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2. Medicare Part D Exam
   
4. 1. A beneficiary wishes to remain with the same company, if at all possible. After review, you notice her current plan no longer covers one of her medications. There are multiple plans that will cover all her medications, how do you proceed? *

   1. a. Inform her she could switch to a more cost effective plan that covers all of her medications and you can review the findings with her
   2. b. If she is uncertain, inform her that she can schedule additional appointments to further review the information and make an informed decision
   3. c. Choose the plan you feel is best for her and her situation
   4. d. Remove the medication from the results and advise her to look into getting a GoodRx card to use for that particular medication
6. 2. Who determines upon what Tier a medication is placed?*

   1. a. The manufacturer of the medication
   2. b. Medicare
   3. c. The individual drug plan
   4. d. Congress
8. 3. Choose the vaccines that are covered under Medicare Part D*

   1. a. Hepatitis B, Influenza (flu), Pneumonia
   2. b. Tetanus, Diphtheria, Pertussis (Tdap) and Shingles
   3. c. Shingles, Hepatitis B, Influenza (flu), Pneumonia, Human Papillomavirus Vaccine (HPV)
   4. d. Vaccines are covered only under Medicare Part B during office visits
10. 4. You are with a client that wants to know what their out of pocket cost of the Shingles vaccine would be. You:*

    1. a. Look the Shingles vaccine up in the plan finder
    2. b. Advise them to contact their doctor
    3. c. Advise them to call their pharmacy
    4. d. Advise them to call their prescription plan
12. 5. The plan finder may not have all of a client’s medications in the system, why might this occur?*

    1. a. The client may have a prescription that is very rarely needed and it hasn’t been filled in the last 12 months
    2. b. The client may have a new prescription, never filled, or currently receives samples
    3. c. The plan finder does not populate Over-the-Counter Medications (Aspirin, Claritin, Vitamin D3, etc.)
    4. d. All of the above
14. 6. Drug plans coverage varies from plan to plan. In what ways do they differ?*

    1. a. Monthly Premium amount
    2. b. Different partnerships with different pharmacies
    3. c. Formularies
    4. d. All the above
16. 7. When a drug plan has a deductible how does the beneficiary pay this?*

    1. a. They have to pay the drug plan the full amount before medications are covered
    2. b. They have to pay the pharmacy the full amount before medications are covered
    3. c. They set up an ACH withdrawal from their account
    4. d. They may have to pay full price for some of their medications at the pharmacy until the full amount of the deductible is reached
18. 8. Which of the following statements is NOT true regarding Medicare Drug plans with a deductible?*

    1. a. Medicare sets the deductible limit each year
    2. b. All medications are applied to the plans deductible no matter the “Tier”
    3. c. Once the deductible is met for the year, a medication that is not on the plan’s formulary will be covered at a reduced amount
    4. d. Amounts paid towards a deductible are transferred from one plan to the next when using a SEP and changing plans outside of open enrollment
20. 9. There are certain cases outside of “open enrollment” referred to as a “Special Enrollment Period” (SEP) during which time a beneficiary is able to change their plan. Which of the following is NOT considered a “SEP”?*

    1. a. Client is approved for one of the federal or state prescription subsidy programs
    2. b. Client moved out of service plan area
    3. c. Client has recently lost creditable drug coverage
    4. d. Client was on no medications when they first enrolled and now they are on a VERY expensive medication that is not covered by their current plan
22. 10. How often can a Medicare beneficiary who has the Extra Help/LIS (Low Income Subsidy) program switch prescription drug plans each year?*

    complete question above

    1. a. Extra help provides a continuous open enrollment period
    2. b. Beneficiaries can switch once every quarter
    3. c. Beneficiaries have one Special Enrollment Period each year
    4. d. None of the above
24. 11. Your client has the Senior Prescription Drug Assistance Program (SPDAP) and he is considering a drug plan but wants to know how his annual out of pocket costs compare when factoring in the state subsidy.*

    1. a. If the monthly drug plan premium is under $40, referencing the “Estimated yearly drug costs” would be sufficient (based off the medications entered)
    2. b. If the premium is above $40 subtract $40 from the monthly premium, then multiply by 12 and Add this figure to the “Estimated yearly drug costs”
    3. c. Explain that when doing a personalized search SPDAP’s numbers are reflected in the plan finder
    4. d. Both A and B
26. 12. The client you are with wants to look at her health coverage (Medigap), how should you proceed?*

