CORRECTLY VERIFIED!!!
Mrs. Chou likes a PFFS plan available in her area that does not offer drug
coverage. She wants to enroll in the plan and enroll in a stand-alone
prescription drug plan. What should you tell her? Correct ans - She
could enroll in a PFFS plan and a stand-alone Medicare prescription drug
plan.
Mrs. Geisler's neighbor told her she should look at her Part D options during
the annual Medicare enrollment period because 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?
Correct ans - 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.
Mr. Moreno invited his neighbor, Agent Tom Smith, to discuss Medicare
Advantage (MA) and Part D plans that Agent Smith sells at the regular
Tuesday brunch the neighbors have for senior citizens. What should Agent
Smith tell Mr. Moreno about the kinds of food that can be provided to
potential enrollees who attend the sales presentation? Correct ans - A
meal cannot be provided, but light snacks would be permitted.
Mr. Rainey is experiencing paranoid delusions and his physician feels that he
should be hospitalized. What should you tell Mr. Rainey (or his
representative) about the length of an inpatient psychiatric hospital stay that
Medicare will cover? Correct ans - Medicare will cover a total of 190
days of inpatient psychiatric care during Mr. Rainey's entire lifetime.
Mr. Bickford did not quite qualify for the extra help low-income subsidy under
the Medicare Part D Prescription Drug program and he is wondering if there is
any other option he has for obtaining help with his considerable drug costs.
What should you tell him? Correct ans - He could check with the
manufacturers of his medications to see if they offer an assistance program
to help people with limited means to obtain the medications they need.
Alternately, he could check to see whether his state has a pharmacy
assistance program to help him with expenses.
Mr. Wong is a single individual. He has a successful business career and is
now able to retire with a comfortable income. Mr. Wong's taxable income is in
excess of $80,000. Mr. Wong has health coverage through his employer but
will sign-up for Medicare Part A, Part B and Part D when he leaves the
workforce. How would you advise him as he budgets for Medicare premiums?
Correct ans - Due to his participation in the workforce he will not have to
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, pay a premium for Part A but he will pay higher premiums for Part B and Part
D due to the amount of his income.
During an appointment scheduled to discuss a Medicare Advantage
Prescription Drug plan (MA-PD), Mr. Peters asked his agent to describe a
stand-alone prescription drug plan (Part D plan) that his neighbor told him
about. What should his agent do? Correct ans - Since Mr. Peters
requested a description of the Part D plan, his agent must have Mr. Peters
sign a new scope of appointment form that includes Part D, and then the
agent may discuss the Part D plan so Mr. Peters can compare plans and make
an informed enrollment choice during the appointment.
By contacting plans available in your area, you have learned that the plan
you represent has a significantly lower monthly premium than the others.
Furthermore, you see that the plan you represent has a unique benefit
package. What should you do to make sure your clients know about these
pieces of information? Correct ans - You may make comparisons
between plans if you can support them by studies or statistical data and
such comparisons are factually based.
Mrs. Fields wants to know whether applying for the Part D low income
subsidy will be worth the time to fill out the paperwork. What could you tell
her? Correct ans - The Part D low income subsidy could substantially
lower her overall costs. She can apply by contacting her state Medicaid office
or calling the Social Security Administration.
Mr. Decaro has looked a Medicare prescription drug plans available in his
area and noted a wide range in premiums. He thought that all drug plans
were required to offer the same standard benefits and would like you to
explain why there is such a range in premiums. What should you tell him?
Correct ans - Some prescription drug plans may have higher operating
costs and/or may offer enhanced coverage in return for an additional
premium amount. He could look at plan designs to see if one of the
enhanced plans would serve his needs better than a plan based on the
standard design.
Mrs. Wellington is enrolled in Parts A and B of Original Medicare. A friend
recently told her that there is an excellent Medicare Advantage (MA) plan
with a five-star rating serving her area. On January 5 she comes to you for
advise as to what options, if any, she has. What should you say regarding
special enrollment periods (SEPs)? Correct ans - Mrs. Wellington is
eligible for a SEP that may be used once until November 30 to enroll in the
five-star plan.
Mr. Landry is approaching his 65th birthday. He has signed up for Medicare
Part A, but he did not enroll in Part B because he has employer-sponsored
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