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AHIP 2022 Module 3 Questions And Answers
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AHIP 2022 Module 3 Questions And AnswersMr. 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? Correct
Answer: Part D plans must cover at least the Part D standard benefits or its actuarial equivalent. They
are not required to offer the standard plan.
Question text
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. What should you tell him? Correct Answer: In
general, he must select a single Part D premium payment mechanism that will be used throughout
the year.
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 Answer: Beneficiaries enrolled in an MA-PPO may not obtain Part D
benefits through a standalone PDP or through their plan. They must obtain them through their plan by
enrolling in an MA-PD.
Mrs. Mulcahy, age 65, 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 Answer: Mrs. Mulcahy can enroll in Part D because she is entitled
to Part A. The rules for Part D are different from those that apply to eligibility for Medicare Advantage
(Part C). Individuals entitled to Part A and/or enrolled in Part B are eligible to enroll in Part D. In
contrast, to enroll in an MA plan an individual must be eligible for Part A and enrolled in Part B.
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? Correct Answer: To
avoid a late enrollment penalty, Mr. Hutchinson must have "creditable" coverage. If he does not, he
must enroll in Medicare Part D during his initial eligibility period to avoid a late enrollment penalty.
Mrs. Lopez is enrolled in a cost plan for her Medicare benefits. 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 Answer: If a Part D
benefit is offered through her plan she may choose to enroll in that plan or a standalone PDP.
Mr. Wingate is a newly enrolled Medicare Part D beneficiary and one of your clients. In addition to
drugs on his plan's formulary he takes several other medications. These include a prescription drug
not on his plan's formulary, over-the-counter medications for colds and allergies, vitamins, and drugs
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