Ahip 2025 Module 3 Exam
Questions and Answers 100%
PASS
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.
Mr. Rice is 68, actively working, and has coverage for medical services and
medications through his employer's group health plan. He is entitled to
premium free Part A and thinking of enrolling in Part B and switching to an
MA-PD because he is paying a very large part of his group coverage
premium, and it does not provide coverage for a number of his medications.
Which of the following is NOT a consideration when making the change?—
ANSWER-Mr. Rice's retiree plan is required to take him back if, within 63
days of having voluntarily quit the employer's plan, he decides that he
prefers it to his Medicare Part D plan.
, 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.
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.
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.
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.
© 2026 Copyright. All Rights Reserved. This document is
protected by copyright law, Copyrighted By Katelyn Whitman
Questions and Answers 100%
PASS
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.
Mr. Rice is 68, actively working, and has coverage for medical services and
medications through his employer's group health plan. He is entitled to
premium free Part A and thinking of enrolling in Part B and switching to an
MA-PD because he is paying a very large part of his group coverage
premium, and it does not provide coverage for a number of his medications.
Which of the following is NOT a consideration when making the change?—
ANSWER-Mr. Rice's retiree plan is required to take him back if, within 63
days of having voluntarily quit the employer's plan, he decides that he
prefers it to his Medicare Part D plan.
, 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.
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.
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.
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.
© 2026 Copyright. All Rights Reserved. This document is
protected by copyright law, Copyrighted By Katelyn Whitman
