#1
Which government program provides prescription drug coverage for Medicare beneficiaries?
Medicare Part D
ExplanationMedicare Part D provides prescription drug coverage for Medicare beneficiaries.
#2
Which of the following is not a factor considered when determining a Medicare Part D premium?
Prescription drug needs
ExplanationPrescription drug needs are not a factor considered when determining a Medicare Part D premium.
#3
What is the Medicare Part D late enrollment penalty?
A penalty for enrolling in Medicare Part D after the initial enrollment period without creditable drug coverage
ExplanationThe Medicare Part D late enrollment penalty is a penalty for enrolling in Medicare Part D after the initial enrollment period without creditable drug coverage.
#4
What is the purpose of the Medicare Part D Explanation of Benefits (EOB) statement?
To outline prescription drug costs and utilization for beneficiaries
ExplanationThe purpose of the Medicare Part D Explanation of Benefits (EOB) statement is to outline prescription drug costs and utilization for beneficiaries.
#5
What is the Medicare Part D Initial Deductible, and how does it work?
A fixed amount paid by the beneficiary before the drug plan starts coverage
ExplanationThe Medicare Part D Initial Deductible is a fixed amount paid by the beneficiary before the drug plan starts coverage.
#6
What is the coverage gap (doughnut hole) in Medicare Part D?
A phase where beneficiaries pay all drug costs out-of-pocket
ExplanationThe coverage gap, or doughnut hole, in Medicare Part D is a phase where beneficiaries pay all drug costs out-of-pocket.
#7
How do Medicare beneficiaries qualify for Extra Help with their prescription drug costs?
Demonstrating financial need
ExplanationMedicare beneficiaries qualify for Extra Help with their prescription drug costs by demonstrating financial need.
#8
What is the purpose of the Medicare Part D Initial Coverage Limit?
To set a threshold for drug coverage before entering the coverage gap
ExplanationThe purpose of the Medicare Part D Initial Coverage Limit is to set a threshold for drug coverage before entering the coverage gap.
#9
Which federal law prohibits Medicare drug plans from covering certain off-label uses of prescription drugs?
Food, Drug, and Cosmetic Act
ExplanationThe Food, Drug, and Cosmetic Act prohibits Medicare drug plans from covering certain off-label uses of prescription drugs.
#10
Which organization offers assistance to Medicare beneficiaries in selecting a Part D plan through its State Health Insurance Assistance Program (SHIP)?
Centers for Medicare & Medicaid Services (CMS)
ExplanationThe Centers for Medicare & Medicaid Services (CMS) offers assistance to Medicare beneficiaries in selecting a Part D plan through its State Health Insurance Assistance Program (SHIP).
#11
Which entity administers the Medicare Part D program?
Centers for Medicare & Medicaid Services (CMS)
ExplanationThe Centers for Medicare & Medicaid Services (CMS) administers the Medicare Part D program.
#12
What is the initial enrollment period for Medicare Part D?
The month of turning 65
ExplanationThe initial enrollment period for Medicare Part D is the month of turning 65.
#13
What is the catastrophic coverage phase in Medicare Part D?
A phase where beneficiaries pay 100% for their prescription drugs
ExplanationThe catastrophic coverage phase in Medicare Part D is a phase where beneficiaries pay 100% for their prescription drugs.
#14
In Medicare Part D, what is the purpose of a formulary?
To list covered drugs and their cost-sharing
ExplanationIn Medicare Part D, the purpose of a formulary is to list covered drugs and their cost-sharing.
#15
Which category of drugs is generally excluded from Medicare Part D coverage?
Over-the-counter (OTC) drugs
ExplanationOver-the-counter (OTC) drugs are generally excluded from Medicare Part D coverage.