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Exam (elaborations)

AHIP 2024 MODULE 3 QUESTIONS AND ANSWER | LATEST UPDATE

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Which of the following statements about Medicare Part D are correct? -:- I, II, and III only -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 pharma...

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  • September 17, 2024
  • 8
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers
  • AHIP
  • AHIP
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2024 /2025 | © copyright | This work may not be copied for profit gain | Excel!




AHIP 2024 MODULE 3 QUESTIONS AND
ANSWER | LATEST UPDATE
Which of the following statements about Medicare Part D are correct?


✓ -:- I, II, and III only

-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.




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?


✓ -:- 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.




Mrs. Fiore is a retired federal worker with coverage under a Federal Employee Health

Benefits (FEHB) plan that includes creditable drug coverage. She is ready to turn 65 and


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, 2024 /2025 | © copyright | This work may not be copied for profit gain | Excel!


become Medicare eligible for the first time. What issues might she consider about whether

to enroll in a Medicare prescription drug plan?


✓ -:- She could compare the coverage to see if the Medicare Part D plan

offers better benefits and coverage than the FEHB plan for the specific

medications she needs and whether any additional benefits are worth the

Part D premium costs on top of her FEHB contribution.




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?


✓ -:- 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?


✓ -:- Yes. Mrs. Walters must be entitled to Part A or enrolled in Part B to

be eligible for coverage under the Medicare prescription drug program.




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