2024 AHIP Module 3 Questions And Correct
Answers, Complete Verified Solution.
Mrs. Imelda Diaz is a Medicare beneficiary enrolled in a MA-PD plan you
represent. Her neighbor recently suffered from a painful case of shingles. Mrs.
Diaz hopes to avoid such an illness through vaccination. She asks you whether
the cost of shingles vaccination will be covered under the plan you represent.
What should you say?
Yes, there is no cost sharing for the shingles vaccine even in the deductible phase of
her prescription drug plan because it is an adult vaccine recommended by the Advisory
Committee on Immunization Practices (AICP).
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 and/or enrolled in Part B to be eligible for
coverage under the Medicare prescription drug program.
Mrs. Berkowitz wants to enroll in a Medicare Advantage plan that does not
include drug coverage and also enroll in a stand-alone Medicare prescription
drug plan. Under what circumstances can she do this?
If the Medicare Advantage plan is a Private Fee-for-Service (PFFS) plan that does not
offer drug coverage or a Medical Savings Account plan, Mrs. Berkowitz can do this.
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.
Mr. Shapiro gets by on a very small amount of fixed income. He has heard there
may be extra help paying for Part D prescription drugs for Medicare beneficiaries
with limited income. He wants to know whether he might qualify. What should you
tell him?
The extra help is available to beneficiaries whose income and assets do not exceed
annual limits specified by the government.
Which of the following statements about Medicare Part D are correct?
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.
Answers, Complete Verified Solution.
Mrs. Imelda Diaz is a Medicare beneficiary enrolled in a MA-PD plan you
represent. Her neighbor recently suffered from a painful case of shingles. Mrs.
Diaz hopes to avoid such an illness through vaccination. She asks you whether
the cost of shingles vaccination will be covered under the plan you represent.
What should you say?
Yes, there is no cost sharing for the shingles vaccine even in the deductible phase of
her prescription drug plan because it is an adult vaccine recommended by the Advisory
Committee on Immunization Practices (AICP).
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 and/or enrolled in Part B to be eligible for
coverage under the Medicare prescription drug program.
Mrs. Berkowitz wants to enroll in a Medicare Advantage plan that does not
include drug coverage and also enroll in a stand-alone Medicare prescription
drug plan. Under what circumstances can she do this?
If the Medicare Advantage plan is a Private Fee-for-Service (PFFS) plan that does not
offer drug coverage or a Medical Savings Account plan, Mrs. Berkowitz can do this.
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.
Mr. Shapiro gets by on a very small amount of fixed income. He has heard there
may be extra help paying for Part D prescription drugs for Medicare beneficiaries
with limited income. He wants to know whether he might qualify. What should you
tell him?
The extra help is available to beneficiaries whose income and assets do not exceed
annual limits specified by the government.
Which of the following statements about Medicare Part D are correct?
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.
