AHIP 2024: all segment exams and FINAL EXAM

Mr. Hutchinson has drug coverage through his former employer's retiree plan. He is concerned about the Part D premium penalty if he does notenroll in a Medicare prescription drug plan, but does not want to purchase extra coverage that he will not need. What should you tell him?

If the drug coverage he has is not expected to pay, on average, at least as much as Medicare's standard Part D coverageexpects to pay, then he will need to enroll in Medicare Part D during his initial eligibility period to avoid the late enrollmentpenalty.

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 nowwhen 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?

Plan sponsors have the option to do nothing when a plan member does not pay their premiums or disenroll the member after a graceperiod and notice

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 theplan and enroll in a stand-alone prescription drug plan. What should you tell her?

She could enroll in a PFFS plan and a stand-alone Medicare prescription drug plan

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 expenses that count toward the Medicare Part D catastrophic limit and include not onlyexpenses paid by a benefi ciary but also in some instances drug manufacturer discounts.