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TERMS SELECTED
Mrs. Paterson is concerned about the deductibles and co-payments associated with
Original Medicare. What can you tell her about Medigap as an option to address this
concern?
Medigap plans help beneficiaries cover Original Medicare benefits, but they coordinate
with Original Medicare coverage.
Anita Magri will turn age 65 in August 2023. Anita intends to enroll in Original Medicare
Part A and Part B. She would also like to enroll in a Medicare Supplement (Medigap)
plan. Anita's older neighbor Mel has told her about the Medigap Plan F in which he is
enrolled. It not only provides foreign travel emergency benefits but also covers his
Medicare Part B deductible. Anita comes to you for advice. What should you tell her?
You are sorry to disappoint Anita, but a Medigap F plan is no longer available to those
who turn age 65 after January 1, 2020. Anita might instead consider other Medigap
plans that offer foreign travel benefits but do not cover the Part B deductible.
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What impact, if any, have recent regulatory changes had on Medigap plans?
b.
The Part B deductible is no longer covered for individuals newly eligible for Medicare
starting January 1, 2020.
Mr. Rainey is experiencing paranoid delusions and his physician feels that he should be
hospitalized. What should you tell Mr. Rainey (or his representative) about the length of
an inpatient psychiatric hospital stay that Medicare will cover?
Medicare will cover a total of 190 days of inpatient psychiatric care during Mr. Rainey's
entire lifetime.
Mrs. Shields is covered by Original Medicare. She sustained a hip fracture and is being
successfully treated for that condition. However, she and her physicians feel that after
her lengthy hospital stay, she will need a month or two of nursing and rehabilitative
care. What should you tell them about Original Medicare's coverage of care in a skilled
nursing facility?
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Mrs. West wears glasses and dentures and has enjoyed considerable pain relief from
arthritis through massage therapy. She is concerned about whether or not Medicare will
cover these items and services. What should you tell her?
Medicare does not cover massage therapy, or, in general, glasses or dentures.
Ms. Gibson recently lost her employer group health and drug coverage and now she
wants to enroll in a PPO that does not include drug coverage. What should you tell her
about obtaining drug coverage?
She can enroll in the PPO, but she will not be able to purchase a stand-alone Medicare
Part D prescription drug plan.
Mrs. Radford asks whether there are any special eligibility requirements for Medicare
Advantage. What should you tell her?
Mrs. Radford must be entitled to Part A and enrolled in Part B to enroll in Medicare
Advantage.
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