Question 1
Medicare will cover Mrs. Shield's skilled nursing services provided
during the first 20 days of her stay, after which she would have a copay
until she has been in the facility for 100 days.
Correct Answer
Mrs. Shields is covered by Original Medicare. She sustained a hip
fracture and is being successfully treated for that condition. However,
she and her physicians feel that after her lengthy hospital stay, she will
need a month or two of nursing and rehabilitative care. What should
you tell them about Original Medicare's coverage of care in a skilled
nursing facility?
Question 2
Medicare does not cover massage therapy, or, in general, glasses or
dentures.
Correct Answer
Mrs. West wears glasses and dentures and has enjoyed considerable
pain relief from arthritis through massage therapy. She is concerned
about whether or not Medicare will cover these items and services.
What should you tell her?
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,Question 3
She should contact her state Medicaid agency to see if she qualifies for
one of several programs that can help with Medicare costs for which she
is responsible.
Correct Answer
Mrs. Park is an elderly retiree. Mrs. Park has a low fixed income. What
could you tell Mrs. Park that might be of assistance?
Question 4
He generally would pay a monthly premium, annual deductible, and
per-prescription cost- sharing.
Correct Answer
Mr. Alonso receives some help paying for his two generic prescription
drugs from his employer's retiree coverage, but he wants to compare it
to a Part D prescription drug plan. He asks you what costs he would
generally expect to encounter when enrolling into a standard Medicare
Part D prescription drug plan. What should you tell him?
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,Question 5
Mrs. Gonzalez cannot purchase a Medigap plan that covers drugs, but she
could keep her Medigap policy and enroll in a Part D prescription drug
plan.
Correct Answer
Mrs. Gonzalez is enrolled in Original Medicare and has a Medigap
policy as well, but it provides no drug coverage. She would like to
keep the coverage she has but replace her existing Medigap plan with
one that provides drug coverage. What should you tell her?
Question 6
He may sign-up for Medicare at any time however coverage usually
begins on the fourth month after dialysis treatments start.
Correct Answer
Mr. Davis is 52 years old and has recently been diagnosed with end-
stage renal disease (ESRD) and will soon begin dialysis. He is
wondering if he can obtain coverage under Medicare. What should you
tell him?
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, Question 7
Mrs. Duarte should file an appeal of this initial determination within 120
days of the date she received the MSN in the mail.
Correct Answer
Mrs. Duarte is enrolled in Original Medicare Parts A and B. She has
recently reviewed her Medicare Summary Notice (MSN) and disagrees
with a determination that partially denied one of her claims for
services. What advice would you give her?
Question 8
Part D covers prescription drugs and she should look at her premiums,
formulary, and cost- sharing among other factors to see if they have
changed.
Correct Answer
Mrs. Geisler's neighbor told her she should look at her Part D options
during the annual Medicare enrollment period because the features of
Part D might have changed. Mrs. Geisler can't remember what Part D
is so she called you to ask what her neighbor was talking about. What
could you tell her?
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Medicare will cover Mrs. Shield's skilled nursing services provided
during the first 20 days of her stay, after which she would have a copay
until she has been in the facility for 100 days.
Correct Answer
Mrs. Shields is covered by Original Medicare. She sustained a hip
fracture and is being successfully treated for that condition. However,
she and her physicians feel that after her lengthy hospital stay, she will
need a month or two of nursing and rehabilitative care. What should
you tell them about Original Medicare's coverage of care in a skilled
nursing facility?
Question 2
Medicare does not cover massage therapy, or, in general, glasses or
dentures.
Correct Answer
Mrs. West wears glasses and dentures and has enjoyed considerable
pain relief from arthritis through massage therapy. She is concerned
about whether or not Medicare will cover these items and services.
What should you tell her?
Trusted by thousands of students and professionals worldwide Page 1 of 54
,Question 3
She should contact her state Medicaid agency to see if she qualifies for
one of several programs that can help with Medicare costs for which she
is responsible.
Correct Answer
Mrs. Park is an elderly retiree. Mrs. Park has a low fixed income. What
could you tell Mrs. Park that might be of assistance?
Question 4
He generally would pay a monthly premium, annual deductible, and
per-prescription cost- sharing.
Correct Answer
Mr. Alonso receives some help paying for his two generic prescription
drugs from his employer's retiree coverage, but he wants to compare it
to a Part D prescription drug plan. He asks you what costs he would
generally expect to encounter when enrolling into a standard Medicare
Part D prescription drug plan. What should you tell him?
Trusted by thousands of students and professionals worldwide Page 2 of 54
,Question 5
Mrs. Gonzalez cannot purchase a Medigap plan that covers drugs, but she
could keep her Medigap policy and enroll in a Part D prescription drug
plan.
Correct Answer
Mrs. Gonzalez is enrolled in Original Medicare and has a Medigap
policy as well, but it provides no drug coverage. She would like to
keep the coverage she has but replace her existing Medigap plan with
one that provides drug coverage. What should you tell her?
Question 6
He may sign-up for Medicare at any time however coverage usually
begins on the fourth month after dialysis treatments start.
Correct Answer
Mr. Davis is 52 years old and has recently been diagnosed with end-
stage renal disease (ESRD) and will soon begin dialysis. He is
wondering if he can obtain coverage under Medicare. What should you
tell him?
Trusted by thousands of students and professionals worldwide Page 3 of 54
, Question 7
Mrs. Duarte should file an appeal of this initial determination within 120
days of the date she received the MSN in the mail.
Correct Answer
Mrs. Duarte is enrolled in Original Medicare Parts A and B. She has
recently reviewed her Medicare Summary Notice (MSN) and disagrees
with a determination that partially denied one of her claims for
services. What advice would you give her?
Question 8
Part D covers prescription drugs and she should look at her premiums,
formulary, and cost- sharing among other factors to see if they have
changed.
Correct Answer
Mrs. Geisler's neighbor told her she should look at her Part D options
during the annual Medicare enrollment period because the features of
Part D might have changed. Mrs. Geisler can't remember what Part D
is so she called you to ask what her neighbor was talking about. What
could you tell her?
Trusted by thousands of students and professionals worldwide Page 4 of 54
