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1. 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?:
Ben- eficiaries under Original Medicare have no cost-sharing for most preventive
services
2. Mrs. Quinn recently turned 66 and decided after many years of work to
begin receiving Social Security benefits. Shortly thereafter Mrs. Quinn
received a letter informing her that she has been automatically enrolled in
Medicare Part B. She wants to understand what this means. What should
you tell Mrs. Quinn?: Part B primarily covers physician services. She will be
paying a monthly premium and, except for many preventive screening and tests,
generally will have 20 percent co-payments for these services in addition to an
annual deductible
3. 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?: He may sign up
for Medicare at any time however coverage usually begins on the fourth month
after dialysis treatment
4. 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?: He generally would pay a
monthly premium, annual deductible, and per-prescription cost sharing.
5. Ms. Brooks has an aggressive cancer and would like to know if
Medicare will cover hospice services in case she needs them. What
should you tell her?: Medicare covers hospice services and they will be
available to her.
6. Mrs. Park is an elderly retiree. Mrs. Park has a low fixed income. What
could you tell Mrs. Park that might be of assistance?: 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.
7. Mrs. Duarte is enrolled in Original Medicare Parts A and B. She has
recently reviewed her Medicare Summary Notice (MSN) and disagrees with a
determi- nation that partially denied one of her claims for services. What
advice would you give her?: Mrs. Duarte should file an appeal of this initial
determination within 120 days of the date she received the MSN in the mail.
8. 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
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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?: Most individuals
who are citizens and age 65 or over are covered under Part A by virtue of having
paid Medicare
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