Question 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?
a. She can enroll in the PPO, but she will not be able to purchase a stand-alone Medicare Part D
prescription drug plan - Correct.
b. b. She can enroll in the PPO and purchase drug coverage through a stand-alone Medicare Part
D prescription drug plan.
c. c. She can enroll in the PPO and purchase drug coverage through a Medigap plan.
d. d. She can enroll in the PPO and if she decides that she wants drug coverage, she will be able
to drop her PPO at any time in favor of a Medicare Advantage plan that includes such drug
coverage
Question 2.
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?
a. Medicaid will cover his cost-sharing, regardless of from which physician or hospital he receives
his Medicare-covered services.
b. He should know that Medicaid will pay cost sharing only for services provided by Medicaid
participating providers-Correct.
c. 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.d. Medicaid will
no longer pay any cost sharing once he is eligible for Medicare, so he will need to rely only on
Medicare providers
Question 3.
You have decided to focus on doing in-home presentations to market the Medicare Advantage (MA)
plans you represent. Before you conduct such sales presentations, what must you do?
a. You must receive an invitation from the beneficiary and document the specific types of
products the beneficiary wants to discuss prior to making an in-home presentation.
b. b. There is no special action that you must take. If they choose, you may go to an individual’s
house to provide presentations and offer assistance with enrolling in a plan.
c. c. You must first contact the Medicare agency to ensure that the individual is actually a
Medicare beneficiary.
d. d. A proper introduction at the door that includes a disclaimer regarding your relationship
with the plan you represent is the only required action you must take, prior to entering the
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