Module 1 Review Questions Graded A

Module 1 Review Questions Graded A Question 1: Mr. Patel is planning his retirement and wants to know about hospitalization costs under Original Medicare. What can you tell him? Answer: Under Original Medicare, there is a single deductible amount for the first 60 days of any inpatient hospital stay, after which it converts into a per-day amount through day 90. After day 90, he would pay a daily amount up to 60 days over his lifetime, after which he would be responsible for all costs. Question 2: What impact have recent regulatory changes had on Medigap plans? Answer: The Part B deductible is no longer covered for individuals newly eligible for Medicare starting January 1, 2020. Question 3: Mr. Singh wants drug coverage without enrolling in a Medicare Advantage plan. What options are available to him? Answer: He can enroll in a stand-alone prescription drug plan and continue to be covered for Part A and Part B services through Original Fee-for-Service Medicare. Question 4: Mrs. Park has a low fixed income and wants help with Medicare costs. What assistance is available to her? Answer: She could contact her state medicaid agency to see if she qualifies for one of several programs that can help with Medicare costs for which she is responsible. Question 5: Mr. Rainey's physician recommends inpatient psychiatric hospitalization. What length of stay will Medicare cover? Answer: Medicare will cover a total of 190 days of inpatient care during his entire lifetime. Ms. Henderson believes that she will qualify for Medicare Coverage when she turns 65, without paying any premiums, because she has been working for 40 years and paying Medicare taxes. What should you tell her? ️In order to obtain Part B coverage, she must pay a standard monthly premium, though it is higher for individuals with higher incomes. Mrs. Duarte is enrolled in Original Medicare Parts A and B. She has recently reviewed her Medicare Summary Notice (MSN) and disagrees with a determination that partially denied one of her claims for services. What advice would you give her? ️Mrs. Duarte should file an appeal of this initial determination within 120 days of the date she received the MSN in the mail. Mrs. Quinn recently turned 66 and decided after many years of work to begin receiving Social Security benefits. Shortly thereafter Mrs. Quinn received a letter informing her that she has been automatically enrolled in Medicare Part B. She wants to understand what this means. What should you tell Mrs. Quinn? ️Part B primarily covers physician services. She will be paying a monthly premium and, with the exception of many preventive and screening tests, generally will have 20% co-payments for these services, in addition to an annual deductible. Mrs. Geisler's neighbor told her she should look at her Part D options during the annual Medicare enrollment period because features of Part D might have changed. Mrs. Geisler can't remember what Part D is so she called you to ask what her neighbor was talking about. What could you tell her? ️Part D covers prescription drugs and she should look at her premiums, formulary, and cost-sharing among other factors to see if they have changed. Mr. Diaz continued working with his company and was insured under his employer's group plan until he reached age 68. He has heard that there is a premium penalty for those who did not sign up for Part B when first eligible and wants to know how much he will have to pay. What should you tell him? ️Mr. Diaz will not pay any penalty because he had continuous coverage under his employer's plan. Mrs. Turner is comparing her employer's retiree insurance to Original Medicare and would like to know which of the following services Original Medicare will cover if the appropriate criteria are met? What could you tell her? ️Original Medicare covers ambulance services