Docsity
Log inSign up
Docsity
Prepare for your exams
Prepare for your exams

Study with the several resources on Docsity

Earn points to download
Earn points to download

Earn points by helping other students or get them with a premium plan

Guidelines and tips
Guidelines and tips
Sell on Docsity
Sell on Docsity
Log inSign up

Prepare for your exams

Study with the several resources on Docsity

Find documents

Prepare for your exams with the study notes shared by other students like you on Docsity

Search Store documents

The best documents sold by students who completed their studies

Search through all study resources
Docsity AINEW

Summarize your documents, ask them questions, convert them into quizzes and concept maps

Explore questions

Clear up your doubts by reading the answers to questions asked by your fellow students

Earn points to download

Earn points by helping other students or get them with a premium plan

Share documents
download point icon20 Points

For each uploaded document

Answer questions
download point icon5 Points

For each given answer (max 1 per day)

All the ways to get free points
Get points immediately

Choose a premium plan with all the points you need

Study Opportunities

Choose your next study program

Get in touch with the best universities in the world. Search through thousands of universities and official partners

Community

Ask the community

Ask the community for help and clear up your study doubts

University Rankings

Discover the best universities in your country according to Docsity users

Free resources

Our save-the-student-ebooks!

Download our free guides on studying techniques, anxiety management strategies, and thesis advice from Docsity tutors

From our blog

Exams and Study
Go to the blog

Medicare Part D Prescription Drug Coverage, Exams of Nursing

Cambridge College of Healthcare & TechnologyNursing

Detailed information and answers to common questions about medicare part d prescription drug coverage. It covers topics such as enrollment, plan options, cost-sharing, low-income subsidies, and the implications of not enrolling when first eligible. Likely intended as a study guide or reference material for individuals preparing for the ahip 2024 module 3 exam, which covers medicare advantage and part d plans. The comprehensive nature of the content and the focus on exam-style questions suggest this document could be useful for university students studying healthcare administration, insurance, or medicare policy, as well as for medicare beneficiaries seeking to understand their prescription drug coverage options.

Typology: Exams

2024/2025

Available from 10/14/2024

Martin-Ray-1
Martin-Ray-1 🇺🇸

5

(8)

6.2K documents

1 / 7

Toggle sidebar

This page cannot be seen from the preview

Don't miss anything!

bg1
AHIP 2024 Module 3 Latest Exam
Version with A+ Graded Answers...!!
1. 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? -
✔✔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.
2. Mrs. Roberts has Original Medicare and would like to enroll in a
Private Fee-for-Service (PFFS) plan. All types of PFFS plans are
available in her area. Which options could Mrs. Roberts consider
before selecting a PFFS plan? - ✔✔A Medicare Advantage
Prescription Drug (MA-PD) PFFS plan that combines medical benefits
and Part D prescription drug coverage, a PFFS plan offering only
medical benefits, or a PFFS plan in combination with a stand-alone
prescription drug plan.
3. 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
pf3
pf4
pf5

Partial preview of the text

Download Medicare Part D Prescription Drug Coverage and more Exams Nursing in PDF only on Docsity!

AHIP 2024 Module 3 Latest Exam

Version with A+ Graded Answers...!!

  1. 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? - ✔✔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.
  2. Mrs. Roberts has Original Medicare and would like to enroll in a Private Fee-for-Service (PFFS) plan. All types of PFFS plans are available in her area. Which options could Mrs. Roberts consider before selecting a PFFS plan? - ✔✔A Medicare Advantage Prescription Drug (MA-PD) PFFS plan that combines medical benefits and Part D prescription drug coverage, a PFFS plan offering only medical benefits, or a PFFS plan in combination with a stand-alone prescription drug plan.
  3. 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.

  1. Mrs. Fiore is a retired federal worker with coverage under a Federal Employee Health Benefits (FEHB) plan that includes creditable drug coverage. She is ready to turn 65 and become Medicare eligible for the first time. What issues might she consider about whether to enroll in a Medicare prescription drug plan? - ✔✔She could compare the coverage to see if the Medicare Part D plan offers better benefits and coverage than the FEHB plan for the specific medications she needs and whether any additional benefits are worth the Part D premium costs on top of her FEHB contribution.
  2. Charles McCarthy is a Medicare beneficiary who suffers from diabetes. Mr. McCarthy is considering enrollment in a MA-PD plan that you represent. He asks you whether his insulin costs will be covered. What should you say? - ✔✔Mr. McCarthy's insulin costs for a one-month supply cannot be more than $35 in any coverage phase under the prescription drug plan beginning in 2023.
  3. Mrs. Walters is entitled to Part A and has medical coverage without drug coverage through an employer retiree plan. She is not enrolled in Part B. Since the employer plan does not cover prescription drugs, she wants to enroll in a Medicare prescription drug plan. Will she be able to? - ✔✔Yes. Mrs. Walters must be entitled to Part A and/or enrolled in Part B to be eligible for coverage under the Medicare prescription drug program.

see whether his state has a pharmacy assistance program to help him with his expenses.

  1. 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.
  2. 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. She currently does not have creditable coverage. What could you tell her about the implications of such a decision? - ✔✔If she does not sign up for a Medicare prescription drug plan as soon as she is eligible to do so, and 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.
  3. Mrs. Imelda Diaz is a Medicare beneficiary enrolled in a MA-PD plan you represent. Her neighbor recently suffered from a painful case of shingles. Mrs. Diaz hopes to avoid such an illness through vaccination. She asks you whether the cost of shingles vaccination will be covered under the plan you represent. What should you say?
    • ✔✔Yes, there is no cost sharing for the shingles vaccine even in the deductible phase of her prescription drug plan because it is an adult

vaccine recommended by the Advisory Committee on Immunization Practices (AICP).

  1. Mrs. Cantwell is enrolled in a prescription drug plan. She has heard about something called True-Out-Pocket costs or "TrOOP" and asks you if any of the following count toward reaching the catastrophic coverage phase. What do you say? I. Her annual PDP deductible II. A drug manufacturer's discount for brand name drugs after her initial coverage period III. The off formulary drug her doctor prescribed but she pays for because the plan denied her exception request IV. Her over-the-counter (OTC) allergy medication. - ✔✔I and II only
  2. Mrs. Lopez is enrolled in a cost plan for her Medicare benefits. 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? - ✔✔If a Part D benefit is offered through her plan she may choose to enroll in that plan or a standalone PDP.
  3. 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.

should enroll in a Part D plan before he has a 63-day break in coverage in order to avoid a premium penalty.

  1. Mrs. McIntire is enrolled in her state's Medicaid plan and has just become eligible for Medicare as well. What can she expect will happen to her drug coverage? - ✔✔Unless she chooses a Medicare Part D prescription drug plan on her own, she will be automatically enrolled in one available in her area.