AHIP Final Exam Answers
Mr. Jacob understands that there is a standard Medicare Part D prescription drug
benefit, but when he looks at information on various plans available in his area,
he sees a wide range in what
...
AHIP Final Exam Answers
Mr. Jacob understands that there is a standard Medicare Part D prescription drug
benefit, but when he looks at information on various plans available in his area,
he sees a wide range in what they charge for deductibles, premiums and cost
sharing. How can you explain this to him?
Medicare Part D drug plans may have different benefit structures, but on
average, they must all be at least as good as the standard model established by
the government.
Mrs. West wears glasses and dentures and has enjoyed considerable pain relief
from arthritis through acupuncture. She is concerned about whether or not
Medicare will cover these items and services. What should you tell her?
Medicare does not cover acupuncture, or, in general, glasses or dentures.
Mr. Bickford did not quite qualify for the extra help low-income subsidy under the
Medicare Part D Prescription Drug program and he is wondering if there is any
other option he has for obtaining help with his considerable drug costs. What
should you tell him?
He could check with the manufacturers of his medications to see if they offer an
assistance program to help people with limited means obtain the medications
they need. Alternatively, he could check to see whether his state has a
pharmacy assistance program to help him with his expenses.
Mr. Lombardi is interested in a Medicare Advantage (MA) PPO plan that you
represent. It is one of three plans operated by the same organization in Mr.
Lombardi’s area. The MA PPO plan does not include drug coverage, but the other
two plans do. Mr. Lombardi likes the PPO plan that does not include drug
coverage and intends to obtain his drug coverage through a stand-alone Medicare
prescription drug plan. What should you tell him about this situation?
He could enroll in one of the MA plans that include prescription drug coverage
or a Medigap plan and a stand-alone prescription drug plan, but he cannot
enroll in the MA-only PPO plan and a stand-alone prescription drug plan.
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?
In general, he must select a single Part D premium payment mechanism that will
be used throughout the year.
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