AHIP Module 3 quizzes with complete answers graded A+
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AHIP Module 3
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AHIP Module 3
AHIP Module 3 quizzes with complete answers graded A+
Which of the following statements about Medicare Part D are correct?
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-servic...
ahip module 3 quizzes with complete answers graded a
which of the following statements about medicare part d are correct
mr rice has coverage for medical services and medications through his employ
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AHIP Module 3
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.
Mr. Rice has coverage for medical services and medications through his employer's
retiree plan. He is considering switching to a Medicare prescription drug plan because
his retiree plan does not cover two important medications. What should he consider
before making a change? - Answer If Mr. Rice drops his drug coverage through the
retiree plan, he may not be able to get it back and he also may lose his medical health
coverage.
What types of tools can Medicare Part D prescription drug plans use that affect the way
their enrollees can access medications? - Answer 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.
Mrs. Allen has a rare condition for which two different brand name drugs are the only
available treatment. She is concerned that since no generic prescription drug is
available and these drugs are very high cost, she will not be able to find a Medicare Part
D prescription drug plan that covers either one of them. What should you tell her? -
Answer Medicare prescription drug plans are required to cover drugs in each
therapeutic category. She should be able to enroll in a Medicare prescription drug plan
that covers the medications she needs.
Mrs. Fiore was in the Army for 35 years and is now retired. She has drug coverage
through the VA. What issues might she consider with regard to whether to enroll in a
Medicare prescription drug plan? - Answer She could compare the coverage to see if
the Medicare Part D plan offers better benefits and coverage than the VA for the
specific medications she needs and whether any additional benefits are worth the Part
D premium costs.
Mr. and Mrs. Vaughn both take a specialized multivitamin prescription each day. Mr.
Vaughn takes a prescription for helping to regrow his hair. They are anxious to have
their Medicare prescription drug plan cover these drug needs. What should you tell
them? - Answer Medicare prescription drug plans are not permitted to cover the
prescription medications the Vaughns are interested in under Part D coverage,
however, plans may cover them as supplemental benefits and the Vaughn's could look
into that possibility.
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