2025 AHIP Final Exam with correct
answersA+ Graded
A Medicare beneficiary has walked into your office and requested that you sit down with
her and discuss her options under the Medicare Advantage program. Before engaging
in such a discussion, what should you do?-CORRECT ANSWERS-You must have her
sign a scope of appointment form, indicating which products she wishes to discuss. You
may then proceed with the discussion.
Agent Harriet Walker has recently begun marketing Medicare Advantage and related
products aimed at meeting the needs of senior citizens. Client Mildred Jones has
expressed interest in a Medicare Advantage plan. It is now the beginning of September.
If you were in Agent Walker's position, what would you do?-CORRECT ANSWERS-
Inquire whether the client qualifies for a special enrollment period, and if not, solicit an
enrollment application once the annual open enrollment election period begins on
October 15th.
Agent Jennings makes a presentation on Medicare advertised as an educational event.
Agent Jennings distributes materials that are solely educational. However, she gives a
brief presentation that mentions plan-specific premiums. Is this a prohibited activity at
an event that has been advertised as educational?-CORRECT ANSWERS-Yes. When
an event has been advertised as "educational," discussing plan-specific premiums is
impermissible.
Alice is enrolled in a MA-PD plan. She makes a permanent move across the country
and wonders what her options are for continuing MA-PD coverage. What would you say
to her in regard to a special enrollment period (SEP)?-CORRECT ANSWERS-She is
likely to qualify for a SEP. She can choose an effective date of up to three months after
the month in which the enrollment form is received by the new plan, but the effective
date may not be earlier than the date of her permanent move.
Anita Magri will turn age 65 in August 2023. Anita intends to enroll in Original Medicare
Part A and Part B. She would also like to enroll in a Medicare Supplement (Medigap)
,plan. Anita's older neighbor Mel has told her about the Medigap Plan F in which he is
enrolled. It not only provides foreign travel emergency benefits but also covers his
Medicare Part B deductible. Anita comes to you for advice. What should you tell her?-
CORRECT ANSWERS-You are sorry to disappoint Anita, but a Medigap F plan is no
longer available to those who turn age 65 after January 1, 2020. Anita might instead
consider other Medigap plans that offer foreign travel benefits but do not cover the Part
B deductible.
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 benefits package. What should you do to make
sure your clients know about these pieces of information?-CORRECT ANSWERS-You
may make comparisons between plans if you can support them with studies or
statistical data and such comparisons are factually based and referenced.
Dr. Elizabeth Brennan does not contract with the ABC PFFS plan but accepts the plan's
terms and conditions for payment. Mary Rodgers sees Dr. Brennan for treatment. How
much may Dr. Brennan charge?-CORRECT ANSWERS-Dr. Brennan can charge Mary
Rogers no more than the cost sharing specified in the PFFS plan's terms and condition
of payment which may include balance billing up to 15%of the Medicare rate.
During a sales presentation to Ms. Daley for a Medicare Advantage plan that has a 5-
star rating in customer service and care coordination, and received an overall plan
performance rating of a 4-star, which of the following would be the best statement to say
to her?-CORRECT ANSWERS-The Medicare Advantage plan received a 5-star rating in
customer service and care coordination with an overall performance rating of 4 stars.
Hank's Fish Store, Inc. is a small company with just 15 employees located in Florida.
Hank, the store owner, has provided excellent health benefits to the store's workforce.
William, one of the store's long-time employees, will soon be reaching age 65 and
eligible for Medicare. William is in good health. He intends to remain an active full-time
employee, working several years after becoming eligible for Medicare. What type(s) of
retiree health benefit will Hank's Fish Store be able to offer William?-CORRECT
ANSWERS-Hank's can continue to offer William the same employee health benefit plan,
or, if William enrolls in Medicare Part B, it can enroll him in a Medicare Advantage plan
that is offered to the public.
If you are to comply with Medicare's guidance regarding educational events, which of
the following would be acceptable activities?-CORRECT ANSWERS-You may distribute
business cards to individuals who request information on how to contact you for further
details on the plan(s) you represent.
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?-
,CORRECT ANSWERS-He generally would pay a monthly premium, annual deductible,
and per-prescription cost-sharing.
Mr. and Mrs. Nunez attended one of your sales presentations. They've asked you to
come to their home to clear up a few questions. During the presentation, Mrs. Nunez
feels tired and tells you that her husband can finish things up. She goes to bed. At the
end of your discussion, Mr. Nunez says that he wants to enroll both himself and his
wife. What should you do?-CORRECT ANSWERS-As long as she can do so, only Mrs.
Nunez can sign her enrollment form. Mrs. Nunez will have to wake up to sign her form
or do so at another time.
Mr. and Mrs. Vaughn both take a specialized multivitamin prescription each day. Mr.
Vaughn takes a prescription to help to regrow his hair. They are anxious to have their
Medicare prescription drug plan cover these drug needs. What should you tell them?-
CORRECT ANSWERS-Medicare prescription drug plans are not permitted to cover the
prescription medications the Vaughns are interested in under Part D coverage,
however, plans may cover them as supplemental benefits and the Vaughns could look
into that possibility.
Mr. Anderson is a very organized individual and has filled out and brought to you an
enrollment form on October 10 for a new plan available on January 1 next year. He is
currently enrolled in Original Medicare. What should you do?-CORRECT ANSWERS-
Tell Mr. Anderson that you cannot accept any enrollment forms until the annual election
period begins.
Mr. Barker enjoys a comfortable retirement income. He recently had surgery and
expected that he would have certain services and items covered by the plan with
minimal out-of-pocket costs because his MA-PD coverage has been very good.
However, when he received the bill, he was surprised to see large charges in excess of
his maximum out-of-pocket limit that included some services and items he thought
would be fully covered. He called you to ask what he could do? What could you tell
him?-CORRECT ANSWERS-You can offer to review the plans appeal process to help
him ask the plan to review the coverage decision.
