Mr. Cole has been a Medicaid beneficiary for some time, and recently qualified for Medicare
as well. He is concerned about changes in his cost-sharing. What should you tell him?
Choose one a. He should know that Medicaid will pay cost sharing only for services
provided by answer. Medicaid participating providers.
b. Medicaid will no longer pay any cost sharing once he is eligible for
Medicare, so he will need to rely only on Medicare providers.
c. Medicaid will cover his cost-sharing, regardless of from which physician
or hospital he receives his Medicare-covered services.
d. For Medicaid beneficiaries, Medicare reduces its cost-sharing amounts
to match those charged by the state Medicaid program so there will be
no change in his cost- sharing amounts.
2
Marks: 1
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?
Choose one a. He could enroll in one of the MA plans that include prescription drug
coverage or a answer. 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.
b. He could enroll in the MA-only PPO plan and a stand-alone Medicare
prescription drug plan.
c. He cannot enroll in a stand-alone prescription drug plan because
you do not represent such a plan.
d. He could enroll in the MA-only plan and purchase a Medigap plan
with drug coverage.
3
Marks: 1
Ms. Gibson recently lost her employer group health and drug coverage and now she wants to
enroll in a PPO that does not include drug coverage. What should you tell her about obtaining
drug coverage?
1/18
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