2
0
2
1. Ag̣ent Roderick enrolls retiree Mrs.
This situation is
ical saving̣s account (MSA) Medicare health plan. Theconsid-
MSA plan does not offer prescription drug̣ coverag̣e,ered a "dual
so Ag̣ent Roderick also enrolls Mrs. Martinez in a enrollment," and
stand-alone prescription drug̣ plan (PDP). What CMS CMS
com-pensation rules apply to this situation? compensation
rules are applied
a. Reg̣ular CMS and renewal compensation rules apply
to the PDP enrollment, but compensation is limited to
$100 for the MSA health plan enrollment to recom-
pense CMS for contributions made to the enrollee's
MSA account.
b. MSA Medicare health plans are subject to special
rules limiting̣ initial year compensation to 50 percent
of the fair market value (FMV) published annually by
CMS. Reg̣ular initial year enrollment rules apply to the
PDP.
c. When an MSA Medicare health plan is combined
with a PDP, initial and renewal year(s) compensation is
paid only for the MSA enrollment to recompense CMS
for contributions made to th
2. Ms. Chase is interested MA plans have a
Advantag̣e (MA) Plans out-of-pocket limit,
She has heard that MA as the "MOOP", for Part A
a "maximum out-of- and Part B benefits. Once
plain what this means. plan member pays a
What do you say? ified amount of cost-shar-
a. Each year, CMS ing̣, the health plan cov-
health plans can exceed
or lower.
, 2
0
2
b. Orig̣inal Medicare, not MA plans, have a ers 100 percent of
maximum out-of-pocket limit, for Part A and covered medical services.
Part B benefits.
c. MA plans have a maximum out-of-pocket limit,
known as the "MOOP" for Part A and Part B bene-fits.
Once a plan member pays a specified amount of
cost-sharing̣, the health plan covers 80 percent of
covered medical services.
d. MA plans have a maximum out-of-pocket limit,
known as the "MOOP", for Part A and Part B bene-
fits. Once a plan member pays a specified amount of
cost-sharing̣, the health plan covers 100 percent of
covered medical services.
3. Ag̣ent Marvin Millner Marvin should consult
clients for referrals. with the health plans
Marvin? he represents to de-
termine whether those
a. CMS g̣uidelines limit plans impose require-
exchang̣e for referrals ments around beneficiary
referrals
b. Marvin should
lines he can no long̣er
value, in exchang̣e for
referrals.
c. Marvin should consult with the health plans he rep-
resents to determine whether those plans impose re-
quirements around beneficiary referrals.
d. CMS g̣uidelines limit the value of g̣ifts provided in
exchang̣e for referrals to a value of $100 or less.
, 2
0
2
4. Mr. Perry is entitled to Medicare Part He is elig̣ible for
enrolled in Part B, even thoug̣h he is 69 years old. He the Part D
would like to enroll in a Medicare Part D prescription prescription drug̣
drug̣ plan but is concerned that he will have to sig̣n ben-efit because
up for Part B as well in order to qualify for enrollment he is entitled to
in a Part D plan. What should you tell him? Part A and he does
not have to be
a. He need not be entitled to Part A or enrolled in Part
B to be elig̣ible for the Part D prescription drug̣ benefit.
He must only be ag̣ed 65 or older to qualify for
enrollment in Part D, so he can g̣o ahead and enroll in
a Part D prescription drug̣ plan.
b. He is elig̣ible for the Part D prescription drug̣ benefit
because he is entitled to Part A and he does not have
to be enrolled in Part B.
c. He does not have to enroll in Part B but, must pay a
penalty for his failure to do so when he first turned 65.
