NURS 325 (NURS 325)

1. Types of Medicare Advantage Plans: PPO, HMO, MSA, Cost Plan, PFFS 2. Medicare-Medicaid plans: Serve both Medicare and Medicaid individuals. In- clude Part D coverage. Individuals sometimes referred to as dual eligibles 3. Medicare Cost Plan: Type of Medicare health plan. Have Part B to enroll. Can join anytime plan is accepting new members. A non network provider will can charge higher coinsurances and deuctibles. Different enrollment/disenrollment periods apply. Can get Part D Rx covera...

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? Question 1Select one: a. The extra help is available to beneficiaries whose income and assets do not exceed annual limits specified by the government. Source: Module 3, Slide - Help for Individuals with Limited Income and Limited Resources a...

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? - Medicare Part B generally covers medically necessary physician and other health care professional services. Mr. Diaz continued working with his company and was insured under his employer's group plan until reached age 68. He has heard that there is a premium penalty...

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? - b. Medicare will cover a total of 190 days of inpatient psychiatric care during Mr. Rainey's entire lifetime. Mr. Singh would like drug coverage but does not want to be enrolled in a Medicare Advantage plan. What should you tell him? - Mr. Singh can e...

Mrs. West wears glasses and dentures and has enjoyed considerable pain relief from arthritis through acupuncture. She is concerned about whether or not Medicare will cover these items and services. What should you tell her? - Medicare does not cover acupuncture, or, in general, glasses or dentures. 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...

Mrs. West wears glasses and dentures and has enjoyed considerable pain relief from arthritis through acupuncture. She is concerned about whether or not Medicare will cover these items and services. What should you tell her? - Medicare does not cover acupuncture, or, in general, glasses or dentures. 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...

Types of Medicare Advantage Plans - PPO, HMO, MSA, Cost Plan, PFFS Medicare-Medicaid plans - Serve both Medicare and Medicaid individuals. Include Part D coverage. Individuals sometimes referred to as dual eligibles Medicare Cost Plan - Type of Medicare health plan. Have Part B to enroll. Can join anytime plan is accepting new members. A non network provider will can charge higher coinsurances and deuctibles. Different enrollment/disenrollment periods apply. Can get Part D Rx coverage if a...

When you market Medicare Advantage and Part D plans, what may you offer as a gift to induce enrollment in a plan? You may provide gifts or prizes to all potential enrollees during an event that does not exceed $15 in retail value. 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 yo...

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? - Medicare Part B generally covers medically necessary physician and other health care professional services. Mr. Diaz continued working with his company and was insured under his employer's group plan until reached age 68. He has heard that there is a premium penalty...

Ms. Moore plans to retire when she turns 65 in a few months. She is in excellent health and will have considerable income when she retires. She is concerned that her income will make it impossible for her to qualify for medicare. What could you tell her to address her concern? - Medicare is a program for people age 65 with certain disabilities, ESRD, and Lou Gehrig's disease so she will be eligible for medicare. Mr. Schmidt would like to plan for retirement and has asked you what is cov...