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AHIP 2024/ 2025 Module 3 graded A+
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AHIP 2024/ 2025 Module 3 graded A+
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AHIP 2024 Module 3Mr. 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? - ANSMr. 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. 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? - ANSA Medicare Advantage Prescription Drug
(MA-PD) PFFS plan that combines medical benefits and Part D prescription drug coverage, a
PFFS plan offering only medical benefits, or a PFFS plan in combination with a stand-alone
prescription drug plan.
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 him?
- ANSMedicare Part D drug plans may have different benefit structures, but on average, they
must all be at least as good as the standard model established by the government.
Mrs. Fiore is a retired federal worker with coverage under a Federal Employee Health Benefits
(FEHB) plan that includes creditable drug coverage. She is ready to turn 65 and become
Medicare eligible for the first time. What issues might she consider about whether to enroll in a
Medicare prescription drug plan? - ANSShe could compare the coverage to see if the Medicare
Part D plan offers better benefits and coverage than the FEHB plan for the specific medications
she needs and whether any additional benefits are worth the Part D premium costs on top of her
FEHB contribution.
Charles McCarthy is a Medicare beneficiary who suffers from diabetes. Mr. McCarthy is
considering enrollment in a MA-PD plan that you represent. He asks you whether his insulin
costs will be covered. What should you say? - ANSMr. McCarthy's insulin costs for a one-month
supply cannot be more than $35 in any coverage phase under the prescription drug plan
beginning in 2023.
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?
- ANSYes. Mrs. Walters must be entitled to Part A and/or enrolled in Part B to be eligible for
coverage under the Medicare prescription drug program.
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