AHIP Medicare Part D Prescription Drug Plans

Question 1

Medicare Part D prescription drug coverage is provided through:

Accepted Answer

Private insurers approved by CMS

Answer

The federal government directly

Answer

State Medicaid agencies

Answer

Hospital systems only

Question 2

What is a formulary in a Medicare Part D plan?

Accepted Answer

A list of covered prescription drugs

Answer

The plan's annual deductible schedule

Answer

The network of participating pharmacies

Answer

A cost-sharing tier for generic drugs only

Question 3

What is the Part D late enrollment penalty based on?

Accepted Answer

1% of the national base beneficiary premium for each full month without creditable coverage

Answer

A flat dollar amount per month

Answer

10% of the plan's premium per year of delay

Answer

A one-time fee equal to one month's premium

Question 4

The 'coverage gap' (donut hole) in Medicare Part D refers to:

Accepted Answer

A temporary limit on drug coverage after total drug costs reach a threshold

Answer

A period with no drug coverage after the deductible

Answer

The gap between Part A and Part B coverage

Answer

A period before the deductible is met

Question 5

What is 'catastrophic coverage' in Medicare Part D?

Accepted Answer

Coverage that begins after very high out-of-pocket drug costs are met

Answer

Coverage for catastrophic medical events like strokes

Answer

Coverage for experimental cancer treatments

Answer

Emergency hospital coverage under Part D

Question 6

Which program provides Extra Help (Low Income Subsidy) for Medicare Part D costs?

Accepted Answer

The Social Security Administration administers the LIS/Extra Help program

Answer

Medicaid only

Answer

State Pharmacy Assistance Programs only

Answer

CMS directly pays pharmacies