has been working with Agent Neil Adams in the selection of a Medicare
Advantage (MA) plan. It is mid-September, and Mrs. Young is going on
vacation. Agent Adams is considering suggesting that he and Mrs. Young
complete the application together before she leaves. He will then submit the
paper application prior the start of the annual enrollment period (AEP). What
would you say If you were advising Agent Adams?
This is a bad idea. Agents are generally prohibited from soliciting or
accepting an enrollment form prior to the start of the AEP.
Another agent working for your agency claims that because you are not
employed by the Medicare Advantage plans that you represent, you are not
subject to the same requirements as the plans themselves. How should you
respond to such a statement?
Your coworker is not correct. Marketing on behalf of a plan is considered
marketing by the plan and requires that all contracted and employed agents
comply with all Medicare marketing rules.
Agent Martinez wishes to solicit Medicare Advantage prospects through e-
mail and asks you for advice as to whether this is possible. What should you
tell her?
Marketing representatives may initiate electronic contact through e-mail but
the subject line must say "marketing" and an opt-out process must be
provided.
During a sales presentation, your client asks you whether the Medicare
agency recommends that she sign up for your plan or stay in Original
Medicare. What should you tell her?
Tell her that the Medicare agency does not endorse or recommend any plan.
, `•
Ms. Lewis understands that Medicare prescription drug plans may use
various methods to control the use of specific drugs. She has heard about a
technique called "step therapy" and is wondering if you can explain what
that is. What should you tell her?
Step therapy involves using one or more lower priced drugs before trying a
more expensive drug when all are used to treat the same condition.
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.
Mr. Castillo, a naturalized citizen, previously enrolled in Medicare Part B but
has recently stopped paying his Part B premium. Mr. Castillo is still covered
by Part A. He would like to enroll in a Medicare Advantage (MA) plan and is
still covered by Part A. What should you tell him?
He is not eligible to enroll in a Medicare Advantage plan until he re-enrolls in
Medicare Part B.
You will be holding a sales event soon, at which you would like to offer door
prizes to attendees. Under guidelines from the Medicare agency, what types
of gifts or prizes would not be allowed in this situation?
Gift cards or gift certificates of $15 or less that can be readily converted to
cash.