
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time, he had employer group coverage that was creditable. During his
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initial Part D eligibility period, he decided not to enroll because he was
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satisfied with his drug coverage. It is now a year later and Mr. Chen has
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lost his employer group coverage within the last two weeks. How would
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you advise him??
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Answer:

Mr. Chen should enroll in a Part D plan before he has a 63-day break in
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coverage in order to avoid a premium penalty.
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,Question:

Ms. Ramos is enrolled in a Medicare Advantage plan that includes
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prescription drug plan (PDP) coverage. She is traveling and wishes to fill
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two of the prescriptions that she has lost. How would you advise her??
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Answer:

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

What types of tools can Medicare Part D prescription drug plans use that
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affect the way their enrollees can access medications??
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Answer:
Part D plans do not have to cover all medications. As a result, their
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formularies, or lists of covered drugs, will vary from plan to plan. In
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addition, they can use cost containment techniques such as tiered co-
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payments and step therapy. i,- i,- i,-




Question:
Mrs. Esmeralda Avila is a Medicare beneficiary enrolled in a MA-PD plan
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you represent. Her neighbor recently suffered from a painful case of
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shingles. Mrs. Avila hopes to avoid such an illness through vaccination.
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, She asks you whether the cost of the shingles vaccination will be covered
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under the plan you represent. What should you say??
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Answer:

Yes, there is no cost sharing for the shingles vaccine even in the
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deductible phase of her prescription drug plan because it is an adult
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vaccine recommended by the Advisory Committee on Immunization
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Practices (AICP). i,-




Question:

Mrs. Strickland is a new Medicare beneficiary who has just retired from
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retail work. She is interested in selecting a Medicare Part D prescription
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drug plan. She takes several medications and is concerned that she has
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not been able to identify a plan that covers all of her medications. She
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does not want to make an abrupt change to new drugs that would be
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covered and asks what she should do. What should you tell her??
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Answer:
Every Part D drug plan is required to cover a single one-month fill of her
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existing medications sometime during a 90-day transition period.
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Question:
Mrs. Nguyen is a retired federal worker with coverage under a Federal
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Employee Health Benefits (FEHB) plan that includes creditable drug
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coverage. She is ready to turn 65 and become Medicare eligible for the
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first time. What issues might she consider about whether to enroll in a
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Medicare prescription drug plan?? i,- i,- i,-