AHIP FINAL EXAM TEST QUESTIONS LATEST VERSION 2022-2024/AHIP FINAL EXAM TEST REAL EXAM QUESTIONS AND ANSWERS

AHIP FINAL EXAM
TEST QUESTIONS
LATEST VERSION
2022-2024/AHIP FINAL
EXAM TEST REAL
EXAM QUESTIONS AND
ANSWERS

Mrs. Reeves is newly eligible to enroll in a Medicare
Advantage plan and her MA Initial Coverage Election Period (ICEP) has just begun. Which of the following can she not do during the ICEP? - ANSWER-She can enroll in a Medigap plan to supplement the benefits of the MA plan that she's also enrolling in.

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.

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. Bickford did not quite qualify for the extra help lowincome 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.

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 innetwork pharmacy

Mr. and Mrs. Vaughn both take a specialized multivitamin prescription each day. Mr. Vaughn takes a prescription for helping 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 Vaughn's could look into that possibility.

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? - ANSWER-Mr. Schultz should enroll in a Part D plan before he has a 63day break in coverage in order to avoid a premium penalty.

Which of the following individuals is most likely to be eligible to enroll in a Part D Plan? - ANSWER-Jose, having been granted asylum, is legally present in the United States thus meeting one of the criteria for Part D eligibility.

What types of tools can Medicare Part D prescription drug plans use that affect the way their enrollees can access medications? - ANSWER-Part D plans do not have to cover all medications. As a result, their formularies, or lists of covered drugs, will vary from plan to plan. In addition, they can use cost containment techniques such as tiered copayments and prior authorization. (not b)

Mr. 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? - ANSWER-Medicare Part D drug plans may have different benefit structures, but on average, they must all be at least as good as the standard model established by the government.