20222023 ahip module 3 questions and answers 100 correct
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2022/2023 AHIP MODULE 3 - QUESTIONS AND ANSWERS (100% CORRECT)
2022/2023 AHIP MODULE 3 - QUESTIONS AND ANSWERS (100%
CORRECT)
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? Correct
Ans - 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. Correct
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? Correct Ans - 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. Correct
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? Correct Ans -
a. If a Part D benefit is offered through her plan she may choose in
enroll in that plan or a standalone PDP. Correct
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. Correct Ans - b. I, II,
and III only Correct
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? Correct Ans
- 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. Correct
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? Correct
Ans - 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. Correct
Mr. Jacob understands that there is a standard Medicare Part D
prescription drug benefit, but when he looks at information on various
plans available in his area, he sees a wide range in what they charge for
deductibles, premiums and cost sharing. How can you explain this to
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