AHIP FINAL EXAM REVISION QUESTIONS AND ANSWERS COMPLETE AND RATED A.
Mr. Hildalgo complains to you that because he takes multiple expensive
drugs, he has trouble paying his cost sharing for his prescription drugs,
particularly at the beginning of the year during the deductible phase. He is
happy with his plan and does not want to change. However, he said he
had heard about a new program called the Medicare Prescription Payment
Plan and asked whether it might help. What do you tell him?
✔✔The Medicare Prescription Payment Plan helps spread out beneficiary
cost-sharing payments but does not decrease the total amount owed.
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.
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?
✔✔TrOOP stands for true out-of-pocket costs that count toward the
Medicare Part D catastrophic limit and include not only expenses paid by a
beneficiary but also in some instances amounts paid by or through
qualified State Pharmaceutical Assistance Programs.
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?