CMS Medicare Specialist Benefits & Drug Coverage

Question 1

Which Medicare part provides outpatient prescription drug coverage?

Accepted Answer

Part D

Answer

Medicare Part D is the voluntary outpatient prescription drug benefit added by the Medicare Modernization Act of 2003.

Question 2

What is a Medicare Part D formulary?

Accepted Answer

A list of covered prescription drugs

Answer

A formulary is the plan's list of covered prescription drugs, typically organized into cost-sharing tiers.

Question 3

What does the Low Income Subsidy (LIS) program help Medicare beneficiaries with?

Accepted Answer

Part D premiums, deductibles, and co-pays

Answer

LIS, also called Extra Help, assists eligible low-income beneficiaries with Part D premium, deductible, and cost-sharing costs.

Question 4

During the Medicare Part D Initial Coverage Period, a beneficiary pays their plan's cost-sharing until total drug costs reach what threshold (2024)?

Accepted Answer

$5,030

Answer

In 2024, the Initial Coverage Period ends when total drug costs (plan plus beneficiary) reach $5,030.

Question 5

Which of the following is NOT a standard Part D coverage phase?

Accepted Answer

Extended Benefit Period

Answer

The standard Part D phases are the Deductible Phase, Initial Coverage Period, Coverage Gap, and Catastrophic Coverage; there is no Extended Benefit Period.

(CMS) Certified Medicare Specialist Practice Test

(CMS) Certified Medicare Specialist Practice Test

CMS Medicare Specialist Benefits & Drug Coverage