Which of the following individuals is most likely to be eligible to enroll in a Part D
Plan?
Give this one a try later!
Jose, a grandfather who was granted asylum and has worked in the United
States for many years.
Mr. Rockwell, age 67, is enrolled in Medicare Part A, but because he continues to
work and is covered by an employer health plan, he has not enrolled in Part B or Part
D. He receives a notice on June 1 that his employer is cutting back on prescription
drug benefits and that as of July 1, his coverage will no longer be creditable. He has
come to you for advice. What advice would you give Mr. Rockwell about special
election periods (SEPs)?
Give this one a try later!
, Mr. Rockwell is eligible for a SEP due to his involuntary loss of creditable
drug coverage; the SEP begins in June and ends on September 1- two
months after the loss of creditable coverage.
Mr. Delgado has looked at Medicare prescription drug plans available in his area and
noted a wide range in premiums. He thought that all the drug plans were required to
offer the same standard benefits and would like you to explain why there is such a
range in premiums. What should you tell him?
Give this one a try later!
Some prescription drug plans may have higher operating costs and/or may
offer enhanced coverage in return for an additional premium amount. He
could look at plan designs to see if one of the enhanced plans would serve
his needs better than a plan based on the standard design.
1. Ms. Henderson believes that she will qualify for Medicare Coverage when she turns
65, without paying any premiums, because she has been working for 40 years and
paying Medicare taxes. What should you tell her?
Give this one a try later!
To obtain Part B coverage, she must pay a standard monthly premium,
though it is higher for individuals with higher incomes.
Mrs. Foster 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?
, Give this one a try later!
Medicare will cover Mrs. Foster'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.
Steban Marsh is a newly appointed agent. Steban intends to conduct an educational
session on Medicare at a senior citizens center near his home. He has advertised the
session as an educational event. Steban asks you what is permissible at such an event.
What should you say?
Give this one a try later!
Steban may provide snacks as long as their value is $15 or less per attendee
and he may make available business reply cards (BRCs).
Ms. Ramos is enrolled in a Medicare Advantage plan that includes prescription drug
plan (PDP) coverage. She is traveling and wishes to fill two of the prescriptions that
she has lost. How would you advise her?
Give this one a try later!
She may fill prescriptions for covered drugs at non-network pharmacies,
but likely at a higher cost than paid at an in-network pharmacy.
Mr. Moy will soon turn age 65. He is slightly younger than his wife. Mr. Moy's wife has
a Medicare Advantage plan, but he wants to understand what coverage Medicare
Supplemental Insurance provides since his health care needs are different from his
wife's needs. What could you tell Mr. Moy?
Plan?
Give this one a try later!
Jose, a grandfather who was granted asylum and has worked in the United
States for many years.
Mr. Rockwell, age 67, is enrolled in Medicare Part A, but because he continues to
work and is covered by an employer health plan, he has not enrolled in Part B or Part
D. He receives a notice on June 1 that his employer is cutting back on prescription
drug benefits and that as of July 1, his coverage will no longer be creditable. He has
come to you for advice. What advice would you give Mr. Rockwell about special
election periods (SEPs)?
Give this one a try later!
, Mr. Rockwell is eligible for a SEP due to his involuntary loss of creditable
drug coverage; the SEP begins in June and ends on September 1- two
months after the loss of creditable coverage.
Mr. Delgado has looked at Medicare prescription drug plans available in his area and
noted a wide range in premiums. He thought that all the drug plans were required to
offer the same standard benefits and would like you to explain why there is such a
range in premiums. What should you tell him?
Give this one a try later!
Some prescription drug plans may have higher operating costs and/or may
offer enhanced coverage in return for an additional premium amount. He
could look at plan designs to see if one of the enhanced plans would serve
his needs better than a plan based on the standard design.
1. Ms. Henderson believes that she will qualify for Medicare Coverage when she turns
65, without paying any premiums, because she has been working for 40 years and
paying Medicare taxes. What should you tell her?
Give this one a try later!
To obtain Part B coverage, she must pay a standard monthly premium,
though it is higher for individuals with higher incomes.
Mrs. Foster 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?
, Give this one a try later!
Medicare will cover Mrs. Foster'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.
Steban Marsh is a newly appointed agent. Steban intends to conduct an educational
session on Medicare at a senior citizens center near his home. He has advertised the
session as an educational event. Steban asks you what is permissible at such an event.
What should you say?
Give this one a try later!
Steban may provide snacks as long as their value is $15 or less per attendee
and he may make available business reply cards (BRCs).
Ms. Ramos is enrolled in a Medicare Advantage plan that includes prescription drug
plan (PDP) coverage. She is traveling and wishes to fill two of the prescriptions that
she has lost. How would you advise her?
Give this one a try later!
She may fill prescriptions for covered drugs at non-network pharmacies,
but likely at a higher cost than paid at an in-network pharmacy.
Mr. Moy will soon turn age 65. He is slightly younger than his wife. Mr. Moy's wife has
a Medicare Advantage plan, but he wants to understand what coverage Medicare
Supplemental Insurance provides since his health care needs are different from his
wife's needs. What could you tell Mr. Moy?
