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,Question 1
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?
Correct Answer
He generally would pay a monthly premium, annual deductible, and per-prescription cost-sharing.
Question 2
You market many different types of insurance and ordinarily you spend time each evening calling potential
clients. To comply with requirements for marketing Medicare Advantage and Part D plans, what must you
do about contacting potential clients to market those plansl?
Correct Answer
You will have to avoid calling any potential client unless he or she initiates contact with you and
specifically asks that you give him or her a call.
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Question 3
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?
Correct Answer
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Medicare will cover a total of 190 days of inpatient psychiatric care during Mr. Rainey's entire lifetime.
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Question 4
Mr. Zachow has a condition for which three drugs are available. He has tried two but had an allergic
reaction to them. Only the third drug works for him and it is not on his Part D plan's formulary. What could
you tell him to do?
Correct Answer
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Mr. Zachow has a right to request a formulary exception to obtain coverage for his Part D drug. He or his
physician could obtain the standardized request form on the plan's website, fill it out, and submit it to his
plan.
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Question 5
Anita Magri will turn age 65 in August 2023. Anita intends to enroll in Original Medicare Part A and Part B.
She would also like to enroll in a Medicare Supplement (Medigap) plan. Anita's older neighbor Mel has told
her about the Medigap Plan F in which he is enrolled. It not only provides foreign travel emergency benefits
but also covers his Medicare Part B deductible. Anita comes to you for advice. What should you tell her?
Correct Answer
You are sorry to disappoint Anita, but a Medigap F plan is no longer available to those who turn age 65
after January 1, 2020. Anita might instead consider other Medigap plans that offer foreign travel benefits
but do not cover the Part B deductible.
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, Question 6
Mrs. Radford asks whether there are any special eligibility requirements for Medicare Advantage. What
should you tell her?
Correct Answer
Mrs. Radford must be entitled to Part A and enrolled in Part B to enroll in Medicare Advantage.
Question 7
A Medicare beneficiary has walked into your office and requested that you sit down with her and discuss
her options under the Medicare Advantage program. Before engaging in such a discussion, what should you
do?
Correct Answer
You must have her sign a scope of appointment form, indicating which products she wishes to discuss.
You may then proceed with the discussion.
Question 8
Which of the following individuals has enrolled in a plan based on a fixed enrollment period?
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Correct Answer
Ben enrolls in a Medicare Advantage plan during the Medicare Advantage Open Enrollment Period (MA
OEP).
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Question 9
Ms. Claggett is sixty-six (66) years old. She has been covered under Original Medicare for the last six years
due to her disability and has never been enrolled in a Medicare Advantage or a Part D plan before. She
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wants to enroll in a Part D plan. She knows that there is such a thing as the "Part D Initial Enrollment Period"
(IEP) and has concluded that, since she has never enrolled in such a plan before, she should be eligible to
enroll under this period. What should you tell her about how the Part D Initial Enrollment Period applies to
her situation?
Correct Answer
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Ms. Claggett has had two IEPs and missed them both. The first occurred three months before and three
months after the month when she was first entitled to Part A OR enrolled in Part B. Because she was
eligible for Medicare before age 65, Ms. Claggett had a second IEP based on turning age 65, which has
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also expired.
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