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 ANSWERS-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. Alternatively, he could check to see whether his state has a
pharmacy assistance program to help him with his expenses.
Mr. Block is currently enrolled in a Medicare Advantage plan that includes drug
coverage. He found a stand-alone Medicare prescription drug plan in his area that offers
better coverage than that available through his MA-PD plan and in addition, has a low
premium. It won't cost him much more and, because he has the means to do so, he
,wishes to enroll in the stand-alone prescription drug plan in addition to his MA-PD plan.
What should you tell him?-CORRECT ANSWERS-If Mr. Block enrolls in the stand-alone
Medicare prescription drug plan, he will be disenrolled from the Medicare Advantage
plan.
Mr. Carlini has heard that Medicare prescription drug plans are only offered through
private companies under a program known as Medicare Advantage (MA), not by the
government. He likes Original Medicare and does not want to sign up for an MA
product, but he also wants prescription drug coverage. What should you tell him?-
CORRECT ANSWERS-Mr. Carlini can stay with Original Medicare and also enroll in a
Medicare prescription drug plan through a private company that has contracted with the
government to provide only such drug coverage to eligible Medicare beneficiaries.
Mr. Chen is enrolled in his employer's group health plan and will be retiring soon. He
would like to know his options since he has decided to drop his retiree coverage and is
eligible for Medicare. What should you tell him?-CORRECT ANSWERS-Mr. Chen can
disenroll from his employer-sponsored coverage to elect a Medicare Advantage or Part
D plan within 2 months of his disenrollment.
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?-CORRECT ANSWERS-He may sign-up for
Medicare at any time however coverage usually begins on the fourth month after
dialysis treatments start.
Mr. Diaz continued working with his company and was insured under his employer's
group plan until he reached age 68. He has heard that there is a premium penalty for
those who did not sign up for Part B when first eligible and wants to know how much he
will have to pay. What should you tell him?-CORRECT ANSWERS-Mr. Diaz will not pay
any penalty because he had continuous coverage under his employer's plan.
Mr. Ford enrolled in an MA-only plan in mid-November during the Annual Election
Period (AEP). On December 1, he calls you up and says that he has changed his mind
and would like to enroll in a MA-PD plan. What enrollment rules would apply in this
case?-CORRECT ANSWERS-He can make as many enrollment changes as he likes
during the Annual Election Period and the last choice made before the end of the period
will be the effective one as of January 1.
Mr. Garcia was told he qualifies for a special election period (SEP), but he lost the
paper that explains what he could do during the SEP. What can you tell him?-
CORRECT ANSWERS-If the SEP is for MA coverage, he will generally have one
opportunity to change his MA coverage.
Mr. Hildalgo complains to you that because he takes multiple expensive drugs, he has
trouble paying his cost sharing for his prescription drugs, particularly at the beginning of
the year during the deductible phase. He is happy with his plan and does not want to
,change. However, he said he had heard about a new program called the Medicare
Prescription Payment Plan and asked whether it might help. What do you tell him?-
CORRECT ANSWERS-The Medicare Prescription Payment Plan helps spread out
beneficiary cost-sharing payments but does not decrease the total amount owed.
Mr. Hutchinson has drug coverage through his former employer's retiree plan. He is
concerned about the Part D premium penalty if he does not enroll in a Medicare
prescription drug plan, but does not want to purchase extra coverage that he will not
need. What should you tell him?-CORRECT ANSWERS-If the drug coverage he has is
not expected to pay, on average, at least as much as Medicare's standard Part D
coverage expects to pay, then he will need to enroll in Medicare Part D during his initial
eligibility period to avoid the late enrollment penalty.
Mr. Jacob understands that there is a standard Medicare Part D prescription drug
benefit, but when he looks at information on various plans available in his area, he sees
a wide range in what they charge for deductibles, premiums, and cost sharing. How can
you explain this to him?-CORRECT ANSWERS-Medicare Part D drug plans may have
different benefit structures, but on average, they must all be at least as good as the
standard model established by the government.
Mr. Kelly 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 ANSWERS-You would need to ask Mr. Kelly if he is entitled to Part A,
enrolled in Part B, and if he lives in the PFFS plan's service area.
Mr. Liu turns 65 on June 19. He has never previously qualified for Medicare so his first
Medicare eligibility date will be June 1. Mr. Liu's ICEP and Part D IEP begin on March 1
and end on September 30. He wants prescription drug coverage with his Part A and
Part B benefits. What advice can you provide him?-CORRECT ANSWERS-He can
enroll in a MA-PD as long as he enrolls in Part B and is entitled to Part A.
Mr. Lombardi is interested in a Medicare Advantage (MA) PPO plan that you represent.
It is one of three plans operated by the same organization in Mr. Lombardi's area. The
MA PPO plan does not include drug coverage, but the other two plans do. Mr. Lombardi
likes the PPO plan that does not include drug coverage and intends to obtain his drug
coverage through a stand-alone Medicare prescription drug plan. What should you tell
him about this situation?-CORRECT ANSWERS-He could enroll either in one of the MA
plans that include prescription drug coverage or Original Medicare with a Medigap plan
and standalone Part D prescription drug coverage, but he cannot enroll in the MA-only
PPO plan and a stand-alone prescription drug plan.
Mr. Lopez has heard that he can sign up for a product called "Medicare Advantage" but
is not sure about what type of plan designs are available through this program. What
should you tell him about the types of health plans that are available through the
Medicare Advantage program?-CORRECT ANSWERS-There are Medicare health
plans such as HMOs, PPOs, PFFS, and MSAs.
,Mr. Lopez, who is fairly well-off financially, would like to enroll in a Medicare prescription
drug plan you represent and simply give you a check to cover his premiums for the
entire year. What should you tell him?-CORRECT ANSWERS-Enrollees should pay
using automatic withdrawal from a bank account or credit or debit card, direct monthly
billing from the plan, or deductions from their Social Security check.
