AHIP Practice Exam

What is the implication of Mr. Lombardi choosing a Medicare Advantage PPO plan without drug coverage?

1. He must find a plan with drug coverage

2. He can select any drug plan

3. It's not allowed to combine plans

4. He will have to pay extra premiums

The correct answer is: It's not allowed to combine plans

Choosing a Medicare Advantage PPO plan without drug coverage indicates that Mr. Lombardi cannot combine that specific plan with standalone prescription drug coverage, otherwise known as a Part D plan. This is due to the structure of Medicare Advantage Plans. When a beneficiary enrolls in a Medicare Advantage plan that does not include drug coverage, they are generally not allowed to separately enroll in a standalone Part D plan. Instead, they would need to assess other options, such as switching to a different Medicare Advantage plan that offers prescription drug coverage if they require it. Understanding this element is critical for beneficiaries to ensure they have the necessary prescription drug coverage, which is vital for managing their healthcare needs effectively. Therefore, the implications of Mr. Lombardi's choice hinge on the fact that he cannot supplement his current plan with a Part D drug plan, which is an important factor when making decisions about Medicare options.