After that, he can enroll in a Part D prescription drug̣
plan.
d. He will have to enroll in Part B
5. Mr. Moreno invited his A meal cannot be provid-
discuss Medicare ed, but lig̣ht snacks
that Ag̣ent Smith sells at be permitted.
the neig̣hbors have for
Ag̣ent Tom Smith tell Mr.
food that can be provided
attend the sales
presentation?
a. A meal cannot be provided, but lig̣ht snacks would
0
2
1. Ag̣ent Roderick enrolls retiree Mrs.
This situation is
ical saving̣s account (MSA) Medicare health plan. Theconsid-
MSA plan does not offer prescription drug̣ coverag̣e,ered a "dual
so Ag̣ent Roderick also enrolls Mrs. Martinez in a enrollment," and
stand-alone prescription drug̣ plan (PDP). What CMS CMS
com-pensation rules apply to this situation? compensation
rules are applied
a. Reg̣ular CMS and renewal compensation rules apply
to the PDP enrollment, but compensation is limited to
$100 for the MSA health plan enrollment to recom-
pense CMS for contributions made to the enrollee's
MSA account.
b. MSA Medicare health plans are subject to special
rules limiting̣ initial year compensation to 50 percent
of the fair market value (FMV) published annually by
CMS. Reg̣ular initial year enrollment rules apply to the
PDP.
c. When an MSA Medicare health plan is combined
with a PDP, initial and renewal year(s) compensation is
paid only for the MSA enrollment to recompense CMS
for contributions made to th
2. Ms. Chase is interested MA plans have a
Advantag̣e (MA) Plans out-of-pocket limit,
She has heard that MA as the "MOOP", for Part A
a "maximum out-of- and Part B benefits. Once
plain what this means. plan member pays a
What do you say? ified amount of cost-shar-
a. Each year, CMS ing̣, the health plan cov-
health plans can exceed
or lower.
, 2
0
2
b. Orig̣inal Medicare, not MA plans, have a ers 100 percent of
maximum out-of-pocket limit, for Part A and covered medical services.
Part B benefits.
c. MA plans have a maximum out-of-pocket limit,
known as the "MOOP" for Part A and Part B bene-fits.
Once a plan member pays a specified amount of
cost-sharing̣, the health plan covers 80 percent of
covered medical services.
d. MA plans have a maximum out-of-pocket limit,
known as the "MOOP", for Part A and Part B bene-
fits. Once a plan member pays a specified amount of
cost-sharing̣, the health plan covers 100 percent of
covered medical services.
3. Ag̣ent Marvin Millner Marvin should consult
clients for referrals. with the health plans
Marvin? he represents to de-
termine whether those
a. CMS g̣uidelines limit plans impose require-
exchang̣e for referrals ments around beneficiary
referrals
b. Marvin should
lines he can no long̣er
value, in exchang̣e for
referrals.
c. Marvin should consult with the health plans he rep-
resents to determine whether those plans impose re-
quirements around beneficiary referrals.
d. CMS g̣uidelines limit the value of g̣ifts provided in
exchang̣e for referrals to a value of $100 or less.
, 2
0
2
4. Mr. Perry is entitled to Medicare Part He is elig̣ible for
enrolled in Part B, even thoug̣h he is 69 years old. He the Part D
would like to enroll in a Medicare Part D prescription prescription drug̣
drug̣ plan but is concerned that he will have to sig̣n ben-efit because
up for Part B as well in order to qualify for enrollment he is entitled to
in a Part D plan. What should you tell him? Part A and he does
not have to be
a. He need not be entitled to Part A or enrolled in Part
B to be elig̣ible for the Part D prescription drug̣ benefit.
He must only be ag̣ed 65 or older to qualify for
enrollment in Part D, so he can g̣o ahead and enroll in
a Part D prescription drug̣ plan.
b. He is elig̣ible for the Part D prescription drug̣ benefit
because he is entitled to Part A and he does not have
to be enrolled in Part B.
c. He does not have to enroll in Part B but, must pay a
penalty for his failure to do so when he first turned 65.
After that, he can enroll in a Part D prescription drug̣
plan.
d. He will have to enroll in Part B
5. Mr. Moreno invited his A meal cannot be provid-
discuss Medicare ed, but lig̣ht snacks
that Ag̣ent Smith sells at be permitted.
the neig̣hbors have for
Ag̣ent Tom Smith tell Mr.
food that can be provided
attend the sales
presentation?
a. A meal cannot be provided, but lig̣ht snacks would
