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Mr. Carlini has heard that Medicare prescription drug plans are only offered through private companies under a program known as Medicare Advantage (MA), not by the government. He likes Original Medicare and does not want to sign up for an MA product, but he also wants prescription drug coverage. Wha...
Voorbeeld 2 van de 8 pagina's
In winkelwagenMr. Carlini has heard that Medicare prescription drug plans are only offered through private companies under a program known as Medicare Advantage (MA), not by the government. He likes Original Medicare and does not want to sign up for an MA product, but he also wants prescription drug coverage. Wha...
Medicare plan means -Answer A MA plan, MA-PD plan or PDP Subcontractor means -Answer **An individual or entity that provides services on behalf of a Medicare plan sponsor. This includes individuals and organizations with DIRECT relationship with the plan sponsor or individuals or organizati...
Voorbeeld 2 van de 11 pagina's
In winkelwagenMedicare plan means -Answer A MA plan, MA-PD plan or PDP Subcontractor means -Answer **An individual or entity that provides services on behalf of a Medicare plan sponsor. This includes individuals and organizations with DIRECT relationship with the plan sponsor or individuals or organizati...
Mrs. Willard wants to know generally how the benefits under Original Medicare might compare to the benefits package of a Medicare Advantage Plan before she starts looking at specific plans. What could you tell her? - Answer Medicare Advantage Plans may offer extra benefits that Original Medicare d...
Voorbeeld 2 van de 8 pagina's
In winkelwagenMrs. Willard wants to know generally how the benefits under Original Medicare might compare to the benefits package of a Medicare Advantage Plan before she starts looking at specific plans. What could you tell her? - Answer Medicare Advantage Plans may offer extra benefits that Original Medicare d...
Mr. Xi will soon turn age 65 and has come to you for advice as to what services are provided under Original Medicare. What should you tell Mr. Xi that best describes the health coverage provided to Medicare beneficiaries? a. Medicare Part B generally provides prescription drug coverage. b. Bene...
Voorbeeld 4 van de 52 pagina's
In winkelwagenMr. Xi will soon turn age 65 and has come to you for advice as to what services are provided under Original Medicare. What should you tell Mr. Xi that best describes the health coverage provided to Medicare beneficiaries? a. Medicare Part B generally provides prescription drug coverage. b. Bene...
Mr. Zachow has a condition for which three drugs are available. He has tried two but had an allergic reaction to them. Only the third drug works for him and it is not on his Part D plan's formulary. What could you tell him to do? - Answer Mr. Zachow has a right to request a formulary exception t...
Voorbeeld 2 van de 10 pagina's
In winkelwagenMr. Zachow has a condition for which three drugs are available. He has tried two but had an allergic reaction to them. Only the third drug works for him and it is not on his Part D plan's formulary. What could you tell him to do? - Answer Mr. Zachow has a right to request a formulary exception t...
A Medicare beneficiary has walked into your office and requested that you sit down with her and discuss her options under the Medicare Advantage program. Before engaging in such a discussion, what should you do? - Answer You must have her sign a scope of appointment form, indicating which products...
Voorbeeld 2 van de 9 pagina's
In winkelwagenA Medicare beneficiary has walked into your office and requested that you sit down with her and discuss her options under the Medicare Advantage program. Before engaging in such a discussion, what should you do? - Answer You must have her sign a scope of appointment form, indicating which products...
Mrs. West wears glasses and dentures and has enjoyed considerable pain relief from arthritis through acupuncture. She is concerned about whether or not Medicare will cover these items and services. What should you tell her? - Answer Medicare does not cover acupuncture, or, in general, glasses or ...
Voorbeeld 2 van de 8 pagina's
In winkelwagenMrs. West wears glasses and dentures and has enjoyed considerable pain relief from arthritis through acupuncture. She is concerned about whether or not Medicare will cover these items and services. What should you tell her? - Answer Medicare does not cover acupuncture, or, in general, glasses or ...
Mr. Lopez, who is fairly well-off financially, would like to enroll in a Medicare prescription drug plan you represent and simply give you a check to cover his premiums for the entire year. What should you tell him? -Answer He will need to mail in his payment with his enrollment form. Mrs. Cho...
Voorbeeld 2 van de 8 pagina's
In winkelwagenMr. Lopez, who is fairly well-off financially, would like to enroll in a Medicare prescription drug plan you represent and simply give you a check to cover his premiums for the entire year. What should you tell him? -Answer He will need to mail in his payment with his enrollment form. Mrs. Cho...
Willard works as a representative focused on the senior marketplace. What would be considered prohibited activity by Willard? - Answer Implying that only seniors can enroll in a Medicare Advantage plan when meeting with Mr. Hernandez, who is 58 but qualifies for Medicare because he is disabled. ...
