Answers Complete GRADED A+
1. Mrs. Park is an elderly retiree. Mrs. Park has a low fixed income.What could
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you tell Mrs. Park that might be of assistance?: She should contact her state Me
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dicaid agency to see if she qualifies forprograms that can help with Medicare costs f
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or which she is responsible.
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2. Madeline Martinez was widowed several years ago. Her husband worked for m
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any years and contributed into the Medicare system. He also left a substan-
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g tial estate which provides Madeline with an annual income of approximately
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$130,000. Madeline, who has only worked part- g g g g g g
time for the last three years, will soon turn age 65 and hopes to enroll in Original
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Medicare. She comes to you for advice. What should you tell her?: You should tell
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Madeline that she will be able to enroll in Medicare Part A without paying monthly prem
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iums due to her husband's long work record and participation in the Medicare system.
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You should also tell Madeline that she will pay Part B premiums at more than the standard l
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owest rate but less than the highest rate due her substantial income.
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3. Mr. Bauer is 49 years old, but eighteen months ago he was declared dis-
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g abled by the Social Security Administration and has been receiving disability p
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ayments. He is wondering whether he can obtain coverage under Medicare. Wh
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at should you tell him: After receiving such disability payments for 24 months, he will
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be automatically enrolled in Medicare, regardless of age.
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4. Mr. Schmidt would like to plan for retirement and has asked you what is cover
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ed under Original Fee-for-
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,Service (FFS) Medicare? What could you tell him?: Part A, which covers hospital, s
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killed nursing facility, hospice and home health services and Part B, which covers profes
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sional services such as those provided by a doctor are covered under Original Medica
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re.
5. Mrs. Pea
H is 66 years old, has coverage under an employer plan, and will retire ne
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xt year. She heard she must enroll in Part B at the beginning of the year to ensur
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e no gap in coverage. What can you tell her?: She may enroll at any time while she is
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covered under her employer plan, but she will have a special eight month enrollment peri
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od that differs from the standard general enrollment period, during which she may enr
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oll in Medicare Part B.
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6. Agent John Miller is meeting with Jerry Smith, a new prospect. Jerry is cur-
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g rently enrolled in Medicare Parts A and B. Jerry has also purchased a Medicare Su
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pplement (Medigap) plan which he has had for several years. However, the plan
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does not provide drug benefits. How would you advise Agent John Miller to proc
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eed?: Tell prospect Jerry Smith that he should consider adding a standalone Part D pres
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cription drug coverage policy to his present coverage.
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7. Mr. Diaz continued working with his company and was insured under his emp
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loyer's group plan until he reached age 68. He has heard that there is a premium
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penalty for those who did not sign up for Part B when first eligible and
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, wants to know how much he will have to pay.What should you tell him?: The
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penalty will be a permanent 10% increase in his Part B premium for every 12-
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month period that passed during which he could have enrolled and did not.
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8. Ms. Moore plans to retire when she turns 65 in a few months. She is in exc
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ellent health and will have considerable income when she retires. She is co
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ncerned that her income will make it impossible for her to qualify for Medica
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re. What could you tell her to address her concern?: Medicare is a
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program for people age 65 or older and those under age 65 with certain disabilities, end
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-stage renal disease, and Lou Gehrig's disease so she will be eligible for Medicare.
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9. Mildred Savage enrolled in Allcare Medicare Advantage plan several years ag
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o. Mildred recently learned that she is suffering from inoperable cancer and has j
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ust a few months to live. She would like to spend these final months in hospice c
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are. Mildred's family asks you whether hospice benefits will be paid for under th
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e Allcare Medicare Advantage plan.What should you say?: Mildred may remain en
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rolled in Allcare and make a hospice election. Hospice benefits will be paid for by Origi
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nal Medicare under Part A and Allcare will continue to pay for any non-
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hospice services. g
10. Mr. Gomez notes that a Private Fee-for- g g g g g g
Service (PFFS) plan available in his area has an attractive premium. He wants to
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know if he must use doctors in a network as his current HMO plan requires him t
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o do. What should you tell him?: He may receive health care services from any doctor
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g allowed to bill Medicare, as long as he shows the doctor the plan's identification card and
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the doctor agrees to accept the PFFS plan's payment terms and conditions, which coul
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d include balance billing.
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11. Mr. Kelly wants to know whether he is eligible to sign up for a Private fee-
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