Alice is enrolled in a MA-PD plan. She makes a permanent move across the country
and wonders what her options are for continuing MA-PD coverage. What would you
say to her in regard to a special enrollment period (SEP)?
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She is likely to qualify for a SEP. She can choose an effective date of up to
three months after the month in which the enrollment form is received by
the new plan, but the effective date may not be earlier than the date of her
permanent move.
Agent Armstrong is employed by XYZ Agency, which is under contract with ABC
Health Plan, a Medicare Advantage (MA) plan that offers plans in multiple states. XYZ
Agency maintains a website marketing the MA plans with which it has contracts. Agent
Armstrong follows up with individuals who request more information about ABC MA
plans via the website and tries to persuade them to enroll in ABC plans. What
,statement best describes the marketing and compliance rules that apply to Agent
Armstrong?
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Agent Armstrong needs to be licensed and appointed in every state in
which beneficiaries to whom he markets ABC MA plans are located.
Mrs. Andrews asked how a Private Fee-for-Service (PFFS) plan might affect her access
to services since she receives some assistance for her health care costs from the
State. What should you tell her?
Give this one a try later!
Medicaid may provide additional benefits, but Medicaid will coordinate
benefits only with Medicaid participating providers.
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?
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He could enroll in one of the MA plans that include prescription drug
coverage or a Medigap plan and a stand-alone prescription drug plan, but
he cannot enroll in the MA-only PPO plan and a stand-alone prescription
drug plan.
, When Myra first became eligible for Medicare, she enrolled in Original Medicare
(Parts A and B). She is now 67 and will turn 68 on July 1. She would now like to enroll in
a Medicare Advantage (MA) plan and approaches you about her options. What
advice would you give her?
Give this one a try later!
She should remain in Original Medicare until the annual election period
running from October 15 to December 7, during which she can select an
MA plan.
Another agent working for your agency claims that because you are not employed by
the Medicare Advantage plans that you represent, you are not subject to the same
requirements as the plans themselves. How should you respond to such a statement?
Give this one a try later!
Your coworker is not correct. Marketing on behalf of a plan is considered
marketing by the plan and requires that all contracted and employed
agents comply with all Medicare marketing rules.
Your friend's mother just moved to an assisted living facility and he asked if you could
present a program for the residents about the MA-PD plans you market. What could
you tell him?
Give this one a try later!
You appreciate the opportunity and would be happy to schedule an
appointment with anyone at their request.
and wonders what her options are for continuing MA-PD coverage. What would you
say to her in regard to a special enrollment period (SEP)?
Give this one a try later!
She is likely to qualify for a SEP. She can choose an effective date of up to
three months after the month in which the enrollment form is received by
the new plan, but the effective date may not be earlier than the date of her
permanent move.
Agent Armstrong is employed by XYZ Agency, which is under contract with ABC
Health Plan, a Medicare Advantage (MA) plan that offers plans in multiple states. XYZ
Agency maintains a website marketing the MA plans with which it has contracts. Agent
Armstrong follows up with individuals who request more information about ABC MA
plans via the website and tries to persuade them to enroll in ABC plans. What
,statement best describes the marketing and compliance rules that apply to Agent
Armstrong?
Give this one a try later!
Agent Armstrong needs to be licensed and appointed in every state in
which beneficiaries to whom he markets ABC MA plans are located.
Mrs. Andrews asked how a Private Fee-for-Service (PFFS) plan might affect her access
to services since she receives some assistance for her health care costs from the
State. What should you tell her?
Give this one a try later!
Medicaid may provide additional benefits, but Medicaid will coordinate
benefits only with Medicaid participating providers.
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?
Give this one a try later!
He could enroll in one of the MA plans that include prescription drug
coverage or a Medigap plan and a stand-alone prescription drug plan, but
he cannot enroll in the MA-only PPO plan and a stand-alone prescription
drug plan.
, When Myra first became eligible for Medicare, she enrolled in Original Medicare
(Parts A and B). She is now 67 and will turn 68 on July 1. She would now like to enroll in
a Medicare Advantage (MA) plan and approaches you about her options. What
advice would you give her?
Give this one a try later!
She should remain in Original Medicare until the annual election period
running from October 15 to December 7, during which she can select an
MA plan.
Another agent working for your agency claims that because you are not employed by
the Medicare Advantage plans that you represent, you are not subject to the same
requirements as the plans themselves. How should you respond to such a statement?
Give this one a try later!
Your coworker is not correct. Marketing on behalf of a plan is considered
marketing by the plan and requires that all contracted and employed
agents comply with all Medicare marketing rules.
Your friend's mother just moved to an assisted living facility and he asked if you could
present a program for the residents about the MA-PD plans you market. What could
you tell him?
Give this one a try later!
You appreciate the opportunity and would be happy to schedule an
appointment with anyone at their request.
