Mr. Alonso receives some help He generally would pay a monthly premium, annual deductible,
paying for his two generic and per-prescription cost-sharing.
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?
Mrs. Gonzalez is enrolled in Mrs. Gonzalez cannot purchase a Medigap plan that covers
Original Medicare and has a drugs, but she could keep her Medigap policy and enroll in a
Medigap policy as well, but it Part D prescription drug plan.
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?
See an expert-written answer!
Mr. Davis is 52 years old and has He may sign-up for Medicare at any time however coverage
recently been diagnosed with usually begins on the fourth month after dialysis treatments start.
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?
Mrs. Duarte is enrolled in Mrs. Duarte should file an appeal of this initial determination
Original Medicare Parts A and B. within 120 days of the date she received the MSN in the mail.
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?
Mrs. Geisler's neighbor told her Part D covers prescription drugs and she should look at her
she should look at her Part D premiums, formulary, and cost-sharing among other factors to
options during the annual see if they have changed.
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?
,Mr. Rainey is experiencing Medicare will cover a total of 190 days of inpatient psychiatric
paranoid delusions and his care during Mr. Rainey's entire lifetime.
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?
Mr. Xi will soon turn age 65 and Beneficiaries under Original Medicare have no cost-sharing for
has come to you for advice as to most preventive services.
what services are provided
under Original Medicare. What
should you tell Mr. Xi that best
describes the health coverage
provided to Medicare
beneficiaries?
Mr. Singh would like drug Mr. Singh can enroll in a stand-alone prescription drug plan and
coverage but does not want to continue to be covered for Part A and Part B services through
be enrolled in a Medicare Original Fee-for-Service Medicare.
Advantage plan. What should
you tell him?
Mrs. Chen will be 65 soon, has Most individuals who are citizens and age 65 or over are covered
been a citizen for twelve years, under Part A by virtue of having paid Medicare taxes while
has been employed full time, working, though some may be covered as a result of paying
and paid taxes during that entire monthly premiums.
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?
Mrs. Quinn recently turned 66 Part B primarily covers physician services. She will be paying a
and decided after many years of monthly premium and, except for many preventive and screening
work to retire and begin tests, generally will have 20% co-payments for these services, in
receiving Social Security addition to an annual deductible.
benefits. Shortly thereafter Mrs.
Quinn received a letter
informing her that she had been
automatically enrolled in
Medicare Part B. She wants to
understand what this means.
What should you tell Mrs.
Quinn?
, Mr. Patel is in good health and is Under Original Medicare, there is a single deductible amount
preparing a budget in due for the first 60 days of any inpatient hospital stay, after which
anticipation of his retirement it converts into a per-day coinsurance amount through day 90.
when he turns 66. He wants to After day 90, he would pay a daily amount up to 60 days over his
understand the health care lifetime, after which he would be responsible for all costs.
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?
What impact, if any, have recent The Part B deductible is no longer covered for individuals newly
regulatory changes had on eligible for Medicare starting January 1, 2020.
Medigap plans?
Mrs. Paterson is concerned Medigap plans do not cover Original Medicare benefits, but they
about the deductibles and co- coordinate with Original Medicare coverage.
payments associated with
Original Medicare. What can you
tell her about Medigap as an
option to address this concern?
See an expert-written answer!
Mrs. Turner is comparing her Original Medicare covers ambulance services.
employer's retiree insurance to
Original Medicare and would
like to know which of the
following services Original
Medicare will cover if the
appropriate criteria are met.
What could you tell her?
Ms. Brooks has aggressive Medicare covers hospice services, and they will be available for
cancer and would like to know if her.
Medicare will cover hospice
services in case she needs them.
What should you tell her?
See an expert-written answer!
Mr. Diaz continued working with Mr. Diaz will not pay any penalty because he had continuous
his company and was insured coverage under his employer's plan.
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?
paying for his two generic and per-prescription cost-sharing.
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?
Mrs. Gonzalez is enrolled in Mrs. Gonzalez cannot purchase a Medigap plan that covers
Original Medicare and has a drugs, but she could keep her Medigap policy and enroll in a
Medigap policy as well, but it Part D prescription drug plan.
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?
See an expert-written answer!
Mr. Davis is 52 years old and has He may sign-up for Medicare at any time however coverage
recently been diagnosed with usually begins on the fourth month after dialysis treatments start.
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?
Mrs. Duarte is enrolled in Mrs. Duarte should file an appeal of this initial determination
Original Medicare Parts A and B. within 120 days of the date she received the MSN in the mail.
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?
Mrs. Geisler's neighbor told her Part D covers prescription drugs and she should look at her
she should look at her Part D premiums, formulary, and cost-sharing among other factors to
options during the annual see if they have changed.
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?
,Mr. Rainey is experiencing Medicare will cover a total of 190 days of inpatient psychiatric
paranoid delusions and his care during Mr. Rainey's entire lifetime.
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?
Mr. Xi will soon turn age 65 and Beneficiaries under Original Medicare have no cost-sharing for
has come to you for advice as to most preventive services.
what services are provided
under Original Medicare. What
should you tell Mr. Xi that best
describes the health coverage
provided to Medicare
beneficiaries?
Mr. Singh would like drug Mr. Singh can enroll in a stand-alone prescription drug plan and
coverage but does not want to continue to be covered for Part A and Part B services through
be enrolled in a Medicare Original Fee-for-Service Medicare.
Advantage plan. What should
you tell him?
Mrs. Chen will be 65 soon, has Most individuals who are citizens and age 65 or over are covered
been a citizen for twelve years, under Part A by virtue of having paid Medicare taxes while
has been employed full time, working, though some may be covered as a result of paying
and paid taxes during that entire monthly premiums.
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?
Mrs. Quinn recently turned 66 Part B primarily covers physician services. She will be paying a
and decided after many years of monthly premium and, except for many preventive and screening
work to retire and begin tests, generally will have 20% co-payments for these services, in
receiving Social Security addition to an annual deductible.
benefits. Shortly thereafter Mrs.
Quinn received a letter
informing her that she had been
automatically enrolled in
Medicare Part B. She wants to
understand what this means.
What should you tell Mrs.
Quinn?
, Mr. Patel is in good health and is Under Original Medicare, there is a single deductible amount
preparing a budget in due for the first 60 days of any inpatient hospital stay, after which
anticipation of his retirement it converts into a per-day coinsurance amount through day 90.
when he turns 66. He wants to After day 90, he would pay a daily amount up to 60 days over his
understand the health care lifetime, after which he would be responsible for all costs.
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?
What impact, if any, have recent The Part B deductible is no longer covered for individuals newly
regulatory changes had on eligible for Medicare starting January 1, 2020.
Medigap plans?
Mrs. Paterson is concerned Medigap plans do not cover Original Medicare benefits, but they
about the deductibles and co- coordinate with Original Medicare coverage.
payments associated with
Original Medicare. What can you
tell her about Medigap as an
option to address this concern?
See an expert-written answer!
Mrs. Turner is comparing her Original Medicare covers ambulance services.
employer's retiree insurance to
Original Medicare and would
like to know which of the
following services Original
Medicare will cover if the
appropriate criteria are met.
What could you tell her?
Ms. Brooks has aggressive Medicare covers hospice services, and they will be available for
cancer and would like to know if her.
Medicare will cover hospice
services in case she needs them.
What should you tell her?
See an expert-written answer!
Mr. Diaz continued working with Mr. Diaz will not pay any penalty because he had continuous
his company and was insured coverage under his employer's plan.
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?
