AHIP 2024 Final Exam Questions and Answers

AHIP 2024 Final Exam Questions and Answers (Verified Answers)

• 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

ANS She couldenroll 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

ANS Every Part D drug plan is required tocover a single one-month fill of her existing medications sometime during a 90-daytransition period. 1 / 3

• 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

ANS Plan sponsors have the option to do nothingwhen a plan member does not pay their premiums or disenroll the member after agrace 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

ANS 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 ANS 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. 2 / 3

• Mrs. Fiore is a retired federal worker with coverage under a Federal Employ-

ee Health Benefits (FEHB) plan that includes creditable drug coverage. She is

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