answers|Brand New Version|
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. 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.
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.
,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? -
ANSWER-He generally would pay a monthly premium,
annual deductible, and per-prescription cost-sharing.
Mrs. Gonzalez is enrolled in Original Medicare and has a
Medigap policy as well, but it provides no drug coverage.
She would like to keep the coverage she has but replace
her existing Medigap plan with one that provides drug
coverage. What should you tell her? - ANSWER-Mrs.
Gonzalez cannot purchase a Medigap plan that covers
, drugs, but she could keep her Medigap policy and enroll in
a Part D prescription drug plan.
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.
Mrs. Duarte is enrolled in Original Medicare Parts A and B.
She has recently reviewed her Medicare Summary Notice
(MSN) and disagrees with a determination that partially
denied one of her claims for services. What advice would