Voorbeeld 1 van de 4 pagina's
In winkelwagenWillard works as a representative focused on the senior marketplace. What would be considered prohibited activity by Willard? - Answer Implying that only seniors can enroll in a Medicare Advantage plan when meeting with Mr. Hernandez, who is 58 but qualifies for Medicare because he is disabled. ...
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? - Answer Medicare Advantage (MA) and Prescription Drug (PDP) plans Correct Another agent work...
Voorbeeld 2 van de 8 pagina's
In winkelwagenMr. 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? - Answer Medicare Advantage (MA) and Prescription Drug (PDP) plans Correct Another agent work...
Mr. Greco is in excellent health, lives in his own home, and has a sizeable income from his investments. He has a friend enrolled in a Medicare Advantage Special Needs Plan (SNP). His friend has mentioned that the SNP charges very low cost-sharing amounts and Mr. Greco would like to join that plan. ...
Voorbeeld 1 van de 4 pagina's
In winkelwagenMr. Greco is in excellent health, lives in his own home, and has a sizeable income from his investments. He has a friend enrolled in a Medicare Advantage Special Needs Plan (SNP). His friend has mentioned that the SNP charges very low cost-sharing amounts and Mr. Greco would like to join that plan. ...
Mr. Kumar is considering a Medicare Advantage HMO and has questions about his ability to access providers. What should you tell him? Choose one answer. a. In Medicare Advantage HMO plans, services provided by primary care physicians are covered at 100%, but those of specialists are covered at ...
Voorbeeld 1 van de 2 pagina's
In winkelwagenMr. Kumar is considering a Medicare Advantage HMO and has questions about his ability to access providers. What should you tell him? Choose one answer. a. In Medicare Advantage HMO plans, services provided by primary care physicians are covered at 100%, but those of specialists are covered at ...
Mrs. Chen will be 65 soon, has been a citizen for twelve years, has been employed full time, and paid taxes during that entire period. She is concerned that she will not qualify for coverage under part A because she was not born in the United States. What should you tell her? Choose one answer. ...
Voorbeeld 2 van de 5 pagina's
In winkelwagenMrs. Chen will be 65 soon, has been a citizen for twelve years, has been employed full time, and paid taxes during that entire period. She is concerned that she will not qualify for coverage under part A because she was not born in the United States. What should you tell her? Choose one answer. ...
Davis is 52 years old and has recently been diagnosed with end-stage renal disease (ESRD) and will soon begin dialysis. He is wondering if he can obtain coverage under Medicare. What should you tell him? - Answer He may sign-up for Medicare at any time however coverage usually begins on the fourth...
Voorbeeld 3 van de 25 pagina's
In winkelwagenDavis is 52 years old and has recently been diagnosed with end-stage renal disease (ESRD) and will soon begin dialysis. He is wondering if he can obtain coverage under Medicare. What should you tell him? - Answer He may sign-up for Medicare at any time however coverage usually begins on the fourth...
Ms. Jensen has heard about "Original Fee-for-Service Medicare" and "Private Fee-for-Service" plans. She wants to know what the difference is if any. What should you tell her? - Answer PFFS plans are a type of Medicare Advantage plan offered by private companies. This year you decide to foc...
Voorbeeld 3 van de 19 pagina's
In winkelwagenMs. Jensen has heard about "Original Fee-for-Service Medicare" and "Private Fee-for-Service" plans. She wants to know what the difference is if any. What should you tell her? - Answer PFFS plans are a type of Medicare Advantage plan offered by private companies. This year you decide to foc...
What impact, if any, have recent regulatory changes had upon Medigap plans? A. The Part A deductible is no longer covered under Medigap plans for all enrollees starting January 1, 2020. B. The Part A deductible is no longer covered for individuals newly eligible for Medicare starting January 1, 20...
Voorbeeld 2 van de 10 pagina's
In winkelwagenWhat impact, if any, have recent regulatory changes had upon Medigap plans? A. The Part A deductible is no longer covered under Medigap plans for all enrollees starting January 1, 2020. B. The Part A deductible is no longer covered for individuals newly eligible for Medicare starting January 1, 20...
Medicare - Answer Parts A & B, Original Medicare Supplement - Answer Medicare Supplement, Medigap Advantage - Answer Medicare Advantage, MA, MAPD Part D - Answer Part of MAPD OR Stand-alone PDP Pre-Medicare - Answer Under 65, Individual and Family, Affordable Care Act (ACA or P...
Voorbeeld 1 van de 3 pagina's
In winkelwagenMedicare - Answer Parts A & B, Original Medicare Supplement - Answer Medicare Supplement, Medigap Advantage - Answer Medicare Advantage, MA, MAPD Part D - Answer Part of MAPD OR Stand-alone PDP Pre-Medicare - Answer Under 65, Individual and Family, Affordable Care Act (ACA or P...
