1. Mrs. Radford asks whether there are any special eligibility requirements forMedicare
Advantage. What should you tell her?
Answer: Mrs. Radford must be entitled to Part A and enrolled in Part B to enroll in Medicare
Advantage.
2. Which of the following statement(s) is/are correct about a Medicare SavingsAccount (MSA)
Plans?
I. MSAs may have either a partial network, full network, or no network ofproviders.
II. MSA plans cover Part A and Part B benefits but not Part D prescription drugbenefits.
III. An individual who is enrolled in an MSA plan is responsible for a minimaldeductible of
$500 indexed for inflation.
IV. Non-network providers must accept the same amount that OriginalMedicare would pay
them as payment in full.
Answer: I, II, and IV only
3. Mrs. Burton is a retiree with substantial income. She is enrolled in an MA-PDplan and was
disappointed with the service she received from her primary care physician because she was
told she would have to wait five weeks to getan appointment when she was feeling ill. She
called you to ask what she coulddo so she would not have to put up with such poor access to
care. What couldyou tell her?
Answer: She could file a grievance with her plan to complain about the lack oftimeliness in
getting an appointment.
4. 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 notinclude drug coverage and intends to obtain his drug coverage through a
stand-alone Medicare prescription drug plan. What should you tell him aboutthis situation?
Answer: He could enroll either in one of the MA plans that include prescription drug coverage
or Original Medicare with a Medigap plan and standalone Part D prescription drug coverage,
but he cannot enroll in the MA-only PPO plan and astand-alone prescription drug plan.
5. Ms. Gibson recently lost her employer group health and drug coverage andnow she wants to
enroll in a PPO that does not include drug coverage. What should you tell her about obtaining
drug coverage?
Answer: She can enroll in the PPO,but she will not be able to purchase a stand-alone Medicare
Part D prescription drugplan.
6. Mr. Kelly wants to know whether he is eligible to sign up for a private
fee-for-service (PFFS) plan. What questions would you need to ask to deter- mine his
eligibility?
Answer: You would need to ask Mr. Kelly if he is enrolled in Part A and
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