GUARANTEED PASS
1. Mrs.Parkis anelderlyretiree.Mrs.Park hasalow fixed income.Whatcould you tell Mrs. Park that might be of assistance?: She
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f should contact her state Medicaid agency to see if she qualifies forprograms that can help with Medicare costs for which she is
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f responsible.
2. Madeline Martinez was widowed several years ago. Her husband worked for many years and contributed into the Medicare
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system.He also left a substan- tial estate which provides Madeline with an annual income of approximately
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$130,000. Madeline, who has only worked part-time for the last three years, will soon turn age 65 and hopes to enroll in Original
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f Medicare. She comes to you for advice.What should you tell her?: You should tell Madeline that she will be able to enroll in Medicare
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f Part A without paying monthly premiums due to her husband's long work record and participation in the Medicare system.You should
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f alsotellMadelinethatshewillpayPartBpremiumsatmorethanthestandardlowest rate but less than the highest rate due her substantial
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f income.
3. Mr. Bauer is 49 years old, but eighteen months ago he was declared dis- abled by the Social Security Administration and has
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been receiving disability payments. He is wondering whether he can obtain coverage under Medicare. What should you tell him:
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After receiving such disability payments for 24 months, he will be automatically enrolled in Medicare, regardless of age.
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4. Mr. Schmidt would like to plan for retirement and has asked you what is covered under Original Fee-for-Service (FFS)
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f Medicare?What could you tell him?: PartA,whichcovershospital,skillednursingfacility,hospiceandhomehealth services and Part B,
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which covers professional services such as those provided by a doctor are covered under Original Medicare.
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5. Mrs.P e aH i s 66yearsold,hascoverageunderanemployerplan,andwillretire next year.She heard she must enroll in Part B at the
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f beginning of the year to ensure no gap in coverage.What can you tell her?: She may enroll at any time
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f whilesheiscoveredunderheremployerplan,butshewillhaveaspecialeightmonth enrollment period that differs from the standard general
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,f enrollment period, during which she may enroll in Medicare Part B.
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6. Agent John
f Miller
f is
f meeting
f with
f Jerry
f Smith,
f a
f new
f prospect.
f Jerry
f f is cur-
f
f rently enrolled in Medicare Parts A and B. Jerry has also purchased a Medicare Supplement (Medigap) plan which he has had for
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several years.However,the plandoes not provide drug benefits.How would you advise Agent John Miller to proceed?: Tell prospec
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JerrySmiththatheshouldconsideraddingastandalone Part D prescription drug coverage policy to his present coverage.
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7. Mr. Diaz continued working with his company and was insured under his employer's group plan until he reached age 68. He
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f has heard that there is a premiumpenaltyforthosewhodidnotsignupforPartBwhenfirsteligibleand
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, wants to know how much he will have to pay. What should you tell him?: The penalty will be a permanent 10% increase in his Part B
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premiumforevery12-month period that passed during which he could have enrolled and did not.
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8. Ms. Moore plans to retire when she turns 65 in a few months. She is in excellent health and will have considerable
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fincome when she retires.She is concerned that her income will make it impossible for her to qualify for Medicare.What
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f could you tell her to address her concern?: Medicare is a
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program for people age 65 or older and those under age 65 with certain disabilities, end-stage renal disease, and Lou Gehrig's disease so
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f she will be eligible for Medicare.
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9. Mildred Savage enrolled in Allcare Medicare Advantage plan several years ago.Mildredrecentlylearnedthatsheissuffering
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frominoperablecancerand has just a few months to live. She would like to spend these final months in hospice care.Mildred's
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ffamily asks you whether hospice benefits will be paid forundertheAllcareMedicareAdvantageplan.Whatshouldyousay?:Mildred
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fmay remain enrolled in Allcare and make a hospice election. Hospice benefits will be paid for by Original Medicare under Part A and
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f Allcare will continue to pay for any non-hospice services.
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10. Mr.GomeznotesthataPrivateFee-for-Service(PFFS)planavailableinhis area has an attractive premium. He wants to know
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f if he must use doctors in a network as his current HMO plan requires him to do.What should you tell
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f him?:HemayreceivehealthcareservicesfromanydoctorallowedtobillMedicare, aslongasheshowsthedoctortheplan'sidentificationcard
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andthedoctoragreesto acceptthePFFSplan'spaymenttermsandconditions,whichcouldincludebalance billing.
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11. Mr. Kelly wants to know whether he is eligible to sign up for a Private fee-for-service (PFFS) plan.What questions would
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fyou need to ask to deter- f f f f f
minehiseligibility?:YouwouldneedtoaskMr.KellyifheisenrolledinPartAand Part B and if he lives in the PFFS plan's service area.
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12. Mrs.Wang wants to know generally how the benefits under Original Medicare might compare to the benefits package
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f of a Medicare Advantage Plan before she starts looking at specific plans.What could you tell her?: - Medicare Advantage
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f Plans may offer extra benefits that Original Medicare does not offer such as vision, hearing, and dental services.It must include a
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