Ahip 2024 module 3
Which of the following statements about Medicare Part D are correct? - ANSI, 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? -
ANSMr. 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 become
Medicare eligible for the first time. What issues might she consider about whether to enroll in a
Medicare prescription drug plan? - ANSShe 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? - ANSThe 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?
- ANSYes. Mrs. Walters must be entitled to Part A or enrolled in Part B to be eligible for
coverage under the Medicare prescription drug program.
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? - ANSIn
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? - ANSI, 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? -
ANSMr. 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 become
Medicare eligible for the first time. What issues might she consider about whether to enroll in a
Medicare prescription drug plan? - ANSShe 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? - ANSThe 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?
- ANSYes. Mrs. Walters must be entitled to Part A or enrolled in Part B to be eligible for
coverage under the Medicare prescription drug program.
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? - ANSIn
general, he must select a single Part D premium payment mechanism that will be used
throughout the year.