Mr. Patel is in good health and is preparing a budget in anticipation of his retirement
when he turns 66. He wants to understand the health care costs he might be exposed to
under Medicare if he were to require hospitalization because of an illness. In general
terms, what could you tell him about his costs for inpatient hospital services under
Original Medicare?-CORRECT ANSWERS-Under Original Medicare, there is a single
deductible amount due for the first 60 days of any inpatient hospital stay, after which it
converts into a per-day coinsurance amount through day 90. After day 90, he would pay
a daily amount up to 60 days over his lifetime, after which he would be responsible for
all costs.
Mr. Prentice has many clients who are Medicare beneficiaries. He should review the
Centers for Medicare & Medicaid Services (CMS) Communication and Marketing
Guidelines to ensure he is compliant with which type of products.-CORRECT
ANSWERS-Medicare Advantage (MA) and Prescription Drug (PDP) plans.
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 ANSWERS-
Medicare will cover a total of 190 days of inpatient psychiatric care during Mr. Rainey's
entire lifetime.
Mr. Rice is 68, actively working, and has coverage for medical services and medications
through his employer's group health plan. He is entitled to premium free Part A and
thinking of enrolling in Part B and switching to an MA-PD because he is paying a very
large part of his group coverage premium, and it does not provide coverage for a
number of his medications. Which of the following is NOT a consideration when making
the change?-CORRECT ANSWERS-Mr. Rice's retiree plan is required to take him back
if, within 63 days of having voluntarily quit the employer's plan, he decides that he
prefers it to his Medicare Part D plan.
Mr. Rodriguez is currently enrolled in a MA plan, but his plan doesn't sufficiently cover
his prescription drug needs. He is interested in changing plans during the upcoming MA
Open Enrollment Period. What are his options during the MA OEP?-CORRECT
ANSWERS-He can switch to a MA-PD plan.
Mr. Romero is 64, retiring soon, and considering enrollment in his employer-sponsored
retiree group health plan that includes drug coverage with nominal copays. He heard
about a neighbor's MA-PD plan that you represent and because he takes numerous
prescription drugs, he is considering signing up for it. What should you tell him?-
,CORRECT ANSWERS-He should compare the benefits in his employer-sponsored
retiree group health plan with the benefits in his neighbor's MA-PD plan to determine
which one will provide sufficient coverage for his prescription needs.
Mr. Sanchez has just turned 65 and is entitled to Part A but has not enrolled in Part B
because he has coverage through an employer plan. If he wants to enroll in a Medicare
Advantage plan, what will he have to do?-CORRECT ANSWERS-He will have to enroll
in Part B.
Mr. Shapiro gets by on a very small amount of fixed income. He has heard there may be
extra help paying for Part D prescription drugs for Medicare beneficiaries with limited
income. He wants to know whether he might qualify. What should you tell him?-
CORRECT ANSWERS-The extra help is available to beneficiaries whose income and
assets do not exceed annual limits specified by the government.
Mr. Singh would like drug coverage but does not want to be enrolled in a Medicare
Advantage plan. What should you tell him?-CORRECT ANSWERS-Mr. Singh can enroll
in a stand-alone prescription drug plan and continue to be covered for Part A and Part B
services through Original Fee-for-Service Medicare.
Mr. Torres has a small savings account. He would like to pay for his monthly Part D
premiums with an automatic monthly withdrawal from his savings account until it is
exhausted, and then have his premiums withheld from his Social Security check. What
should you tell him?-CORRECT ANSWERS-In general, he must select a single Part D
premium payment mechanism that will be used throughout the year.
Mr. Wells is trying to understand the difference between Original Medicare and
Medicare Advantage. What would be the correct description?-CORRECT ANSWERS-
Medicare Advantage is a way of covering all the Original Medicare benefits through
private health insurance companies.
Mr. Wendt suffers from diabetes which has gotten progressively worse during the last
year. He is currently enrolled in Original Medicare (Parts A and B) and a Part D
prescription drug plan and did not enroll in a Medicare Advantage (MA) plan during the
last annual open enrollment period (AEP) which has just closed. Mr. Wendt has heard
certain MA plans might provide him with more specialized coverage for his diabetes and
wants to know if he must wait until the next annual open enrollment period (AEP) before
enrolling in such a plan. What should you tell him?-CORRECT ANSWERS-If there is a
special needs plan (SNP) in Mr. Wendt's area that specializes in caring for individuals
with diabetes, he may enroll in the SNP at any time under a special election period
(SEP).
Mr. Wingate is a newly enrolled Medicare Part D beneficiary and one of your clients. In
addition to drugs on his plan's formulary, he takes several other medications. These
include a prescription drug not on his plan's formulary, over-the-counter medications for
colds and allergies, vitamins, and drugs from an Internet-based Canadian pharmacy to
,promote hair growth and reduce joint swelling. His neighbor recently told him about a
concept called TrOOP and he asks you if any of his other medications could count
toward TrOOP should he ever reach the Part D catastrophic limit. What should you
say.-CORRECT ANSWERS-None of the costs of Mr. Wingate's other medications
would currently count toward TrOOP but he may wish to ask his plan for an exception to
cover the prescription, not on its formulary.
Mr. Xi will soon turn age 65 and has come to you for advice as to what services are
provided under Original Medicare. What should you tell Mr. Xi that best describes the
health coverage provided to Medicare beneficiaries?-CORRECT ANSWERS-
Beneficiaries under Original Medicare have no cost-sharing for most preventive
services.
Mr. Yoo's employer has recently dropped comprehensive creditable prescription drug
coverage that was offered to company retirees. The company told Mr. Yoo that,
because he was affected by this change, he would qualify for a special election period.
Mr. Yoo contacted you to find out more about what this means. What can you tell him?-
CORRECT ANSWERS-It means that he qualifies for a one-time opportunity to enroll in
an MA-PD or Part D prescription drug plan.
