AHIP 2024 final exam with Actual Questions and
Answers Verified by Expert | 2024-2025
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>>He will need to enroll in a Medicare prescription drug plan upon becoming eligible
for the program in order to avoid a premium penalty. To reduce his expenses, he should look
for a plan with a zero premium.
Mr. Schultz 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. Schultz has lost his employer group coverage within the last two weeks. How would you
advise him? - ANSWER>>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.
Mrs. Fields wants to know whether applying for the Part D low income subsidy will be worth
the time to fill out the paperwork. What could you tell her? - ANSWER>>The Part D low income
subsidy could substantially lower her overall costs. She can apply by contacting her state
Medicaid office, or calling the Social Security Administration.
,Mrs. Quinn has just turned 65, is in excellent health and has a relatively high income. She uses
no medications and sees no reason to spend money on a Medicare prescription drug plan if she
does not need the coverage. She currently does not have creditable coverage. What could you
tell her about the implications of such a decision? - ANSWER>>If she does not sign up for a
Medicare prescription drug plan as soon as she is eligible to do so, if she does sign up at a later
date, her premium will be permanently increased by 1% of the national average premium for
every month that she was not covered.
Mrs. Imelda Diaz is a Medicare beneficiary enrolled in a MA-PD plan you represent. Her
neighbor recently suffered from a painful case of shingles. Mrs. Diaz hopes to avoid such an
illness through vaccination. She asks you whether the cost of shingles vaccination will be
covered under the plan you represent. What should you say? - ANSWER>>Yes, there is no cost
sharing for the shingles vaccine even in the deductible phase of her prescription drug plan
because it is an adult vaccine recommended by the Advisory Committee on Immunization
Practices (AICP).
Mrs. Walters is entitled to Part A and has medical coverage without drug coverage through an
employer retiree plan. She is not enrolled in Part B. Since the employer plan does not cover
prescription drugs, she wants to enroll in a Medicare prescription drug plan. Will she be able
to? - ANSWER>>Yes. Mrs. Walters must be entitled to Part A or enrolled in Part B to be eligible
for coverage under the Medicare prescription drug program.
, Mr. Shapiro gets by on a very small amount of 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? - ANSWER>>The extra help
is available to beneficiaries whose income and assets do not exceed annual limits specified by
the government.
Which of the following statements about Medicare Part D are correct? - ANSWER>>I, II, and III
only
-I. Part D plans must enroll any eligible beneficiary who applies regardless of health status
except in limited circumstances.
II. Private fee-for-service (PFFS) plans are not required to use a pharmacy 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.
Mrs. Roberts has Original Medicare and would like to enroll in a Private Fee-for-Service (PFFS)
plan. All types of PFFS plans are available in her area. Which options could Mrs. Roberts
consider before selecting a PFFS plan? - ANSWER>>A Medicare Advantage Prescription Drug
(MA-PD) PFFS plan that combines medical benefits and Part D prescription drug coverage, a
Answers Verified by Expert | 2024-2025
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>>He will need to enroll in a Medicare prescription drug plan upon becoming eligible
for the program in order to avoid a premium penalty. To reduce his expenses, he should look
for a plan with a zero premium.
Mr. Schultz 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. Schultz has lost his employer group coverage within the last two weeks. How would you
advise him? - ANSWER>>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.
Mrs. Fields wants to know whether applying for the Part D low income subsidy will be worth
the time to fill out the paperwork. What could you tell her? - ANSWER>>The Part D low income
subsidy could substantially lower her overall costs. She can apply by contacting her state
Medicaid office, or calling the Social Security Administration.
,Mrs. Quinn has just turned 65, is in excellent health and has a relatively high income. She uses
no medications and sees no reason to spend money on a Medicare prescription drug plan if she
does not need the coverage. She currently does not have creditable coverage. What could you
tell her about the implications of such a decision? - ANSWER>>If she does not sign up for a
Medicare prescription drug plan as soon as she is eligible to do so, if she does sign up at a later
date, her premium will be permanently increased by 1% of the national average premium for
every month that she was not covered.
Mrs. Imelda Diaz is a Medicare beneficiary enrolled in a MA-PD plan you represent. Her
neighbor recently suffered from a painful case of shingles. Mrs. Diaz hopes to avoid such an
illness through vaccination. She asks you whether the cost of shingles vaccination will be
covered under the plan you represent. What should you say? - ANSWER>>Yes, there is no cost
sharing for the shingles vaccine even in the deductible phase of her prescription drug plan
because it is an adult vaccine recommended by the Advisory Committee on Immunization
Practices (AICP).
Mrs. Walters is entitled to Part A and has medical coverage without drug coverage through an
employer retiree plan. She is not enrolled in Part B. Since the employer plan does not cover
prescription drugs, she wants to enroll in a Medicare prescription drug plan. Will she be able
to? - ANSWER>>Yes. Mrs. Walters must be entitled to Part A or enrolled in Part B to be eligible
for coverage under the Medicare prescription drug program.
, Mr. Shapiro gets by on a very small amount of 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? - ANSWER>>The extra help
is available to beneficiaries whose income and assets do not exceed annual limits specified by
the government.
Which of the following statements about Medicare Part D are correct? - ANSWER>>I, II, and III
only
-I. Part D plans must enroll any eligible beneficiary who applies regardless of health status
except in limited circumstances.
II. Private fee-for-service (PFFS) plans are not required to use a pharmacy 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.
Mrs. Roberts has Original Medicare and would like to enroll in a Private Fee-for-Service (PFFS)
plan. All types of PFFS plans are available in her area. Which options could Mrs. Roberts
consider before selecting a PFFS plan? - ANSWER>>A Medicare Advantage Prescription Drug
(MA-PD) PFFS plan that combines medical benefits and Part D prescription drug coverage, a
