Ms. Moore plans to retire when she turns 65 in a few months. She is in excellent health and will
have considerable income when she retires. She is concerned that her income will make it
impossible for her to qualify for Medicare. What could you tell her? - answers✔✔Medicare is a
program for people age 65 or older & those age under 65 with certain disabilities; ESRD, & ALS
so she will be eligible for Medicare.
Mrs. Chen will be 65 soon, has been a citizen for 12 years, has been employed full-time, & paid
taxes during the entire period. She is concerned that she will not qualify for coverage under Part
A because she was not born in the U.S. what should you tell her? - answers✔✔Most people
who are citizens & age 65 and older are covered under Part A by virtue of having paid Medicare
taxes while working, though some may be covered as a result of paying monthly premiums.
Mr. Patel is in good health and is preparing a budget in anticipation of his retirement when he
turns 66. He wants to understand the healthcare costs he might be exposed under Medicare if
he were to require hospitalization as a result of an illness. What could you tell him about his
costs for inpatient hospital services under OG Medicare? - answers✔✔Under OG Medicare,
there is a single deductible amount due for the first 60 days of any inpatient hospital stay, after
which it converts into a per-day coinsurance 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.
Mrs. Park is an elderly retiree and has a low fixed income. Would could you tell Mrs. Park that
may help her? - answers✔✔She could contact her state Medicaid to see if she qualifies for one
of several programs that can help with Medicare costs for which she is responsible.
Mr. Schmidt would like to plan for retirement and has asked you what is covered under OG
Medicare? What would you tell him? - answers✔✔Part A covers hospital, SNF, hospice, & home
health services & Part B, which covers professional services such as those provided by a doctor
are covered under OG Medicare
, Mrs. West wears glasses and dentures and has enjoyed considerable pain relief from arthritis
through massage therapy. She is concerned whether or not Medicare will cover these items.
What should you tell her? - answers✔✔Medicare does not cover massage therapy or in general
glasses or dentures
Mr. A receives some help paying for his 2 generic prescr. drugs from his employer's retiree
coverage, but he wants to compare it to Part D PDP. He asks you what costs he would generally
encounter when enrolling into a standard Medicare Pt D drug plan? what should you tell him? -
answers✔✔He would generally pay a monthly premium, annual ded., & prescr. cost-sharing.
Mrs. P is 66 years old, has coverage under an employer plan, & will retire next year. She heard
she must enroll in Pt B at the beginning of the year to ensure no gap in coverage. What can you
tell her? - answers✔✔She may enroll at anytime while she is covered under her employer plan,
but she will have an 8 month enrollment period after the last month her employer plan that
differs from the standard GEP, during which she may enroll in Med Pt B
Mrs. G is enrolled in a OG med & has a Medigap policy as well, but it provides no drug coverage.
She would like to keep the coverage she has but keep the coverage that she has but replace her
existing Medigap with one that provides drug coverage. What would you tell her? -
answers✔✔Mrs. G can not purchase a Medigap plan that covers drugs, she she could keep her
medigap policy & enroll in a Pt D PDP
Mr. D is 52 years old & has recently been diagnosed with ESRD & will soon begin dialysis. He is
wondering if he can get coverage under Medicare. What should you tell him? - answers✔✔He
may sign up for Medicare at anytime, however coverage usually begins on the 4th month after
dialysis tx begins.
Mr. H believes that she will qualify for Medicare when she turns 65 without paying any
premiums bc she has worked 40 years & paid Medicare taxes. What should you tell her? -
answers✔✔To get Pt B coverage, she must pay a standard monthly premium, though it is higher
for people with higher incomes.