Mr. Zachow has a condition for which three drugs are available. He has tried two but
had an allergic reaction to them. Only the third drug works for him and it is not on his
Part D plan's formulary. What could you tell him to do?-CORRECT ANSWERS-Mr.
Zachow has a right to request a formulary exception to obtain coverage for his Part D
drug. He or his physician could obtain the standardized request form on the plan's
website, fill it out, and submit it to his plan.
Mrs. Albertson has been enrolled in a Medicare Part D plan for several years. She takes
several brand name drugs and is interested in learning about the Medicare Prescription
Payment Plan. What should you tell her?-CORRECT ANSWERS-Enrollees can opt out
of the program at any time. However, they will continue to be billed for any cost-sharing
amounts still owed.
Mrs. Allen has a rare condition for which two different brand name drugs are the only
available treatment. She is concerned that since no generic prescription drug is
available and these drugs are very high cost, she will not be able to find a Medicare Part
D prescription drug plan that covers either one of them. What should you tell her?-
CORRECT ANSWERS-Medicare prescription drug plans are required to cover drugs in
each therapeutic category. She should be able to enroll in a Medicare prescription drug
plan that covers the medications she needs.
Mrs. Burton is a retiree with substantial income. She is enrolled in an MA-PD plan and
was disappointed with the service she received from her primary care physician
because she was told she would have to wait five weeks to get an appointment when
she was feeling ill. She called you to ask what she could do so she would not have to
put up with such poor access to care. What could you tell her?-CORRECT ANSWERS-
,She could file a grievance with her plan to complain about the lack of timeliness in
getting an appointment.
Mrs. Chen will be 65 soon, has been a citizen for twelve years, has been employed full
time, and paid taxes during that entire period. She is concerned that she will not qualify
for coverage under part A because she was not born in the United States. What should
you tell her?-CORRECT ANSWERS-Most individuals who are citizens and age 65 or
over are covered under Part A by virtue of having paid Medicare taxes while working,
though some may be covered as a result of paying monthly premiums.
Mrs. Chi is age 75 and enjoys a comfortable but not extremely high-income level. She
wishes to enroll in a MA MSA plan that she heard about from her neighbor. She also
wants to have prescription drug coverage since her doctor recently prescribed several
expensive medications. Currently, she is enrolled in Original Medicare and a standalone
Part D plan. How would you advise Mrs. Chi?-CORRECT ANSWERS-Mrs. Chi may
enroll in a MA MSA plan and remain in her current standalone Part D prescription drug
plan.
Mrs. Chou likes a Private Fee-for-Service (PFFS) plan available in her area that does
not include drug coverage. She wants to enroll in the plan and enroll in a stand-alone
prescription drug plan. What should you tell her?-CORRECT ANSWERS-She could
enroll in a PFFS plan and a stand-alone Medicare prescription drug plan.
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?-CORRECT
ANSWERS-Mrs. Duarte should file an appeal of this initial determination within 120
days of the date she received the MSN in the mail.
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?-CORRECT ANSWERS-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.
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?-CORRECT ANSWERS-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.
Mrs. Hernandez is one of your clients. She has read that there is a new program that
may help her manage prescription drug costs. What do you tell her about the Medicare
Prescription Payment Plan?-CORRECT ANSWERS-Part D enrollees can opt into the
, Medicare Prescription Payment Plan at the beginning of the plan year or any point
during the year.
Mrs. Kelly, age 65, is entitled to Part A but has not yet enrolled in Part B. She is
considering enrollment in a Medicare Advantage plan (Part C). What should you advise
her to do before she can enroll in a Medicare Advantage plan?-CORRECT ANSWERS-
To join a Medicare Advantage plan, she also must enroll in Part B.
Mrs. Kendrick is in good health, has worked for many years, and is six months away
from turning 65. She wants to know what she will have to do to enroll in a Medicare
Advantage (MA) plan as soon as possible. What could you tell her?-CORRECT
ANSWERS-She may enroll in an MA plan beginning three months immediately before
her first entitlement to both Medicare Part A and Part B.
Mrs. Lopez is enrolled in a cost plan for her Medicare benefits. She has recently lost
creditable coverage previously available through her husband's employer. She is
interested in enrolling in a Medicare Part D prescription drug plan (PDP). What should
you tell her?-CORRECT ANSWERS-If a Part D benefit is offered through her plan she
may choose to enroll in that plan or a standalone PDP.
Mrs. Lyons is in good health, uses a single prescription, and lives independently in her
own home. She is attracted by the idea of maintaining control over a Medical Savings
Account (MSA) but is not sure if the plan associated with the account will fit her needs.
What specific piece of information about a Medicare MSA plan would it be important for
her to know, prior to enrolling in such a plan?-CORRECT ANSWERS-All MSAs cover
Part A and Part B benefits, but not Part D prescription drug benefits, which could be
obtained by also enrolling in a separate prescription drug plan.
Mrs. Mulcahy, age 65, is concerned that she may not qualify for enrollment in a
Medicare prescription drug plan because, although she is entitled to Part A, she is not
enrolled under Medicare Part B. What should you tell her?-CORRECT ANSWERS-An
individual who is entitled to Part A or enrolled under Part B is eligible to enroll in a
Medicare prescription drug plan. As long as Mrs. Mulcahy is entitled to Part A, she does
not need to enroll under Part B before enrolling in a prescription drug plan.
Mrs. Park is an elderly retiree. Mrs. Park has a low fixed income. What could you tell
Mrs. Park that might be of assistance?-CORRECT ANSWERS-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.
