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2025 AHIP Final EXAM 2024 AND PRACTICE QUESTIONS |ACCURATE ANSWERS| VERIFIED FOR GUARANTEED PASS |GRADED A |NEW VERSION WITH 100+ QUESTIONS$25.49
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2025 AHIP Final EXAM 2024 AND
PRACTICE QUESTIONS |ACCURATE
ANSWERS| VERIFIED FOR GUARANTEED
PASS |GRADED A |NEW VERSION WITH
100+ QUESTIONS
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?
- ANSWER He could check with the manufacturers of his medications to see if
they offer an assistance program to help people with limited means to 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.
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?
- ANSWER 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.
Mr. and Mrs. Vaughn both take a specialized multivitamin prescription each day.
Mr. Vaughn takes a prescription to help to regrow his hair. They are anxious to
have their Medicare prescription drug plan cover these drug needs. What should
you tell them?
,- ANSWER Medicare prescription drug plans are not permitted to cover the
prescription medications the Vaughns are interested in under Part D coverage,
however, plans may cover them as supplemental benefits and the Vaughns could
look into that possibility.
Mr. Hildalgo complains to you that because he takes multiple expensive drugs, he
has trouble paying his cost sharing for his prescription drugs, particularly at the
beginning of the year during the deductible phase. He is happy with his plan and
does not want to change. However, he said he had heard about a new program
called the Medicare Prescription Payment Plan and asked whether it might help.
What do you tell him?
- ANSWER The Medicare Prescription Payment Plan helps spread out beneficiary
cost-sharing payments but does not decrease the total amount owed.
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?
- ANSWER In general, he must select a single Part D premium payment
mechanism that will be used throughout the year.
One of your clients, Lauren Nichols, has heard about a Medicare concept from one
of her neighbors called TrOOP. She asks you to explain it. What do you say?
- ANSWER TrOOP stands for true out-of-pocket costs that count toward the
Medicare Part D catastrophic limit and include not only expenses paid by a
beneficiary but also in some instances amounts paid by or through qualified State
Pharmaceutical Assistance Programs.
, Mr. Zachow has a condition for which three drugs are available. He has tried two
but had an allergic reaction to them. Only the third drug works for him and it is
not on his Part D plan's formulary. What could you tell him to do?
- ANSWER Mr. Zachow has a right to request a formulary exception to obtain
coverage for his Part D drug. He or his physician could obtain the standardized
request form on the plan's website, fill it out, and submit it to his plan.
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?
- ANSWER If a Part D benefit is offered through her plan she may choose to enroll
in that plan or a standalone PDP.
Mrs. Hernandez is one of your clients. She has read that there is a new program
that may help her manage prescription drug costs. What do you tell her about the
Medicare Prescription Payment Plan?
- ANSWER Part D enrollees can opt into the Medicare Prescription Payment Plan at
the beginning of the plan year or any point during the year.
Ms. Edwards is enrolled in a Medicare Advantage plan that includes prescription
drug plan (PDP) coverage. She is traveling and wishes to fill two of the
prescriptions that she has lost. How would you advise her?
- ANSWER She may fill prescriptions for covered drugs at non-network
pharmacies, but likely at a higher cost than paid at an in-network pharmacy.
During a sales presentation to Ms. Daley for a Medicare Advantage plan that has a
5-star rating in customer service and care coordination, and received an overall
plan performance rating of a 4-star, which of the following would be the best
statement to say to her?
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