AHIP MODULE 3 ACTUAL EXAM COMPLETE 120 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES|ALREADY GRADED A+

AHIP MODULE 3 ACTUAL EXAM 2023-2024

COMPLETE 120 QUESTIONS AND CORRECT

DETAILED ANSWERS WITH RATIONALES|ALREADY

GRADED A+

Under what conditions can a Medicare prescription drug plan reduce its

coverage for a given drug during the first 60 days of the year? -

ANSWER- a. When a formulary change is in response to a drug's

removal from the market. Correct

Which of the following steps may a Part D sponsor adopt for

beneficiaries who are at risk of misusing or abusing frequently abused

drugs?

I. Identifying at risk individuals by using criteria that includes the

number of opioid prescriptions the beneficiary has and the number of

prescribers who have written those prescriptions.

II. Locking an at-risk beneficiary into one pharmacy.

III. Locking an at-risk beneficiary into one prescriber.

IV. Increasing deductibles and copays for at-risk beneficiaries. -

ANSWER- b. I, II and III only Correct

Mrs. Roswell is a new Medicare beneficiary and 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? - ANSWER- a. 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. Correct

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- d. 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. Correct

Mrs. Quinn has just turned 65, is in excellent health, and has a relatively

high income. She uses no medications and sees no reason to spend

money on a Medicare prescription drug plan if she does not need the

coverage. What could you tell her about the implications of such a

decision? - ANSWER- a. If she does not sign up for a Medicare

prescription drug plan as soon as she is eligible to do so, if she does sign

up at a later date, her premium will be permanently increased by 1% of

the national average premium for every month that she was not covered.

Correct

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- d. In general, he must select a single Part D premium

payment mechanism that will be used throughout the year. Correct

Mr. Katz reached the Part D coverage gap in August last year. His

prescriptions have not changed, he is keeping the same Part D plan and

the benefits, cost-sharing, and coverage of his drugs are all the same as

last year. He asked what to expect for this year about his out-of-pocket

costs. What could you tell him? - ANSWER- a. Because he reached the

coverage gap last year, he will probably reach it again this year close to

the same time. Correct

Mrs. Grant uses several very expensive drugs and anticipates that she

will enter catastrophic coverage at some point during the year. To help

her determine when she is likely to qualify for catastrophic coverage,

she asked which expenses count toward the out-of-pocket limit that

qualifies her for catastrophic coverage. Which one of the following

would count? - ANSWER- a. Prescription drugs she purchases when in

the Part D coverage gap. Correct

Mr. Shapiro gets by on a very small fixed income. He has heard there

may be extra help paying for Part D prescription drugs for Medicare

beneficiaries with limited income. He wants to know whether he might

qualify. What should you tell him? - ANSWER- a. The extra help is

available to beneficiaries whose income and assets do not exceed annual

limits specified by the government. Correct

Mrs. Fields wants to know whether applying for the Part D low income

subsidy will be worth the time to fill out the paperwork. What could you