AHIP 2026 Certification Version 2 All New Qs & As for + Exam - ! Complete And Study material 7pages LEARNEXAMS

1. Mrs. Mulcahy, age 65, is concerned that she may not qualify for enrollmentin a Medicare prescription drug plan because, although she is entitled to PartA, she is not enrolled under Medicare Part B. What should you tell her? Answer: An individual 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, shedoes not need to enroll under Part B before enrolling in a prescription drug plan. 2. Which of the following statements about Medicare Part D are correct? I. Part D plans must enroll any eligible beneficiary who applies regardless ofhealth status except in limited circumstances. II. Private fee-for-service (PFFS) plans are not required to use a pharmacynetwork but may choose to have one. III. Beneficiaries enrolled in a MA-Medical Savings Account (MSA) plan mayonly 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. Answer: I, II, and III only 3. One of your clients, Lauren Nichols, has heard about a Medicare conceptfrom one of her neighbors called TrOOP. She asks you to explain it. What do you say? Answer: 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. 4. Mr.Zachow has a condition for which three drugs are available. He has triedtwo 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: Mr.Zachow has a right to request a formulary exception to obtain coverage for his PartD drug.He or his physician could obtain the standardized request form on the plan'swebsite, fill it out, and submit it to his plan.