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? Correct Answer: 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? Correct Answer: 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? Correct Answer: 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. Correct Answer: 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? Correct
Answer: 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
Mrs. Andrews was preparing a budget for next year because she takes quite a few prescription
drugs, she will reach the coverage gap, and wants to be sure she has enough money set aside for
those months. She received assistance calculating her projected expenses from her daughter who
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