2024 AHIP Final Exam (ACTUAL TEST ) Questions and Answers (Solved)
2024 AHIP Final Exam (ACTUAL TEST ) Questions and Answers (Solved)
Mr. Lopez, who is
... [Show More] fairly well-off financially, would like to enroll in a Medicare
prescription drug plan you represent and simply give you a check to cover his
premiums for the entire year. What should you tell him?
He will need to mail in his payment with his enrollment form.
Mrs. Chou likes a Private Fee-for-Service (PFFS) plan available in her area that
does not include drug coverage. She wants to enroll in the plan and enroll in a
stand-alone prescription drug plan. What should you tell her?
She could enroll in a PFFS plan and a stand-alone Medicare prescription drug plan.
Mrs. Roswell is a new Medicare beneficiary who has just retired from retail work.
She 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?
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.
Mr. Robinson was quite ill recently and forgot to pay his monthly premium for his
MA-PD plan. He is worried that he will lose his coverage now when he needs it the
most. He is certain his plan will disenroll him because that is what happened to a
friend of his in a similar type of plan. What can you tell Mr. Robinson about his
situation?
Plan sponsors have the option to do nothing when a plan member does not pay
their premiums or disenroll the member after a grace period and notice.
Mrs. Allen has a rare condition for which two different brand name drugs are the
only available treatment. She is concerned that since no generic prescription drug
is available and these drugs are very high cost, she will not be able to find a
Medicare Part D prescription drug plan that covers either one of them. What
should you tell her?
Medicare prescription drug plans are required to cover drugs in each therapeutic
category. She should be able to enroll in a Medicare prescription drug plan that
covers the medications she needs.
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?
TrOOP stands for true out-of-pocket expenses that count toward the Medicare Part
D catastrophic limit and include not only expenses paid by a beneficiary but also in
some instances drug manufacturer discounts.
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? [Show Less]