Mr. Schultz was still working when he first qualified for Medicare. At that time, he had
employer group coverage that was creditable. During his initial Part D eligibility
period, he decided not to enroll because he was satisfied with his drug coverage. It is
now a year later and Mr. Schultz has lost his employer group coverage within the last
two weeks. How would you advise him?
Give this one a try later!
Mr. Schultz should enroll in a Part D plan before he has a 63-day break in
coverage in order to avoid a premium penalty.
Mrs. Roberts has Original Medicare and would like to enroll in a Private Fee-for-
Service (PFFS) plan. All types of PFFS plans are available in her area. Which options
could Mrs. Roberts consider before selecting a PFFS plan?
Give this one a try later!
, A Medicare Advantage Prescription Drug (MA-PD) PFFS plan that
combines medical benefits and Part D prescription drug coverage, a PFFS
plan offering only medical benefits, or a PFFS plan in combination with a
stand-alone prescription drug plan.
Mrs. Fiore is a retired federal worker with coverage under a Federal Employee Health
Benefits (FEHB) plan that includes creditable drug coverage. She is ready to turn 65
and become Medicare eligible for the first time. What issues might she consider about
whether to enroll in a Medicare prescription drug plan?
Give this one a try later!
She could compare the coverage to see if the Medicare Part D plan offers
better benefits and coverage than the FEHB plan for the specific
medications she needs and whether any additional benefits are worth the
Part D premium costs on top of her FEHB contribution.
Mr. Wingate is a newly enrolled Medicare Part D beneficiary and one of your clients.
In addition to drugs on his plan's formulary, he takes several other medications. These
include a prescription drug not on his plan's formulary, over-the-counter medications
for colds and allergies, vitamins, and drugs from an Internet-based Canadian
pharmacy to promote hair growth and reduce joint swelling. His neighbor recently
told him about a concept called TrOOP and he asks you if any of his other
medications could count toward TrOOP should he ever reach the Part D catastrophic
limit. What should you say.
Give this one a try later!
None of the costs of Mr. Wingate's other medications would currently
count toward TrOOP but he may wish to ask his plan for an exception to
cover the prescription, not on its formulary.
employer group coverage that was creditable. During his initial Part D eligibility
period, he decided not to enroll because he was satisfied with his drug coverage. It is
now a year later and Mr. Schultz has lost his employer group coverage within the last
two weeks. How would you advise him?
Give this one a try later!
Mr. Schultz should enroll in a Part D plan before he has a 63-day break in
coverage in order to avoid a premium penalty.
Mrs. Roberts has Original Medicare and would like to enroll in a Private Fee-for-
Service (PFFS) plan. All types of PFFS plans are available in her area. Which options
could Mrs. Roberts consider before selecting a PFFS plan?
Give this one a try later!
, A Medicare Advantage Prescription Drug (MA-PD) PFFS plan that
combines medical benefits and Part D prescription drug coverage, a PFFS
plan offering only medical benefits, or a PFFS plan in combination with a
stand-alone prescription drug plan.
Mrs. Fiore is a retired federal worker with coverage under a Federal Employee Health
Benefits (FEHB) plan that includes creditable drug coverage. She is ready to turn 65
and become Medicare eligible for the first time. What issues might she consider about
whether to enroll in a Medicare prescription drug plan?
Give this one a try later!
She could compare the coverage to see if the Medicare Part D plan offers
better benefits and coverage than the FEHB plan for the specific
medications she needs and whether any additional benefits are worth the
Part D premium costs on top of her FEHB contribution.
Mr. Wingate is a newly enrolled Medicare Part D beneficiary and one of your clients.
In addition to drugs on his plan's formulary, he takes several other medications. These
include a prescription drug not on his plan's formulary, over-the-counter medications
for colds and allergies, vitamins, and drugs from an Internet-based Canadian
pharmacy to promote hair growth and reduce joint swelling. His neighbor recently
told him about a concept called TrOOP and he asks you if any of his other
medications could count toward TrOOP should he ever reach the Part D catastrophic
limit. What should you say.
Give this one a try later!
None of the costs of Mr. Wingate's other medications would currently
count toward TrOOP but he may wish to ask his plan for an exception to
cover the prescription, not on its formulary.