Mrs. Paterson is concerned about the deductibles and co-payments associated with
Original Medicare. What can you tell her about Medigap as an option to address this
concern?-CORRECT ANSWERS-Medigap plans do not cover Original Medicare
benefits, but they coordinate with Original Medicare coverage.
answersA+ Graded
A Medicare beneficiary has walked into your office and requested that you sit down with
her and discuss her options under the Medicare Advantage program. Before engaging
in such a discussion, what should you do?-CORRECT ANSWERS-You must have her
sign a scope of appointment form, indicating which products she wishes to discuss. You
may then proceed with the discussion.
Agent Harriet Walker has recently begun marketing Medicare Advantage and related
products aimed at meeting the needs of senior citizens. Client Mildred Jones has
expressed interest in a Medicare Advantage plan. It is now the beginning of September.
If you were in Agent Walker's position, what would you do?-CORRECT ANSWERS-
Inquire whether the client qualifies for a special enrollment period, and if not, solicit an
enrollment application once the annual open enrollment election period begins on
October 15th.
Agent Jennings makes a presentation on Medicare advertised as an educational event.
Agent Jennings distributes materials that are solely educational. However, she gives a
brief presentation that mentions plan-specific premiums. Is this a prohibited activity at
an event that has been advertised as educational?-CORRECT ANSWERS-Yes. When
an event has been advertised as "educational," discussing plan-specific premiums is
impermissible.
Alice is enrolled in a MA-PD plan. She makes a permanent move across the country
and wonders what her options are for continuing MA-PD coverage. What would you say
to her in regard to a special enrollment period (SEP)?-CORRECT ANSWERS-She is
likely to qualify for a SEP. She can choose an effective date of up to three months after
the month in which the enrollment form is received by the new plan, but the effective
date may not be earlier than the date of her permanent move.
Anita Magri will turn age 65 in August 2023. Anita intends to enroll in Original Medicare
Part A and Part B. She would also like to enroll in a Medicare Supplement (Medigap)
,plan. Anita's older neighbor Mel has told her about the Medigap Plan F in which he is
enrolled. It not only provides foreign travel emergency benefits but also covers his
Medicare Part B deductible. Anita comes to you for advice. What should you tell her?-
CORRECT ANSWERS-You are sorry to disappoint Anita, but a Medigap F plan is no
longer available to those who turn age 65 after January 1, 2020. Anita might instead
consider other Medigap plans that offer foreign travel benefits but do not cover the Part
B deductible.
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 benefits package. What should you do to make
sure your clients know about these pieces of information?-CORRECT ANSWERS-You
may make comparisons between plans if you can support them with studies or
statistical data and such comparisons are factually based and referenced.
Dr. Elizabeth Brennan does not contract with the ABC PFFS plan but accepts the plan's
terms and conditions for payment. Mary Rodgers sees Dr. Brennan for treatment. How
much may Dr. Brennan charge?-CORRECT ANSWERS-Dr. Brennan can charge Mary
Rogers no more than the cost sharing specified in the PFFS plan's terms and condition
of payment which may include balance billing up to 15%of the Medicare rate.
During a sales presentation to Ms. Daley for a Medicare Advantage plan that has a 5-
star rating in customer service and care coordination, and received an overall plan
performance rating of a 4-star, which of the following would be the best statement to say
to her?-CORRECT ANSWERS-The Medicare Advantage plan received a 5-star rating in
customer service and care coordination with an overall performance rating of 4 stars.
Hank's Fish Store, Inc. is a small company with just 15 employees located in Florida.
Hank, the store owner, has provided excellent health benefits to the store's workforce.
William, one of the store's long-time employees, will soon be reaching age 65 and
eligible for Medicare. William is in good health. He intends to remain an active full-time
employee, working several years after becoming eligible for Medicare. What type(s) of
retiree health benefit will Hank's Fish Store be able to offer William?-CORRECT
ANSWERS-Hank's can continue to offer William the same employee health benefit plan,
or, if William enrolls in Medicare Part B, it can enroll him in a Medicare Advantage plan
that is offered to the public.
If you are to comply with Medicare's guidance regarding educational events, which of
the following would be acceptable activities?-CORRECT ANSWERS-You may distribute
business cards to individuals who request information on how to contact you for further
details on the plan(s) you represent.
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?-
,CORRECT ANSWERS-He generally would pay a monthly premium, annual deductible,
and per-prescription cost-sharing.
Mr. and Mrs. Nunez attended one of your sales presentations. They've asked you to
come to their home to clear up a few questions. During the presentation, Mrs. Nunez
feels tired and tells you that her husband can finish things up. She goes to bed. At the
end of your discussion, Mr. Nunez says that he wants to enroll both himself and his
wife. What should you do?-CORRECT ANSWERS-As long as she can do so, only Mrs.
Nunez can sign her enrollment form. Mrs. Nunez will have to wake up to sign her form
or do so at another time.
Mr. and Mrs. Vaughn both take a specialized multivitamin prescription each day. Mr.
Vaughn takes a prescription to help to regrow his hair. They are anxious to have their
Medicare prescription drug plan cover these drug needs. What should you tell them?-
CORRECT ANSWERS-Medicare prescription drug plans are not permitted to cover the
prescription medications the Vaughns are interested in under Part D coverage,
however, plans may cover them as supplemental benefits and the Vaughns could look
into that possibility.
Mr. Anderson is a very organized individual and has filled out and brought to you an
enrollment form on October 10 for a new plan available on January 1 next year. He is
currently enrolled in Original Medicare. What should you do?-CORRECT ANSWERS-
Tell Mr. Anderson that you cannot accept any enrollment forms until the annual election
period begins.
Mr. Barker enjoys a comfortable retirement income. He recently had surgery and
expected that he would have certain services and items covered by the plan with
minimal out-of-pocket costs because his MA-PD coverage has been very good.
However, when he received the bill, he was surprised to see large charges in excess of
his maximum out-of-pocket limit that included some services and items he thought
would be fully covered. He called you to ask what he could do? What could you tell
him?-CORRECT ANSWERS-You can offer to review the plans appeal process to help
him ask the plan to review the coverage decision.
