AHIP Module 3 Actual Exam 2025 Latest
Update Questions and Correct Answers
Rated A+
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? -Answer-
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.
Mrs. Mulcahy is concerned that she may not qualify for enrollment in a
Medicare prescription drug plan because, although she is entitled to
Part A, she is not enrolled under Medicare Part B. What should you
tell her? -Answer-d. Everyone who is entitled to Part A or enrolled
under Part B is eligible to enroll in a Medicare prescription drug plan.
As long as Mrs. Mulcahy is entitled to Part A, she does not need to
enroll under Part B before enrolling in a prescription drug plan
Mrs. Lopez is enrolled in a Medicare Advantage cost plan. She has
recently lost creditable coverage previously available through her
husband's employer. She is interested in enrolling in a Medicare Part
D prescription drug plan (PDP). What should you tell her? -Answer-a.
If a Part D benefit is offered through her plan she may choose in enroll
in that plan or a standalone PDP
Which of the following statements about Medicare Part D are correct?
, 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.
IV. Beneficiaries enrolled in a MA-PPO may obtain Part D benefits
through a standalone PDP or through their plan. -Answer-b. I, II, and
III only
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? -Answer-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.
Mrs. Andrews was preparing a budget for next year because she
takes quite a few prescription drugs, she will reach the coverage gap,
and wants to be sure she has enough money set aside for those
months. She received assistance calculating her projected expenses
from her daughter who is a pharmacist, but she doesn't think the
calculations are correct because her out-of-pocket expenses would be
lower than last year. She calls to ask if you can help. What might you
tell her? -Answer-d. It would not be unusual for her costs to be a bit
less because the Bipartisan Budget Act of 2018 moved up the date for
closing the so-called "donut hole" for brand name drugs to 2019.
Mr. Jacob understands that there is a standard Medicare Part D
prescription drug benefit, but when he looks at information on various
Update Questions and Correct Answers
Rated A+
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? -Answer-
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.
Mrs. Mulcahy is concerned that she may not qualify for enrollment in a
Medicare prescription drug plan because, although she is entitled to
Part A, she is not enrolled under Medicare Part B. What should you
tell her? -Answer-d. Everyone who is entitled to Part A or enrolled
under Part B is eligible to enroll in a Medicare prescription drug plan.
As long as Mrs. Mulcahy is entitled to Part A, she does not need to
enroll under Part B before enrolling in a prescription drug plan
Mrs. Lopez is enrolled in a Medicare Advantage cost plan. She has
recently lost creditable coverage previously available through her
husband's employer. She is interested in enrolling in a Medicare Part
D prescription drug plan (PDP). What should you tell her? -Answer-a.
If a Part D benefit is offered through her plan she may choose in enroll
in that plan or a standalone PDP
Which of the following statements about Medicare Part D are correct?
, 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.
IV. Beneficiaries enrolled in a MA-PPO may obtain Part D benefits
through a standalone PDP or through their plan. -Answer-b. I, II, and
III only
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? -Answer-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.
Mrs. Andrews was preparing a budget for next year because she
takes quite a few prescription drugs, she will reach the coverage gap,
and wants to be sure she has enough money set aside for those
months. She received assistance calculating her projected expenses
from her daughter who is a pharmacist, but she doesn't think the
calculations are correct because her out-of-pocket expenses would be
lower than last year. She calls to ask if you can help. What might you
tell her? -Answer-d. It would not be unusual for her costs to be a bit
less because the Bipartisan Budget Act of 2018 moved up the date for
closing the so-called "donut hole" for brand name drugs to 2019.
Mr. Jacob understands that there is a standard Medicare Part D
prescription drug benefit, but when he looks at information on various
