LEP FINAL EXAM 2025 QUESTIONS WITH COMPLETE SOLUTIONS!!
What impact, if any, have recent regulatory changes had on Medigap plans? - (answer)The Part B
deductible is no longer covered for individuals newly eligible for Medicare starting January 1, 2020.
Mr. Diaz continued working with his company and was insured 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? -
(answer)Mr. Diaz will not pay any penalty because he had continuous coverage under his employer's
plan.
Mrs. Shields is covered by Original Medicare. She sustained a hip fracture and is being successfully
treated for that condition. However, she and her physicians feel that after her lengthy hospital stay, she
will need a month or two of nursing and rehabilitative care. What should you tell them about Original
Medicare's coverage of care in a skilled nursing facility? - (answer)Medicare will cover Mrs. Shield's
skilled nursing services provided during the first 20 days of her stay, after which she would have a copay
until she has been in the facility for 100 days.
Mrs. Quinn recently turned 66 and decided after many years of work to retire and begin receiving Social
Security 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? - (answer)Part B primarily covers physician services. She will be paying a monthly
premium and, except for many preventive and screening tests, generally will have 20% co-payments for
these services, in addition to an annual deductible.
Mrs. Turner is comparing her 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? - (answer)Original Medicare covers ambulance services.
Mrs. Park is an elderly retiree. Mrs. Park has a low fixed income. What could you tell Mrs. Park that
might be of assistance? - (answer)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.
Mrs. West wears glasses and dentures and has enjoyed considerable pain relief from arthritis through
massage therapy. She is concerned about whether or not Medicare will cover these items and services.
What should you tell her? - (answer)Medicare does not cover massage therapy, or, in general, glasses or
dentures.
, LEP FINAL EXAM 2025 QUESTIONS WITH COMPLETE SOLUTIONS!!
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 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? - (answer)Most individuals
who are citizens and age 65 or over are covered under Part A by virtue of having paid Medicare taxes
while working, though some may be covered as a result of paying monthly premiums.
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? - (answer)He may sign-up for Medicare at any time however coverage usually begins on the fourth
month after dialysis treatments start.
Mr. Lombardi is interested in a Medicare Advantage (MA) PPO plan that you represent. It is one of three
plans operated by the same organization in Mr. Lombardi's area. The MA PPO plan does not include
drug coverage, but the other two plans do. Mr. Lombardi likes the PPO plan that does not include drug
coverage and intends to obtain his drug coverage through a stand-alone Medicare prescription drug
plan. What should you tell him about this situation? - (answer)He could enroll either in one of the MA
plans that include prescription drug coverage or Original Medicare with a Medigap plan and standalone
Part D prescription drug coverage, but he cannot enroll in the MA-only PPO plan and a stand-alone
prescription drug plan.
Mr. Lopez has heard that he can sign up for a product called "Medicare Advantage" but is not sure about
what type of plan designs are available through this program. What should you tell him about the types
of health plans that are available through the Medicare Advantage program? - (answer)There are
Medicare health plans such as HMOs, PPOs, PFFS, and MSAs.
Mr. Romero is 64, retiring soon, and considering enrollment in his employer-sponsored retiree group
health plan that includes drug coverage with nominal copays. He heard about a neighbor's MA-PD plan
that you represent and because he takes numerous prescription drugs, he is considering signing up for
it. What should you tell him? - (answer)He should compare the benefits in his employer-sponsored
retiree group health plan with the benefits in his neighbor's MA-PD plan to determine which one will
provide sufficient coverage for his prescription needs.
Mr. Barker enjoys a comfortable retirement income. He recently had surgery and expected that he
would have certain services and items covered by the plan with minimal out-of-pocket costs because his
MA-PD coverage has been very good. However, when he received the bill, he was surprised to see large
What impact, if any, have recent regulatory changes had on Medigap plans? - (answer)The Part B
deductible is no longer covered for individuals newly eligible for Medicare starting January 1, 2020.
Mr. Diaz continued working with his company and was insured 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? -
(answer)Mr. Diaz will not pay any penalty because he had continuous coverage under his employer's
plan.
Mrs. Shields is covered by Original Medicare. She sustained a hip fracture and is being successfully
treated for that condition. However, she and her physicians feel that after her lengthy hospital stay, she
will need a month or two of nursing and rehabilitative care. What should you tell them about Original
Medicare's coverage of care in a skilled nursing facility? - (answer)Medicare will cover Mrs. Shield's
skilled nursing services provided during the first 20 days of her stay, after which she would have a copay
until she has been in the facility for 100 days.
Mrs. Quinn recently turned 66 and decided after many years of work to retire and begin receiving Social
Security 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? - (answer)Part B primarily covers physician services. She will be paying a monthly
premium and, except for many preventive and screening tests, generally will have 20% co-payments for
these services, in addition to an annual deductible.
Mrs. Turner is comparing her 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? - (answer)Original Medicare covers ambulance services.
Mrs. Park is an elderly retiree. Mrs. Park has a low fixed income. What could you tell Mrs. Park that
might be of assistance? - (answer)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.
Mrs. West wears glasses and dentures and has enjoyed considerable pain relief from arthritis through
massage therapy. She is concerned about whether or not Medicare will cover these items and services.
What should you tell her? - (answer)Medicare does not cover massage therapy, or, in general, glasses or
dentures.
, LEP FINAL EXAM 2025 QUESTIONS WITH COMPLETE SOLUTIONS!!
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 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? - (answer)Most individuals
who are citizens and age 65 or over are covered under Part A by virtue of having paid Medicare taxes
while working, though some may be covered as a result of paying monthly premiums.
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? - (answer)He may sign-up for Medicare at any time however coverage usually begins on the fourth
month after dialysis treatments start.
Mr. Lombardi is interested in a Medicare Advantage (MA) PPO plan that you represent. It is one of three
plans operated by the same organization in Mr. Lombardi's area. The MA PPO plan does not include
drug coverage, but the other two plans do. Mr. Lombardi likes the PPO plan that does not include drug
coverage and intends to obtain his drug coverage through a stand-alone Medicare prescription drug
plan. What should you tell him about this situation? - (answer)He could enroll either in one of the MA
plans that include prescription drug coverage or Original Medicare with a Medigap plan and standalone
Part D prescription drug coverage, but he cannot enroll in the MA-only PPO plan and a stand-alone
prescription drug plan.
Mr. Lopez has heard that he can sign up for a product called "Medicare Advantage" but is not sure about
what type of plan designs are available through this program. What should you tell him about the types
of health plans that are available through the Medicare Advantage program? - (answer)There are
Medicare health plans such as HMOs, PPOs, PFFS, and MSAs.
Mr. Romero is 64, retiring soon, and considering enrollment in his employer-sponsored retiree group
health plan that includes drug coverage with nominal copays. He heard about a neighbor's MA-PD plan
that you represent and because he takes numerous prescription drugs, he is considering signing up for
it. What should you tell him? - (answer)He should compare the benefits in his employer-sponsored
retiree group health plan with the benefits in his neighbor's MA-PD plan to determine which one will
provide sufficient coverage for his prescription needs.
Mr. Barker enjoys a comfortable retirement income. He recently had surgery and expected that he
would have certain services and items covered by the plan with minimal out-of-pocket costs because his
MA-PD coverage has been very good. However, when he received the bill, he was surprised to see large
