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1. What impact, if any, have recent regulatory changes The Part B deductible is
had on Medigap plans? no longer covered for in-
dividuals newly eligible for
Medicare starting January 1,
2020.
2. Mr. Diaz continued working with his company and Mr. Diaz will not pay any
was insured under his employer's group plan until he penalty because he had con-
reached age 68. He has heard that there is a premium tinuous coverage under his
penalty for those who did not sign up for Part B when employer's plan.
first eligible and wants to know how much he will
have to pay. What should you tell him?
3. Mrs. Shields is covered by Original Medicare. She sus- Medicare will cover Mrs.
tained a hip fracture and is being successfully treated Shield's skilled nursing ser-
for that condition. However, she and her physicians vices provided during the
feel that after her lengthy hospital stay, she will need first 20 days of her stay, after
a month or two of nursing and rehabilitative care. which she would have a co-
What should you tell them about Original Medicare's pay until she has been in the
coverage of care in a skilled nursing facility? facility for 100 days.
4. Mrs. Quinn recently turned 66 and decided after Part B primarily covers physi-
many years of work to retire and begin receiving So- cian services. She will be
cial Security benefits. Shortly thereafter Mrs. Quinn paying a monthly premium
received a letter informing her that she had been and, except for many pre-
automatically enrolled in Medicare Part B. She wants ventive and screening tests,
to understand what this means. What should you tell generally will have 20%
Mrs. Quinn? co-payments for these ser-
vices, in addition to an annu-
al deductible.
5.
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Mrs. Turner is comparing her employer's retiree in- Original Medicare covers
surance to Original Medicare and would like to know ambulance services.
which of the following services Original Medicare will
cover if the appropriate criteria are met. What could
you tell her?
6. Mrs. Park is an elderly retiree. Mrs. Park has a low She should contact her state
fixed income. What could you tell Mrs. Park that Medicaid agency to see if
might be of assistance? she qualifies for one of
several programs that can
help with Medicare costs for
which she is responsible.
7. Mrs. West wears glasses and dentures and has en- Medicare does not cover
joyed considerable pain relief from arthritis through massage therapy, or, in gen-
massage therapy. She is concerned about whether eral, glasses or dentures.
or not Medicare will cover these items and services.
What should you tell her?
8. Mrs. Chen will be 65 soon, has been a citizen for Most individuals who are cit-
twelve years, has been employed full time, and paid izens and age 65 or over
taxes during that entire period. She is concerned that are covered under Part A
she will not qualify for coverage under part A because by virtue of having paid
she was not born in the United States. What should Medicare taxes while work-
you tell her? ing, though some may be
covered as a result of paying
monthly premiums.
9. Mr. Davis is 52 years old and has recently been diag- He may sign-up for
nosed with end-stage renal disease (ESRD) and will Medicare at any time how-
soon begin dialysis. He is wondering if he can obtain ever coverage usually begins
coverage under Medicare. What should you tell him? on the fourth month after
dialysis treatments start.