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 ANSWERS-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. Alternatively, he could check to see whether his state has a
pharmacy assistance program to help him with his expenses.
Mr. Block is currently enrolled in a Medicare Advantage plan that includes drug
coverage. He found a stand-alone Medicare prescription drug plan in his area that offers
better coverage than that available through his MA-PD plan and in addition, has a low
premium. It won't cost him much more and, because he has the means to do so, he
,wishes to enroll in the stand-alone prescription drug plan in addition to his MA-PD plan.
What should you tell him?-CORRECT ANSWERS-If Mr. Block enrolls in the stand-alone
Medicare prescription drug plan, he will be disenrolled from the Medicare Advantage
plan.
Mr. Carlini has heard that Medicare prescription drug plans are only offered through
private companies under a program known as Medicare Advantage (MA), not by the
government. He likes Original Medicare and does not want to sign up for an MA
product, but he also wants prescription drug coverage. What should you tell him?-
CORRECT ANSWERS-Mr. Carlini can stay with Original Medicare and also enroll in a
Medicare prescription drug plan through a private company that has contracted with the
government to provide only such drug coverage to eligible Medicare beneficiaries.
Mr. Chen is enrolled in his employer's group health plan and will be retiring soon. He
would like to know his options since he has decided to drop his retiree coverage and is
eligible for Medicare. What should you tell him?-CORRECT ANSWERS-Mr. Chen can
disenroll from his employer-sponsored coverage to elect a Medicare Advantage or Part
D plan within 2 months of his disenrollment.
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?-CORRECT ANSWERS-He may sign-up for
Medicare at any time however coverage usually begins on the fourth month after
dialysis treatments start.
Mr. Diaz continued working with his company and was insured under his employer's
group plan until he reached age 68. He has heard that there is a premium penalty for
those who did not sign up for Part B when first eligible and wants to know how much he
will have to pay. What should you tell him?-CORRECT ANSWERS-Mr. Diaz will not pay
any penalty because he had continuous coverage under his employer's plan.
Mr. Ford enrolled in an MA-only plan in mid-November during the Annual Election
Period (AEP). On December 1, he calls you up and says that he has changed his mind
and would like to enroll in a MA-PD plan. What enrollment rules would apply in this
case?-CORRECT ANSWERS-He can make as many enrollment changes as he likes
during the Annual Election Period and the last choice made before the end of the period
will be the effective one as of January 1.
Mr. Garcia was told he qualifies for a special election period (SEP), but he lost the
paper that explains what he could do during the SEP. What can you tell him?-
CORRECT ANSWERS-If the SEP is for MA coverage, he will generally have one
opportunity to change his MA coverage.
Mr. Hildalgo complains to you that because he takes multiple expensive drugs, he has
trouble paying his cost sharing for his prescription drugs, particularly at the beginning of
the year during the deductible phase. He is happy with his plan and does not want to
,change. However, he said he had heard about a new program called the Medicare
Prescription Payment Plan and asked whether it might help. What do you tell him?-
CORRECT ANSWERS-The Medicare Prescription Payment Plan helps spread out
beneficiary cost-sharing payments but does not decrease the total amount owed.
Mr. Hutchinson has drug coverage through his former employer's retiree plan. He is
concerned about the Part D premium penalty if he does not enroll in a Medicare
prescription drug plan, but does not want to purchase extra coverage that he will not
need. What should you tell him?-CORRECT ANSWERS-If the drug coverage he has is
not expected to pay, on average, at least as much as Medicare's standard Part D
coverage expects to pay, then he will need to enroll in Medicare Part D during his initial
eligibility period to avoid the late enrollment penalty.
Mr. Jacob understands that there is a standard Medicare Part D prescription drug
benefit, but when he looks at information on various plans available in his area, he sees
a wide range in what they charge for deductibles, premiums, and cost sharing. How can
you explain this to him?-CORRECT ANSWERS-Medicare Part D drug plans may have
different benefit structures, but on average, they must all be at least as good as the
standard model established by the government.
Mr. Kelly 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 ANSWERS-You would need to ask Mr. Kelly if he is entitled to Part A,
enrolled in Part B, and if he lives in the PFFS plan's service area.
Mr. Liu turns 65 on June 19. He has never previously qualified for Medicare so his first
Medicare eligibility date will be June 1. Mr. Liu's ICEP and Part D IEP begin on March 1
and end on September 30. He wants prescription drug coverage with his Part A and
Part B benefits. What advice can you provide him?-CORRECT ANSWERS-He can
enroll in a MA-PD as long as he enrolls in Part B and is entitled to Part A.
Mr. Lombardi is interested in a Medicare Advantage (MA) PPO plan that you represent.
It is one of three plans operated by the same organization in Mr. Lombardi's area. The
MA PPO plan does not include drug coverage, but the other two plans do. Mr. Lombardi
likes the PPO plan that does not include drug coverage and intends to obtain his drug
coverage through a stand-alone Medicare prescription drug plan. What should you tell
him about this situation?-CORRECT ANSWERS-He could enroll either in one of the MA
plans that include prescription drug coverage or Original Medicare with a Medigap plan
and standalone Part D prescription drug coverage, but he cannot enroll in the MA-only
PPO plan and a stand-alone prescription drug plan.
Mr. Lopez has heard that he can sign up for a product called "Medicare Advantage" but
is not sure about what type of plan designs are available through this program. What
should you tell him about the types of health plans that are available through the
Medicare Advantage program?-CORRECT ANSWERS-There are Medicare health
plans such as HMOs, PPOs, PFFS, and MSAs.
,Mr. Lopez, who is fairly well-off financially, would like to enroll in a Medicare prescription
drug plan you represent and simply give you a check to cover his premiums for the
entire year. What should you tell him?-CORRECT ANSWERS-Enrollees should pay
using automatic withdrawal from a bank account or credit or debit card, direct monthly
billing from the plan, or deductions from their Social Security check.
