AHIP 2024 Module 3 Exam Questions and Answers, With
Complete Solution.
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 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.
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?
In general, he must select a single Part D premium payment mechanism that will be
used throughout the year.
Complete Solution.
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 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.
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?
In general, he must select a single Part D premium payment mechanism that will be
used throughout the year.
