AHIP Exam AHM-540 Topic 5 Question 103 Discussion

Actual exam question for AHIP's AHM-540 exam

Question #: 103
Topic #: 5

Adele Stanley, a member of the Greenhouse Health Plan, recently went to a network pharmacy to have a prescription filled. The pharmacist informed Ms. Stanley that the prescribed drug was not in the plan formulary and that reimbursement for the drug was not available except in extraordinary circumstances. The pharmacist asked Ms. Stanley if she would accept a generic substitute.

If Ms. Stanley agrees to the generic substitution, she will receive a drug that

Ahas not been tested for safety and efficacy in large clinical trials B. is available without a prescription at a reasonable cost

Chas been classified by the Food and Drug Administration (FDA) as safe, but that has not been proven fully effective

Dcontains active ingredients that are identical to those of the prescribed brand-name drug

Show Suggested Answer

Suggested Answer: D

by Sheron at Nov 18, 2024, 10:54 AM

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23 days ago

Wait, so the plan doesn't cover the prescribed drug? That seems a bit sketchy. I'd want to make sure the generic is truly equivalent before agreeing to it.

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