Mr. Carlini has heard that Medicare prescription drug plans are only offered through
private companies under a program known as Medicare Advantage (MA), not by the
government. He likes Original Medicare and does not wa
...
Mr. Carlini has heard that Medicare prescription drug plans are only offered through
private companies under a program known as Medicare Advantage (MA), not by the
government. He likes Original Medicare and does not want to sign up for an MA
product, but he also wants prescription drug coverage. What should you tell him? -
✔✔b. Mr. Carlini can stay with Original Medicare and also enroll in a Medicare
prescription drug plan through a private company that has contracted with the
government to provide only such drug coverage to eligible Medicare beneficiaries.
Correct
Mrs. Mulcahy is concerned that she may not qualify for enrollment in a Medicare
prescription drug plan because, although she is entitled to Part A, she is not enrolled
under Medicare Part B. What should you tell her? - ✔✔d. Everyone who is entitled to
Part A or enrolled under Part B is eligible to enroll in a Medicare prescription drug plan.
As long as Mrs. Mulcahy is entitled to Part A, she does not need to enroll under Part B
before enrolling in a prescription drug plan. Correct
Mrs. Lopez is enrolled in a Medicare Advantage cost plan. She has recently lost
creditable coverage previously available through her husband's employer. She is
interested in enrolling in a Medicare Part D prescription drug plan (PDP). What should
you tell her? - ✔✔a. If a Part D benefit is offered through her plan she may choose in
enroll in that plan or a standalone PDP. Correct
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.
III. Beneficiaries enrolled in a MA-Medical Savings Account (MSA) plan may only obtain
Part D benefits through a standalone PDP.
IV. Beneficiaries enrolled in a MA-PPO may obtain Part D benefits through a standalone
PDP or through their plan. - ✔✔b. I, II, and III only Correct
All plans must cover at least the standard Part D coverage or its actuarial equivalent.
What costs would a beneficiary incur for prescription drugs in 2019 under the standard
coverage? - ✔✔c. Standard Part D coverage would require payment of an annual
deductible, 25% cost-sharing up to the coverage gap, a portion of costs for both
generics and brand-name drugs in the coverage gap, and co-pays or co-insurance after
the coverage gap. Correct
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