2024 AHIP Module 3
Complete Questions & Answers (Solved) 100% Correct
- Mrs. Imelda Diaz is a Medicare beneficiary enrolled in a MA-PD plan you
represent. Her neighbor recently suffered from a painful case of shingles. Mrs. Diaz hopes to avoid such an illness through vaccination. She asks you whether the cost of shingles vaccination will be covered under the plan you represent. What should you say?Answer: Yes, there is no cost sharing for the shingles vaccine even in the deductible phase of her prescription drug plan because it is an adult vaccine recommended by the Advisory Committee on Immunization Practices (AICP).
- Mrs. Fields wants to know whether applying for the Part D low-income subsidy
will be worth the time to fill out the paperwork. What could you tell her?
Answer: The Part D low-income subsidy could substantially lower her overall
costs. She can apply by contacting her state Medicaid office or calling the Social Security Administration.
- 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?Answer: Yes. 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.
- Mrs. Berkowitz wants to enroll in a Medicare Advantage plan that does not
include drug coverage and also enroll in a stand-alone Medicare prescription drug plan. Under what circumstances can she do this?
Answer: If the Medicare Advantage plan is a Private Fee-for-Service (PFFS) plan
that does not offer drug coverage or a Medical Savings Account plan, Mrs. Berkowitz can do this.
- Mr. Torres has a small savings account. He would like to pay for his monthly Part D
premiums with an automatic monthly withdrawal from his savings account until it is exhausted, and then have his premiums withheld from his Social Security check. 1 / 2
What should you tell him?
Answer: In general, he must select a single Part D premium payment mechanism
that will be used throughout the year.
- 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 income. He wants to know whether he might qualify. What should you tell him?Answer: The extra help is available to beneficiaries whose income and assets do not exceed annual limits specified by the government.
- Which of the following statements about Medicare Part D are correct?
- 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.
Answer: I, II, and III only
- Mrs. Quinn has just turned 65, is in excellent health and has a relatively high
income. She uses no medications and sees no reason to spend money on a Medicare prescription drug plan if she does not need the coverage. She currently does not have creditable coverage. What could you tell her about the implications of such a decision?Answer: If she does not sign up for a Medicare prescription drug plan as soon as she is eligible to do so, and if she does sign up at a later date, her premium will be permanently increased by 1% of the national average premium for every month that she was not covered.
- Mrs. Cantwell is enrolled in a prescription drug plan. She has heard about
- Her annual PDP deductible
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something called True-Out-Pocket costs or "TrOOP" and asks you if any of the following count toward reaching the catastrophic coverage phase. What do you say?
II. A drug manufacturer's discount for brand name drugs after her initial coverage period