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Ahip Module 3 2025 | Certified Exam
Questions With Correct Answers
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? -correct-answer-b. 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. Correct
Under what conditions can a Medicare prescription drug plan reduce its coverage
for a given drug during the first 60 days of the year? -correct-answer-a. When a
formulary change is in response to a drug's removal from the market. Correct
Which of the following steps may a Part D sponsor adopt for beneficiaries who are
at risk of misusing or abusing frequently abused drugs?
I. Identifying at risk individuals by using criteria that includes the number of opioid
prescriptions the beneficiary has and the number of prescribers who have written
those prescriptions.
II. Locking an at-risk beneficiary into one pharmacy.
III. Locking an at-risk beneficiary into one prescriber.
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IV. Increasing deductibles and copays for at-risk beneficiaries. -correct-answer-b. I,
II and III only Correct
Mrs. Roswell is a new Medicare beneficiary and is interested in selecting a
Medicare Part D prescription drug plan. She takes a number of medications and is
concerned that she has not been able to identify a plan that covers all of her
medications. She does not want to make an abrupt change to new drugs that
would be covered and asks what she should do. What should you tell her? -
correct-answer-a. Every Part D drug plan is required to cover a single one-month
fill of her existing medications sometime during a 90 day transition period. Correct
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? -correct-
answer-d. 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. Correct
Mrs. Quinn has just turned 65, is in excellent health, and has a relatively high
income. She uses no medications and sees no reason to spend money on a
Medicare prescription drug plan if she does not need the coverage. What could
you tell her about the implications of such a decision? -correct-answer-a. If she
does not sign up for a Medicare prescription drug plan as soon as she is eligible to
do so, if she does sign up at a later date, her premium will be permanently
increased by 1% of the national average premium for every month that she was
not covered. Correct
Ahip Module 3 2025 | Certified Exam
Questions With Correct Answers
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? -correct-answer-b. 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. Correct
Under what conditions can a Medicare prescription drug plan reduce its coverage
for a given drug during the first 60 days of the year? -correct-answer-a. When a
formulary change is in response to a drug's removal from the market. Correct
Which of the following steps may a Part D sponsor adopt for beneficiaries who are
at risk of misusing or abusing frequently abused drugs?
I. Identifying at risk individuals by using criteria that includes the number of opioid
prescriptions the beneficiary has and the number of prescribers who have written
those prescriptions.
II. Locking an at-risk beneficiary into one pharmacy.
III. Locking an at-risk beneficiary into one prescriber.
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IV. Increasing deductibles and copays for at-risk beneficiaries. -correct-answer-b. I,
II and III only Correct
Mrs. Roswell is a new Medicare beneficiary and is interested in selecting a
Medicare Part D prescription drug plan. She takes a number of medications and is
concerned that she has not been able to identify a plan that covers all of her
medications. She does not want to make an abrupt change to new drugs that
would be covered and asks what she should do. What should you tell her? -
correct-answer-a. Every Part D drug plan is required to cover a single one-month
fill of her existing medications sometime during a 90 day transition period. Correct
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? -correct-
answer-d. 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. Correct
Mrs. Quinn has just turned 65, is in excellent health, and has a relatively high
income. She uses no medications and sees no reason to spend money on a
Medicare prescription drug plan if she does not need the coverage. What could
you tell her about the implications of such a decision? -correct-answer-a. If she
does not sign up for a Medicare prescription drug plan as soon as she is eligible to
do so, if she does sign up at a later date, her premium will be permanently
increased by 1% of the national average premium for every month that she was
not covered. Correct
