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Mr. Dalton is in excellent health, lives in his own home, and has
a sizeable income from his investments. He has a friend
enrolled in a Medicare Advantage Special Needs Plan (SNP).
His friend has mentioned that the SNP charges very low cost-
sharing amounts and Mr. Dalton would like to join that plan.
What should you tell him? - CORRECT ANSWER-SNPs limit
enrollment to certain subpopulations of beneficiaries. Given his
current situation, he is unlikely to qualify and would not be able
to enroll in the SNP.
Mr. Anderson wants to know whether he is eligible to sign up
for a Private fee-for-service (PFFS) plan. What questions would
you need to ask to determine his eligibility? - CORRECT ANSWER-You
would need to ask Mr. Anderson if he is entitled to Part A,
enrolled in Part B, and if he lives in the PFFS plan's service
area.
Herber Noble is turning 65 next month, Herber legally entered
the United States over twenty years ago but is not a citizen.
Since his entry into the country, Herber has worked at Smallcap
Incorporated and contributed to the Medicare system. Herber
suffers from diabetes. He will soon retire and asks you if he can
, enroll in a Medicare Advantage plan that you represent. How
would you respond? - CORRECT ANSWER-Herber is eligible to enroll
in Medicare Advantage as long as he is entitled to Part A and
enrolled in Part B. Herber should go to the Social Security
website to enroll in Medicare Part A and B if he has not done so
already. Once he is enrolled, he can choose a Medicare
Advantage plan.
Which of the following individuals is most likely to be eligible to
enroll in a Part D Plan? - CORRECT ANSWER-Jose, a grandfather who
was granted asylum and has worked in the United States for
many years.
Mrs. Castro has just turned 65, is in excellent health and has a
relatively high income. She uses no medications and sees no
reason to spend money on a Medicare prescription drug plan if
she does not need the coverage. She currently does not have
creditable coverage. What could you tell her about the
implications of such a decision? - CORRECT ANSWER-If she does not
sign up for a Medicare prescription drug plan as soon as she is
eligible to do so, and if she does sign up at a later date, her
premium will be permanently increased by 1% of the national
average premium for every month that she was not covered.
Mr. Chen was still working when he first qualified for Medicare.
At that time, he had employer group coverage that was
creditable. During his initial Part D eligibility period, he
decided not to enroll because he was satisfied with his drug
coverage. It is now a year later and Mr. Chen has lost his
employer group coverage within the last two weeks. How would
you advise him? - CORRECT ANSWER-Mr. Chen should enroll in a
Part D plan before he has a 63-day break in coverage in order to
avoid a premium penalty.