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AHIP Module 3 - Medicare Part D Rx Coverage

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Mrs. Esmeralda Avila is a Medicare beneficiary enrolled in a MA-PD plan you represent. Her neighbor recently suffered from a painful case of shingles. Mrs. Avila hopes to avoid such an illness through vaccination. She asks you whether the cost of the shingles vaccination will be covered under the plan you represent. What should you say? Mrs. Willis has a rare condition for which two different brand name drugs are the only available treatment. She is concerned that since no generic prescription drugs are available and these drugs are very high cost, she will not be able to find a Medicare Part D prescription drug plan that covers either one of them. What should you tell her?
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    1. Mrs. Esmeralda Avila is a Medicare beneficiary enrolled in a MA-PD plan you represent. Her neighbor recently suffered from a painful case of shingles. Mrs. Avila hopes to avoid such an illness through vaccination. She asks you whether the cost of the shingles vaccination will be covered under the plan you represent. What should you say?
    Yes, there is no cost sharing for the shingles vaccine even in the deductible phase of her prescription drug plan because it is an adult vaccine recommended by the Advisory Committee on Immunization Practices (AICP).
    Yes, provided she has already satisfied her annual deductible before obtaining the vaccination.
    No, because the shingles vaccine is considered experimental. Mrs. Avila will be responsible for the full cost of the vaccination out-of-pocket.
    Yes, 25 percent of the cost of the shingles vaccine will be covered under the provisions of the Inflation Reduction Act (IRA).
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