Unite -2024-Medicare Basics Assessment
Margaret currently has an MAPD Plan. What would happen if you enrolled her into a stand-alone PDP? -
CORRECT ANS-She would be disenrolled automatically from her MAPD Plan.
What is Medicare Part D? -CORRECT ANS-A voluntary program, offered by private insurance companies
that are contracted with the federal government, that provides prescription drug coverage for an
additional monthly plan premium
Which of the following statements is true about eligibility requirements for stand-alone Medicare
Prescription Drug Plans? -CORRECT ANS-A consumer must be entitled to Medicare Part A and/or
enrolled in Medicare Part B
Aside from a Medicare Advantage Plan or other health plan that includes prescription drug coverage,
how else could a Medicare-eligible consumer get Part D prescription drug coverage? -CORRECT ANS-
They could enroll in a stand-alone Medicare Prescription Drug Plan (PDP).
In what order do the four prescription drug coverage stages occur? -CORRECT ANS-Deductible, Initial
Coverage, Coverage Gap, Catastrophic Coverage
Which of these statements is true about the drug utilization management (UM) rules? -CORRECT ANS-
Prior authorization, quantity limit, and step therapy are some examples of UM rules.
A consumer may have to pay a Late Enrollment Penalty (LEP) if they did NOT enroll in a Medicare
Advantage plan with Part D benefits or stand-alone prescription drug plan when they were first eligible
for Medicare Parts A and/or B or went without creditable prescription drug coverage for
______________. -CORRECT ANS-63 or more continuous days
Through which means is financial assistance offered to a consumer who qualifies for Low Income
Subsidy for their part of Medicare Part D costs? -CORRECT ANS-Through subsidies such as lower or no
monthly plan premiums and lower or no copayments
Formulary is defined as: -CORRECT ANS-A list of medications covered within the benefit plan, based on
CMS guidelines and developed in collaboration with physicians and pharmacists.
Margaret currently has an MAPD Plan. What would happen if you enrolled her into a stand-alone PDP? -
CORRECT ANS-She would be disenrolled automatically from her MAPD Plan.
What is Medicare Part D? -CORRECT ANS-A voluntary program, offered by private insurance companies
that are contracted with the federal government, that provides prescription drug coverage for an
additional monthly plan premium
Which of the following statements is true about eligibility requirements for stand-alone Medicare
Prescription Drug Plans? -CORRECT ANS-A consumer must be entitled to Medicare Part A and/or
enrolled in Medicare Part B
Aside from a Medicare Advantage Plan or other health plan that includes prescription drug coverage,
how else could a Medicare-eligible consumer get Part D prescription drug coverage? -CORRECT ANS-
They could enroll in a stand-alone Medicare Prescription Drug Plan (PDP).
In what order do the four prescription drug coverage stages occur? -CORRECT ANS-Deductible, Initial
Coverage, Coverage Gap, Catastrophic Coverage
Which of these statements is true about the drug utilization management (UM) rules? -CORRECT ANS-
Prior authorization, quantity limit, and step therapy are some examples of UM rules.
A consumer may have to pay a Late Enrollment Penalty (LEP) if they did NOT enroll in a Medicare
Advantage plan with Part D benefits or stand-alone prescription drug plan when they were first eligible
for Medicare Parts A and/or B or went without creditable prescription drug coverage for
______________. -CORRECT ANS-63 or more continuous days
Through which means is financial assistance offered to a consumer who qualifies for Low Income
Subsidy for their part of Medicare Part D costs? -CORRECT ANS-Through subsidies such as lower or no
monthly plan premiums and lower or no copayments
Formulary is defined as: -CORRECT ANS-A list of medications covered within the benefit plan, based on
CMS guidelines and developed in collaboration with physicians and pharmacists.
