Medicare exam 1 When soliciting referrals from current members ..

When soliciting referrals from current members of an MA or Part D plan, what may you do? ANSWER : You may request names and mailing addresses Ordinarily, you obtain referrals from a third-party that initiates contact with potential clients and usually sets up appts. for you. How would the guidelines for marketing MA and Part D plans apply to this practice? ANSWER : Third parties may not make unsolicited calls, visits, or emails to Medicare beneficiaries in order to set up such appts., or for any other reason related to the marketing of MA or Part D. My contracting plans available in your area, you have learned that the plan you represent has a significantly lower monthly premium than the others. Furthermore, you see that the plan you represent has a unique benefit package. What should you do to make sure your clients know about these pieces of information? ANSWER : You may present comparative information that has been created and approved by the CMS, such as a print-out from the Medicare plan comparison website. The Medicare agency has requested a list of contracted representatives from a PFFS plan that you represent. In this situation, what will the plan do? ANSWER : Plans will provide to the Medicare agency a complete list of all of their contracted representatives who are marketing PFFS products, and will authorize the agency to provide those names to state departments of insurance when they request it. Weiss is entitled to Part A and has medical coverage w/o drug coverage through an employer retiree plan. She is not enrolled in Part B. Since the employer plan does not cover Rx's, she wants to enroll in a Medicare Rx plan. Will she be able to? ANSWER : Yes. Mrs. Weiss must be entitled to Part A OR enrolled in Part B to be eligible for coverage under the Medicare Rx plan. Saunders is entitled to Part A, but has not enrolled in Part B because he has coverage through an employer plan. If he wants to enroll in MA plan, what will he have to do? ANSWER : He will have to enroll in Part B Kelly wants to know whether he is eligible to sign up for a PFFS plan. What questions would you need to ask to determine his eligibility? ANSWER : You would need to ask Mr. Kelly if he is enrolled in Part A and Part B and if he lives in the PFFS plan's service area. Gonzalez is entitled to Part A, but has not yet enrolled in Part B. If he wants to enroll in a PFFS plan, what will he have to do? ANSWER : He will have to enroll in Part B prior to enrolling in the PFFS plan. Brown wants to enroll in a MA plan that does not include drug coverage and also enroll in a stand-alone Medicare Rx plan. Under what circumstances can she do this? ANSWER : If the MA plan is a PFFS plan that does not offer drug coverage or a MSA, Mrs. Brown can do this. Roberts has Original Medicare and would like to enroll in a PFFS plan. All types of PFFS plans are available in her area. What option could Mrs. Roberts consider before selecting a PFFS plan? ANSWER : A MA-PD PFFS plan that combines medical benefits and Part D Rx coverage, a PFFS plan offering only medical benefits, of PFFS plan in combination with a stand-alone Rx plan. Nunez attended one of you sales presentations. They've asked you to come to their home to clear up a few questions. During the presentation, Mrs. Nunez feels tired and tells you that her husband can finish things up. She goes to bed. At the end of your discussion, Mr. Nunez says that he wants to enroll both himself and his wife. What should you do? ANSWER : As long as she is able to do so, only Mrs. Nunez can sign her enrollment form. Mrs. Nunez will have to wake up to sign her form or do so at another time. You are meeting with Ms. Berlin and she has completed the enrollment form for a MA-PD plan you represent. You notice that her handwriting is illegible and as a result, the spelling of her street looks incorrect. She asks you to fill in the corrected street name. What should you do? ANSWER : You may correct this information as long as you add your initials and date next to the correction. Block is currently enrolled in a MA plan that includes drug coverage. He found a stand-alone Medicare Rx plan in his area that offers better coverage then that available through his MA-PD plan in addition has a low premium. It won't cost him much more and, because he has the means to do so, he wishes to enroll in the stand-alone Rx plan in addition to his MA-PD plan. What should you tell him? ANSWER : If Mr. Block enrolls in the stand-alone Medicare Rx plan, he will be dis-enrolled from the MA plan.