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AHIP Module 3 Verified Solutions

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AHIP Module 3 Verified Solutions Question 1: Why do Medicare Part D plans vary in terms of their coverage and costs? Answer: Medicare Part D plans may have different benefit structures, but on average, they must cover all medications to the same level as the standard model established by the ...

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  • July 19, 2024
  • 4
  • 2023/2024
  • Exam (elaborations)
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AHIP Module 3 Verified Solutions
Question 1: Why do Medicare Part D plans vary in terms of their coverage and costs?



Answer: Medicare Part D plans may have different benefit structures, but on average, they must cover
all medications to the same level as the standard model established by the government.



Question 2: What tools do Medicare Part D plans use to affect access to medications?



Answer: Part D plans can use cost containment techniques such as tiered co-payments and prior
authorization, and their formularies will vary from plan to plan.



Question 3: What can Mrs. Edwards do if she needs to fill her prescriptions while traveling?



Answer: She may fill prescriptions at non-network pharmacies, but likely at a higher cost than at an in-
network pharmacy.



Question 4: Can Mrs. Mulcahy enroll in a Medicare prescription drug plan despite not being enrolled
under Medicare Part B?



Answer: Yes, an individual who is entitled to Part A or enrolled under Part B is eligible to enroll in a
Medicare prescription drug plan. Mrs. Mulcahy does not need to enroll under Part B before enrolling in
a prescription drug plan.



Question 5: What should Mr. Hutchinson do about enrolling in a Medicare prescription drug plan?



Answer: If his employer retiree plan does not expect to pay at least as much as Medicare's standard Part
D coverage expects to pay, he will need to enroll in Medicare Part D during his initial eligibility period to
avoid the late enrollment penalty.



Question 6: Which statements about Medicare Part D are correct?

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