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Entertaining AHIP 2025 Exam Study Questions and Answers

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Medicare Prescription Payment Plan - Beginning in 2025, the prescription drug law, known as the Inflation Reduction Act, requires all Medicare prescription drug plans (Medicare Part D plans) — including both standalone Medicare prescription drug plans and Medicare Advantage plans with prescriptio...

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  • August 25, 2024
  • 10
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers
  • AHIP .
  • AHIP .
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Entertaining AHIP 2025 Exam Study
Questions and Answers



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AHIP
8/25/24

, Entertaining AHIP 2025 EXAM

Medicare Prescription Payment Plan - Beginning in 2025, the prescription drug law,
known as the Inflation Reduction Act, requires all Medicare prescription drug plans
(Medicare Part D plans) — including both standalone Medicare prescription drug plans
and Medicare Advantage plans with prescription drug coverage — to offer enrollees the
option to pay out-of-pocket prescription drug costs in the form of capped monthly
payments instead of all at once at the pharmacy.


Benefits of Medicare Prescription Payment Plan - Expanding benefits, lowering drug
costs, and improving the sustainability of the Medicare program


What is the Medicare Prescription Payment Plan? - Offers Part D enrollees the option to
pay out-of-pocket prescription drug costs in the form of capped monthly payments
instead of all at once to the pharmacy under the Medicare Prescription Payment Plan.


How does the Medicare Prescription Payment Plan work? - For beneficiaries facing high
costs on their prescriptions, it provides them with the option of paying out-of-pocket drug
costs in installments. It does not offer a discount, just manageable payments


A client enjoys a comfortable retirement income. He recently had surgery and expected
that he would have certain services and items covered by the plan with minimal out-of-
pocket costs because his MA-PD coverage has been very good. However, when he
received the bill, he was surprised to see large charges in excess of his maximum out-
of-pocket limit that included some services and items he thought would be fully covered.
He called you to ask what he could do? What could you tell him? - Medicare Advantage
(MA) plan enrollees have a right to obtain a review (appeal) to certain decisions about
health care payment, coverage of services, or prescription drug coverage. Medicare
health plans must provide enrollees with a written description of the appeals process.


A client is enrolled in her state's Medicaid program in addition to Medicare. What should
she be aware of when considering enrollment in a Medicare Advantage (MA) plan? -



Entertaining AHIP 2025 EXAM

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