Mr. Patel is in good health and is preparing a budget in anticipation of his retirement
when he turns 66. He wants to understand the health care costs he might be exposed to
under Medicare if he were to require hospitalization because of an illness. In general
terms, what could you tell him about his costs for inpatient hospital services under
Original Medicare?-CORRECT ANSWERS-Under Original Medicare, there is a single
deductible amount due for the first 60 days of any inpatient hospital stay, after which it
converts into a per-day coinsurance amount through day 90. After day 90, he would pay
a daily amount up to 60 days over his lifetime, after which he would be responsible for
all costs.
Mr. Prentice has many clients who are Medicare beneficiaries. He should review the
Centers for Medicare & Medicaid Services (CMS) Communication and Marketing
Guidelines to ensure he is compliant with which type of products.-CORRECT
ANSWERS-Medicare Advantage (MA) and Prescription Drug (PDP) plans.
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 ANSWERS-
Medicare will cover a total of 190 days of inpatient psychiatric care during Mr. Rainey's
entire lifetime.
Mr. Rice is 68, actively working, and has coverage for medical services and medications
through his employer's group health plan. He is entitled to premium free Part A and
thinking of enrolling in Part B and switching to an MA-PD because he is paying a very
large part of his group coverage premium, and it does not provide coverage for a
number of his medications. Which of the following is NOT a consideration when making
the change?-CORRECT ANSWERS-Mr. Rice's retiree plan is required to take him back
if, within 63 days of having voluntarily quit the employer's plan, he decides that he
prefers it to his Medicare Part D plan.
Mr. Rodriguez is currently enrolled in a MA plan, but his plan doesn't sufficiently cover
his prescription drug needs. He is interested in changing plans during the upcoming MA
Open Enrollment Period. What are his options during the MA OEP?-CORRECT
ANSWERS-He can switch to a MA-PD plan.
Mr. Romero is 64, retiring soon, and considering enrollment in his employer-sponsored
retiree group health plan that includes drug coverage with nominal copays. He heard
about a neighbor's MA-PD plan that you represent and because he takes numerous
prescription drugs, he is considering signing up for it. What should you tell him?-
,CORRECT ANSWERS-He should compare the benefits in his employer-sponsored
retiree group health plan with the benefits in his neighbor's MA-PD plan to determine
which one will provide sufficient coverage for his prescription needs.
Mr. Sanchez has just turned 65 and is entitled to Part A but has not enrolled in Part B
because he has coverage through an employer plan. If he wants to enroll in a Medicare
Advantage plan, what will he have to do?-CORRECT ANSWERS-He will have to enroll
in Part B.
Mr. Shapiro gets by on a very small amount of fixed income. He has heard there may be
extra help paying for Part D prescription drugs for Medicare beneficiaries with limited
income. He wants to know whether he might qualify. What should you tell him?-
CORRECT ANSWERS-The extra help is available to beneficiaries whose income and
assets do not exceed annual limits specified by the government.
Mr. Singh would like drug coverage but does not want to be enrolled in a Medicare
Advantage plan. What should you tell him?-CORRECT ANSWERS-Mr. Singh can enroll
in a stand-alone prescription drug plan and continue to be covered for Part A and Part B
services through Original Fee-for-Service Medicare.
Mr. Torres has a small savings account. He would like to pay for his monthly Part D
premiums with an automatic monthly withdrawal from his savings account until it is
exhausted, and then have his premiums withheld from his Social Security check. What
should you tell him?-CORRECT ANSWERS-In general, he must select a single Part D
premium payment mechanism that will be used throughout the year.
Mr. Wells is trying to understand the difference between Original Medicare and
Medicare Advantage. What would be the correct description?-CORRECT ANSWERS-
Medicare Advantage is a way of covering all the Original Medicare benefits through
private health insurance companies.
Mr. Wendt suffers from diabetes which has gotten progressively worse during the last
year. He is currently enrolled in Original Medicare (Parts A and B) and a Part D
prescription drug plan and did not enroll in a Medicare Advantage (MA) plan during the
last annual open enrollment period (AEP) which has just closed. Mr. Wendt has heard
certain MA plans might provide him with more specialized coverage for his diabetes and
wants to know if he must wait until the next annual open enrollment period (AEP) before
enrolling in such a plan. What should you tell him?-CORRECT ANSWERS-If there is a
special needs plan (SNP) in Mr. Wendt's area that specializes in caring for individuals
with diabetes, he may enroll in the SNP at any time under a special election period
(SEP).
Mr. Wingate is a newly enrolled Medicare Part D beneficiary and one of your clients. In
addition to drugs on his plan's formulary, he takes several other medications. These
include a prescription drug not on his plan's formulary, over-the-counter medications for
colds and allergies, vitamins, and drugs from an Internet-based Canadian pharmacy to
,promote hair growth and reduce joint swelling. His neighbor recently told him about a
concept called TrOOP and he asks you if any of his other medications could count
toward TrOOP should he ever reach the Part D catastrophic limit. What should you
say.-CORRECT ANSWERS-None of the costs of Mr. Wingate's other medications
would currently count toward TrOOP but he may wish to ask his plan for an exception to
cover the prescription, not on its formulary.
Mr. Xi will soon turn age 65 and has come to you for advice as to what services are
provided under Original Medicare. What should you tell Mr. Xi that best describes the
health coverage provided to Medicare beneficiaries?-CORRECT ANSWERS-
Beneficiaries under Original Medicare have no cost-sharing for most preventive
services.
Mr. Yoo's employer has recently dropped comprehensive creditable prescription drug
coverage that was offered to company retirees. The company told Mr. Yoo that,
because he was affected by this change, he would qualify for a special election period.
Mr. Yoo contacted you to find out more about what this means. What can you tell him?-
CORRECT ANSWERS-It means that he qualifies for a one-time opportunity to enroll in
an MA-PD or Part D prescription drug plan.
