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Ahip module 3 final questions and answers 2015/2016
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Ahip 2024 module 3 final1.
2. 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? >ANS>Mr. 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.
3. Mr. Bickford did not quite qualify for the extra help low-income subsidy under the
Medicare Part D Prescription Drug program and he is wondering if there is any other
option he has for obtaining help with his considerable drug costs. What should you tell
him? >ANS>He could check with the manufacturers of his medications to see if they
offer an assistance program to help people with limited means obtain the medications
they need. Alternatively, he could check to see whether his state has a pharmacy
assistance program to help him with his expenses.
4. 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? >ANS>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.
5. Mr. Hutchinson has drug coverage through his former employer's retiree plan. He is
concerned about the Part D premium penalty if he does not enroll in a Medicare
prescription drug plan, but does not want to purchase extra coverage that he will not
need. What should you tell him? >ANS>If the drug coverage he has is not expected to
pay, on average, at least as much as Medicare's standard Part D coverage expects to
pay, then he will need to enroll in Medicare Part D during his initial eligibility period to
avoid the late enrollment penalty.
6. 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? >ANS>Medicare 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.
7. Mr. Schultz was still working when he first qualified for Medicare. At that time, he had
employer group coverage that was creditable. During his initial Part D eligibility period,
he decided not to enroll because he was satisfied with his drug coverage. It is now a
year later and Mr. Schultz has lost his employer group coverage within the last two
weeks. How would you advise him? >ANS>Mr. Schultz should enroll in a Part D plan
before he has a 63-day break in coverage in order to avoid a premium penalty.
8. Mr. Shapiro gets by on a very small amount of fixed income. He has heard there may be
extra help paying for Part D prescription drugs for Medicare beneficiaries with limited
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