    1. a. Explain that there is no Medigap Open Enrollment Period. She may review and change her Medigap coverage at any time of the year but she may be subjected to medical underwriting
    2. b. Use the Medigap Policy Search tool on the plan finder to view the plans and companies available to her
    3. c. Inform her each appointment is designated for either Medicare D however, she may ask for a Medigap Resource Packet at the front desk
    4. d. Both A and C
28. 13. A client comes up as a “full dual” in the plan finder, but they have a letter saying they “no longer automatically qualify for full help” how do you proceed?*

    1. a. Do the plan search and explain the results based on the “full dual” status & schedule an additional appointment with staff
    2. b. Do an anonymous search with no subsidies, and explain the results with no “help” and explain what their costs will look like moving forward if they don’t qualify for subsidy programs
    3. c. Refer them to 1-800-MEDICARE
    4. d. Both A and B
30. 14. The client you are with has “Partial Help,” they are diabetic but not currently on insulin. Their doctor is considering prescribing insulin. Currently the most effective plan does cover this insulin. How would you proceed?*

    1. a. Suggest they enroll in the plan that will cover the insulin to ensure the insulin is covered
    2. b. Suggest they do nothing until the doctor changes their medications
    3. c. Inform the client that the “Partial Help” program provides a “Special Enrollment Period” once per quarter
    4. d. Let the client know if the medication prescribed is not covered to ask the doctor for samples
32. 15. The client you are working with has “Late Enrollment Penalty” (LEP) and when reviewing the drug plan results you inform the client that the plan finder does not reflect the LEP, how will the client know what their penalty is this year?*

    1. a. Since they paid the LEP last year they no longer have to pay it
    2. b. Because they will have to pay the same amount this year to the plan they have enrolled
    3. c. Since the penalty is subject to change annually based upon the National Average Drug Plan Premium the plan the client is enrolled with will inform the client of the new LEP
    4. d. Because the LEP is a one-time penalty
34. 16. If a client wants to take additional time to review the drug plan results and enroll at a later date, how can the client enroll in a new Medicare drug plan after the appointment?*

    1. a. The client can call 1-800-Medicare
    2. b. The client can call the Social Security Administration at 1-800-772-1213
    3. c. The client can call the desired drug plan
    4. d. Both A and C
36. 17. When you get to the page that says there are 27 Prescription Drug Plans available you notice the current plan has extremely high costs compared to some of the other plans, what is most likely to be the reason?*

    1. a. They are on a new medication with a very high cost
    2. b. The Rx plan changed the medication prices
    3. c. Most likely some of their medications will not be covered by their current plan in 2020
    4. d. Both A and B
38. 18. When starting the review process for prescription plans which option is the best to select?*

    1. a. Medicare Advantage Plan
    2. b. Drug plan (Part D)
    3. c. Drug plan (Part D) + Medigap policy
    4. d. Learn more about Medicare options before I see plans
40. 19. When you get to the page that says, 27 Prescription Drug Plans available which way should you “filter plans”?*

    1. a. Star Rating
    2. b. Preferred Insurance Carrier
    3. c. Accepted Across the US
    4. d. None of the above
42. 20. The client you are working with is adamant they do not want a plan with a deductible due to their low fixed income; you explain this may not be their best option due to the high cost of the zero deductible plans and proceed by:*

    1. a. Sorting plans by lowest yearly deductible & go over costs
    2. b. Sorting plans by lowest drug costs & go over costs
    3. c. Sorting plans by lowest monthly premium & go over costs
    4. d. Both A and B
44. 21. In the plan finder if you select the “continue without logging in” option once you have entered the client’s Rx list and the plan finder times out you will have to:*

    1. a. Pick up where you left off
    2. b. Copy and enter the drug list ID
    3. c. Start from the beginning
    4. d. Log back into previous search
46. 22. In the plan finder where are the two places that you can see if a pharmacy is preferred or standard*

    1. a. In the estimated drug costs during coverage phases section
    2. b. On the pharmacy selection page
    3. c. In the estimated yearly drug cost section
    4. d. Both A and C
48. 23. In the plan finder where can you find the Rx tier information?*

    1. a. In the add your prescription drug section
    2. b. In the plan details section under other drug information
    3. c. In the plan details section under overview
    4. d. In the drug coverage and costs section
50. 24. In the estimated yearly drug costs section what costs are reflected in these totals?*

    1. a. Monthly premiums & Rx costs
    2. b. Rx costs & deductible
    3. c. Only the Rx costs
    4. d. Monthly premium, Rx costs & deductible
52. 25. You are working with a beneficiary’s son and he is their rep payee, whose zip code should you use when creating an account*

    1. a. The son’s
    2. b. The beneficiary’s
    3. c. Both
    4. d. None of the above, have the client verify info with SSA first
54. Type name as signature*
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