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AHIP Final Exam Version 2 Newest 2025 Exam
Complete Questions And 100%Correct Answers With
Rationales|Already Graded A+
Mr. Hildalgo complains to you that because he takes
multiple expensive drugs, he has trouble paying his cost
sharing for his prescription drugs, particularly at the
beginning of the year during the deductible phase. He is
happy with his plan and does not want to change.
However, he said he had heard about a new program
called the Medicare Prescription Payment Plan and asked
whether it might help. What do you tell him? - ANSWER-
The Medicare Prescription Payment Plan helps spread out
beneficiary cost-sharing payments but does not decrease
the total amount owed.
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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? -
ANSWER-In general, he must select a single Part D
premium payment mechanism that will be used throughout
the year.
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
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some instances amounts paid by or through qualified
State Pharmaceutical Assistance Programs.
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.
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
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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.
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.
Ms. Edwards is enrolled in a Medicare Advantage plan
that includes prescription drug plan (PDP) coverage. She
AHIP Final Exam Version 2 Newest 2025 Exam
Complete Questions And 100%Correct Answers With
Rationales|Already Graded A+
Mr. Hildalgo complains to you that because he takes
multiple expensive drugs, he has trouble paying his cost
sharing for his prescription drugs, particularly at the
beginning of the year during the deductible phase. He is
happy with his plan and does not want to change.
However, he said he had heard about a new program
called the Medicare Prescription Payment Plan and asked
whether it might help. What do you tell him? - ANSWER-
The Medicare Prescription Payment Plan helps spread out
beneficiary cost-sharing payments but does not decrease
the total amount owed.
,2|Page
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? -
ANSWER-In general, he must select a single Part D
premium payment mechanism that will be used throughout
the year.
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
,3|Page
some instances amounts paid by or through qualified
State Pharmaceutical Assistance Programs.
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.
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
, 4|Page
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.
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.
Ms. Edwards is enrolled in a Medicare Advantage plan
that includes prescription drug plan (PDP) coverage. She
