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Mrs. Fields wants to know whether applying for the Part D low income subsidy will be worth the
time to fill out the paperwork. What could you tell her? - -correct ans- -The Part D low income
subsidy could substantially lower her overall costs. She can apply by contacting her state
Medicaid office, or calling the Social Security Administration.
Mr. Fitzgerald did not quite qualify for the extra help low-income subsidy under the Medicare
Part D Prescription Drug program and he is wondering if there is any other option he has for
obtaining help with his considerable drug costs. What should you tell him? - -correct ans- -He
could check with the manufacturers of his medications to see if they offer an assistance program
to help people with limited means obtain the medications they need. Alternatively, he could
check to see whether his state has a pharmacy assistance program to help him with his
expenses.
Mrs. Quinn has just turned 65, is in excellent health, and has a relatively high income. She uses
no medications and sees no reason to spend money on a Medicare prescription drug plan if she
does not need the coverage. What could you tell her about the implications of such a decision? -
correct ans- -If she does not sign up for a Medicare prescription drug plan as soon as she is
eligible to do so, if she does sign up at a later date, her premium will be permanently increased
by 1% of the national average premium for every month that she was not covered.
Mr. Torres has a small savings account. He would like to pay for his monthly Part D premiums
with an automatic monthly withdrawal from his savings account until it is exhausted, and then
have his premiums withheld from his Social Security check. What should you tell him? - -correct
ans- -In general, he must select a single Part D premium payment mechanism that will be used
throughout the year.
,Mrs. Fiore was in the Army for 35 years and is now retired. She has drug coverage through the
VA. What issues might she consider with regard to whether to enroll in a Medicare prescription
drug plan? - -correct ans- -She could compare the coverage to see if the Medicare Part D plan
offers better benefits and coverage than the VA for the specific medications she needs and
whether any additional benefits are worth the Part D premium costs.
Mr. Hutchinson has drug coverage through his former employer's retiree plan. He is concerned
about the Part D premium penalty if he does not enroll in a Medicare prescription drug plan, but
does not want to purchase extra coverage that he will not need. What should you tell him? -
correct ans- -If the drug coverage he has is not expected to pay, on average, at least as much as
Medicare's standard Part D coverage expects to pay, then he will need to enroll in Medicare Part
D during his initial eligibility period to avoid the late enrollment penalty.
Mr. Jenkins has coverage for medical services and medications through his employer's retiree
plan. He is considering switching to a Medicare prescription drug plan because his retiree plan
does not cover two important medications. What should he consider before making a change? -
correct ans- -If Mr. Jenkins drops his drug coverage through the retiree plan, he may not be able
to get it back and he also may lose his medical health coverage.
Since 1999, Mrs. Patel has had a Medigap policy that covers drugs. This year she received a letter
from her Medigap insurer telling her that her Medigap drug coverage is not "creditable." She
wants you to explain what this means and what she should do. What should you tell her? -
correct ans- -The letter is letting her know that her Medigap drug coverage is coverage that does
not expect to pay, on average, at least as much as Medicare's standard Part D coverage expects
to pay. If she signs up for a Medicare prescription drug plan now, she may have to pay a premium
penalty if her special enrollment period has expired.
Mrs. McIntire is enrolled in her state's Medicaid plan and has just become eligible for Medicare
as well. What can she expect will happen with respect to her drug coverage? - -correct ans-
Unless she chooses a Medicare Part D prescription drug plan on her own, she will be
automatically enrolled in one available in her area.
, Mr. Prentice has many clients who are Medicare beneficiaries. He should review the Centers for
Medicare & Medicaid Services' Marketing Guidelines to ensure he is compliant for which type of
products? - -correct ans- -Medicare Advantage (MA) and Prescription Drug (PDP) plans
Another agent working for your agency claims that because you are not employed by the
Medicare Advantage plans that you represent, you are not subject to the same requirements as
the plans themselves. How should you respond to such a statement? - -correct ans- -Your
coworker is not correct. Marketing on behalf of a plan is considered marketing by the plan and
requires that all contracted and employed agents comply with all Medicare marketing rules.
You work for a company that has marketed Medigap products for many years. The company has
added Medicare Advantage and Part D plans and you will begin marketing those plans this fall.
You are planning what materials to use to easily show the differences in benefits, premiums and
cost sharing for each of the products. What do you need to do with your materials before using
them for marketing purposes? - -correct ans- -You must submit your materials to the plan you
represent, so CMS can review and approve the materials to ensure they are accurate.
Which of the following is a correct statement about state laws as they pertain to marketing
representatives? - -correct ans- -Medicare health plans must comply with requests for
information from state insurance departments investigating complaints about a marketing
representative.
You are seeking to represent an individual Medicare Advantage plan and an individual Part D
plan in your state. You have completed the required training for each plan, but you did not
achieve a passing score on the tests that came after the training. What can you do in this
situation? - -correct ans- -You will not be able to represent any Medicare Advantage or Part D
plan until you complete the training and achieve an adequate score, although you will not have
to take a test if you exclusively market employer/union group plans and the companies do not
require testing.
Your colleague works at a third party marketing organization (TMO) and she said she did not
need to take the Medicare training for brokers and agents or pass a test to market Medicare
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