Mrs. Park is an elderly retiree. Mrs. Park has a low fixed income. What could you tell Mrs. Park that might be of assistance? - Answer She should contact her state Medicaid agency to see if she qualifies forprograms that can help with Medicare costs for which she is responsible. Madeline Martin...
Voorbeeld 2 van de 9 pagina's
In winkelwagenMrs. Park is an elderly retiree. Mrs. Park has a low fixed income. What could you tell Mrs. Park that might be of assistance? - Answer She should contact her state Medicaid agency to see if she qualifies forprograms that can help with Medicare costs for which she is responsible. Madeline Martin...
Edward IP suffered from serious kidney disease. As a result. Edward became eligible for Medicare coverage due to end-stage renal disease (ESRD). A close relative donated their kidney and Edward successfully underwent transplant surgery 12 months ago. Edward is now age 50 and asks you if his Medicare...
Voorbeeld 3 van de 27 pagina's
In winkelwagenEdward IP suffered from serious kidney disease. As a result. Edward became eligible for Medicare coverage due to end-stage renal disease (ESRD). A close relative donated their kidney and Edward successfully underwent transplant surgery 12 months ago. Edward is now age 50 and asks you if his Medicare...
Annual Enrollment period (AEP) - Answer The AEP occurs October 15 through December 7 each year. During this time, all Medicare eligible beneficiaries can enroll in, disenrollment from or change MA,, MA-PD or PDP plans. coverage changes made during the AEP are effective January 1 of the following y...
Voorbeeld 2 van de 6 pagina's
In winkelwagenAnnual Enrollment period (AEP) - Answer The AEP occurs October 15 through December 7 each year. During this time, all Medicare eligible beneficiaries can enroll in, disenrollment from or change MA,, MA-PD or PDP plans. coverage changes made during the AEP are effective January 1 of the following y...
Types of Medicare Advantage Plans - Answer PPO, HMO, MSA, Cost Plan, PFFS Medicare-Medicaid plans - Answer Serve both Medicare and Medicaid individuals. Include Part D coverage. Individuals sometimes referred to as dual eligibles Medicare Cost Plan - Answer Type of Medicare health plan. ...
Voorbeeld 1 van de 4 pagina's
In winkelwagenTypes of Medicare Advantage Plans - Answer PPO, HMO, MSA, Cost Plan, PFFS Medicare-Medicaid plans - Answer Serve both Medicare and Medicaid individuals. Include Part D coverage. Individuals sometimes referred to as dual eligibles Medicare Cost Plan - Answer Type of Medicare health plan. ...
Ms. Moore plans to retire when she turns 65 in a few months. She is in excellent health and will have considerable income when she retires. She is concerned that her income will make it impossible for her to qualify for Medicare. What could you tell her to address her concern? a. Eligibility fo...
Voorbeeld 2 van de 12 pagina's
In winkelwagenMs. Moore plans to retire when she turns 65 in a few months. She is in excellent health and will have considerable income when she retires. She is concerned that her income will make it impossible for her to qualify for Medicare. What could you tell her to address her concern? a. Eligibility fo...
Medicare Advantage - Answer -Cover all Part A and Part B benefits; -Provide plan cost-sharing actuarially equivalent to cost sharing under Medicare Parts A and B, but may be different for specific services; and -Include an annual maximum out-of-pocket (MOOP) limit on total enrollee cost sharing...
Voorbeeld 3 van de 27 pagina's
In winkelwagenMedicare Advantage - Answer -Cover all Part A and Part B benefits; -Provide plan cost-sharing actuarially equivalent to cost sharing under Medicare Parts A and B, but may be different for specific services; and -Include an annual maximum out-of-pocket (MOOP) limit on total enrollee cost sharing...
Mr. Davis is 52 years old and has recently been diagnosed with end-stage renal disease (ESRD) and will soon begin dialysis. He is wondering if he can obtain coverage under Medicare. What should you tell him? - Answer He may sign-up for Medicare at any time however coverage usually begins on the fo...
Voorbeeld 4 van de 39 pagina's
In winkelwagenMr. Davis is 52 years old and has recently been diagnosed with end-stage renal disease (ESRD) and will soon begin dialysis. He is wondering if he can obtain coverage under Medicare. What should you tell him? - Answer He may sign-up for Medicare at any time however coverage usually begins on the fo...
This year you have decided to focus your efforts on marketing to employer group plans. One employer provides you with a list of their retirees and asks you to contact them to explain the characteristics of the plan they have selected. What should you do? - Answer You may go ahead and call them. ...
Voorbeeld 1 van de 4 pagina's
In winkelwagenThis year you have decided to focus your efforts on marketing to employer group plans. One employer provides you with a list of their retirees and asks you to contact them to explain the characteristics of the plan they have selected. What should you do? - Answer You may go ahead and call them. ...
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