Mr. Zachow has a condition for which three drugs are available. He has tried two but
had an allergic reaction to them. Only the third drug works for him and it is not on his
Part D plan's formulary. What could you tell him to do?-CORRECT ANSWERS-Mr.
Zachow has a right to request a formulary exception to obtain coverage for his Part D
drug. He or his physician could obtain the standardized request form on the plan's
website, fill it out, and submit it to his plan.
Mrs. Albertson has been enrolled in a Medicare Part D plan for several years. She takes
several brand name drugs and is interested in learning about the Medicare Prescription
Payment Plan. What should you tell her?-CORRECT ANSWERS-Enrollees can opt out
of the program at any time. However, they will continue to be billed for any cost-sharing
amounts still owed.
Mrs. Allen has a rare condition for which two different brand name drugs are the only
available treatment. She is concerned that since no generic prescription drug is
available and these drugs are very high cost, she will not be able to find a Medicare Part
D prescription drug plan that covers either one of them. What should you tell her?-
CORRECT ANSWERS-Medicare prescription drug plans are required to cover drugs in
each therapeutic category. She should be able to enroll in a Medicare prescription drug
plan that covers the medications she needs.
Mrs. Burton is a retiree with substantial income. She is enrolled in an MA-PD plan and
was disappointed with the service she received from her primary care physician
because she was told she would have to wait five weeks to get an appointment when
she was feeling ill. She called you to ask what she could do so she would not have to
put up with such poor access to care. What could you tell her?-CORRECT ANSWERS-
,She could file a grievance with her plan to complain about the lack of timeliness in
getting an appointment.
Mrs. Chen will be 65 soon, has been a citizen for twelve years, has been employed full
time, and paid taxes during that entire period. She is concerned that she will not qualify
for coverage under part A because she was not born in the United States. What should
you tell her?-CORRECT ANSWERS-Most individuals who are citizens and age 65 or
over are covered under Part A by virtue of having paid Medicare taxes while working,
though some may be covered as a result of paying monthly premiums.
Mrs. Chi is age 75 and enjoys a comfortable but not extremely high-income level. She
wishes to enroll in a MA MSA plan that she heard about from her neighbor. She also
wants to have prescription drug coverage since her doctor recently prescribed several
expensive medications. Currently, she is enrolled in Original Medicare and a standalone
Part D plan. How would you advise Mrs. Chi?-CORRECT ANSWERS-Mrs. Chi may
enroll in a MA MSA plan and remain in her current standalone Part D prescription drug
plan.
Mrs. Chou likes a Private Fee-for-Service (PFFS) plan available in her area that does
not include drug coverage. She wants to enroll in the plan and enroll in a stand-alone
prescription drug plan. What should you tell her?-CORRECT ANSWERS-She could
enroll in a PFFS plan and a stand-alone Medicare prescription drug plan.
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?-CORRECT
ANSWERS-Mrs. Duarte should file an appeal of this initial determination within 120
days of the date she received the MSN in the mail.
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?-CORRECT ANSWERS-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.
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?-CORRECT ANSWERS-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.
Mrs. Hernandez is one of your clients. She has read that there is a new program that
may help her manage prescription drug costs. What do you tell her about the Medicare
Prescription Payment Plan?-CORRECT ANSWERS-Part D enrollees can opt into the
, Medicare Prescription Payment Plan at the beginning of the plan year or any point
during the year.
Mrs. Kelly, age 65, is entitled to Part A but has not yet enrolled in Part B. She is
considering enrollment in a Medicare Advantage plan (Part C). What should you advise
her to do before she can enroll in a Medicare Advantage plan?-CORRECT ANSWERS-
To join a Medicare Advantage plan, she also must enroll in Part B.
Mrs. Kendrick is in good health, has worked for many years, and is six months away
from turning 65. She wants to know what she will have to do to enroll in a Medicare
Advantage (MA) plan as soon as possible. What could you tell her?-CORRECT
ANSWERS-She may enroll in an MA plan beginning three months immediately before
her first entitlement to both Medicare Part A and Part B.
Mrs. Lopez is enrolled in a cost plan for her Medicare benefits. She has recently lost
creditable coverage previously available through her husband's employer. She is
interested in enrolling in a Medicare Part D prescription drug plan (PDP). What should
you tell her?-CORRECT ANSWERS-If a Part D benefit is offered through her plan she
may choose to enroll in that plan or a standalone PDP.
Mrs. Lyons is in good health, uses a single prescription, and lives independently in her
own home. She is attracted by the idea of maintaining control over a Medical Savings
Account (MSA) but is not sure if the plan associated with the account will fit her needs.
What specific piece of information about a Medicare MSA plan would it be important for
her to know, prior to enrolling in such a plan?-CORRECT ANSWERS-All MSAs cover
Part A and Part B benefits, but not Part D prescription drug benefits, which could be
obtained by also enrolling in a separate prescription drug plan.
Mrs. Mulcahy, age 65, is concerned that she may not qualify for enrollment in a
Medicare prescription drug plan because, although she is entitled to Part A, she is not
enrolled under Medicare Part B. What should you tell her?-CORRECT ANSWERS-An
individual who is entitled to Part A or enrolled under Part B is eligible to enroll in a
Medicare prescription drug plan. As long as Mrs. Mulcahy is entitled to Part A, she does
not need to enroll under Part B before enrolling in a prescription drug plan.
Mrs. Park is an elderly retiree. Mrs. Park has a low fixed income. What could you tell
Mrs. Park that might be of assistance?-CORRECT ANSWERS-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.
Mrs. Paterson is concerned about the deductibles and co-payments associated with
Original Medicare. What can you tell her about Medigap as an option to address this
concern?-CORRECT ANSWERS-Medigap plans do not cover Original Medicare
benefits, but they coordinate with Original Medicare coverage.
