b. Mary may make an unlimited number of MA enrollment requests and may disenroll from her current MA plan. However, she and her physicians feel that after her lengthy hospital stay she will need a month or two of nursing and rehabilitative care. Mr. Singh would like drug coverage but does not want to be enrolled in a medicare advantage plan. Mrs. Allen should be able to find a plan that covers the medications she needs.). Why do you think Seamus Heaney might have chosen this rhyme scheme for a poem about a couples relationship What could you tell Mrs. Park that might be of assistance? ART. He wants to know if Medicare covers cancer screening. You need $28,974\$28,974$28,974 at the end of 101010 years, and your only investment outlet is an 888 percent long-term certificate of deposit (compounded annually). Becky Knauer recently resigned from her position as controller for Shamalay Automotive, a small, struggling foreign car dealer in Upper Saddle River, New Jersey. a. Correct. During the MA Open Enrollment Period, from January 1 - March 31, she may disenroll from the MA-PD plan into Original Medicare and also may add a stand-alone prescription drug plan. She will be paying a monthly premium and, with the exception of many preventive and screening tests, generally will have 20% coinsurance for these services, in addition to an annual deductible. b. Agent Jennings distributes materials that are solely educational in nature. She will have a six-month window during which she can select a plan other than the one into which she has been automatically enrolled. She should use an existing prescription drug coverage to get as large a supply of her existing drugs as possible, and then pick new drugs that are covered under her Medicare plan's formulary. b. partnerships ABC is a Medicare Advantage (MA) plan sponsor. (Marketing representatives may engage in marketing activities in a retail pharmacy in common areas. What should you tell him? 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? She is worried that she will not be able to enroll in another plan available in her new residence until the Annual Election Period. (Mrs. Davenport has three clear choices: (1) remain in the ABC MA plan, (2) enroll in another MA plan in her service area, or (3) enroll in a Special Needs Plan (SPN) for persons suffering from ESRD if one is available in her area.). b. Medigap plans help beneficiaries cover coinsurance, co-payments, and/or deductibles for medically necessary services. -If she does not sign up for a Medicare prescription drug plan as soon as she is eligible to do so, and 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. b. c. Despite the terms of her contract forbidding the use of social media, Agent Meadows could send out a tweet stating that "Best Care offers a Medicare Advantage benefit package offering the lowest cost comprehensive dental benefit package available. c. Yes, but Mrs. Walters must drop the employer coverage prior to enrolling in a Medicare prescription drug plan. Mrs. Radford asks whether there are any special eligibility requirements for Medicare Advantage. He can enroll in a standalone prescription drug plan and c. Agent Lopez's compensation is not impacted because Ralph's disenrollment occurred more than 30 days after the effective date of coverage. (The CMS Communication and Marketing Guidelines apply to MA and PDP plans.). How can businesses utilize this technology to attract more customers, sell more products, advertise their products, facilitate the sale of products, and conduct and manage their businesses more efficiently and effectively? a. Medicare Health Plans may offer extra benefits that Original Medicare does not offer such as vision, hearing, and dental services and must include a maximum out-of-pocket limit on Part A and Part B services. You are working with a number of plans and community organizations to sponsor an educational event. c. You must state in the advertisement that it will be an educational event and that the education will consist of specific information about the participating plans. What impact, if any, will the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) have upon Medigap plans? What types of vegetation are found in the northernmost region of the Scandinavian Peninsula? You will not be able to represent any Medicare Advantage or Part D plan until you complete the training and achieve an adequate score.However, you will not have to take a test if you exclusively market employer/union group plans and the companies do not require testing. WebMr. She is in excellent health and will have considerable income when she retires. c. Authorization may be obtained by directing a beneficiary to a website to provide consent as long as the website includes a mechanism for an electronic signature that is valid under applicable law. -Mrs. Radford must be entitled to Part A and enrolled in Part B to enroll in Medicare Advantage. (Discussion or distribution of plan-specific information is prohibited at any educational event.). Singh has sat as the member of Parliament (MP) for Burnaby South since 2019. She takes a number of medications and is concerned that she has not been able to identify a plan that covers all of her medications. WebClick here to get an answer to your question Mr. singh would like drug coverage, but does not want to be enrolled into a health plan. Next week you will be participating in your first "educational event" for prospective enrollees. b. Mrs. Mulcahy is concerned that she may not qualify for enrollment in a Medicare prescription drug plan because, although she is entitled to Part A, she is not enrolled under Medicare Part B. She would also like to enroll in a Medicare Supplement (Medigap) plan. 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. Juan asks you if he will be entitled to Medicare and if he enrolls how that will impact his employer-sponsored healthcare coverage. -Medicare prescription drug plans are not permitted to cover the prescription medications the Vaughns are interested in under Part D coverage, however, plans may cover them as supplemental benefits and the Vaughn's could look into that possibility. Ms. Moore plans to retire when she turns 65 in a few months. Mr. Lopez has heard that he can sign up for a product called "Medicare Advantage" but is not sure about what type of plan designs are available through this program. c. You must submit your materials to the plan you represent, so CMS can review and approve the materials to ensure they are accurate. a. . b. When an event has been advertised as "educational," discussing plan-specific premiums is impermissible. b. Ms. Claggett is sixty-six (66) years old. What should you tell him? b. II and III only b. Though energy in him is mostly inbuilt, he does a lot of things to boost it. What could you tell him? What could you tell him? You must only ensure that the advertisement is factually accurate. 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. WebSingh would like drug coverage, but does not want to be enrolled in a Medicare Advantage plan. Standard Part D coverage would require payment of only fixed per-prescription co-payments. c. You may provide her with the required enrollment materials and take her completed enrollment application. How would you advise Agent John Miller to proceed? d. In order to join a Medicare Advantage plan, she also must enroll in Part B. d. In order to join a Medicare Advantage plan, she also must enroll in Part B. c. 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. What should you tell him? Agent Lopez helps Ralph to enroll in Top Choice Medicare Advantage plan during the Annual Open Enrollment Period. Standard Part D coverage would require payment of an annual deductible, and once past the catastrophic coverage threshold, the beneficiary pays whichever is greater of either the co-pays for generic and brand name drugs or coinsurance of 5%. (An individual enrolled in a MA PFFS plan that does not include a Part D benefit may enroll in a stand-alone Part D prescription drug plan. Juan Perez, who Agent John Miller is meeting with Jerry Smith, a new prospect. d. He will need to enroll in a Medicare prescription drug plan upon becoming eligible for the program in order to avoid a premium penalty. (Mr. Carlini can stay in Original Medicare and obtain prescription drug benefits through a stand-alone Part D plan. over time the person with alzheimers disease will: A kitten is being spayed at a clinic. b. Medicare will cover Mrs. Shields' skilled nursing services provided during the first 20 days of her stay, after which she would have a coinsurance until she has been in the facility for 100 days. She wants to understand what this means. c. She may enroll in an MA plan beginning three months immediately before her first entitlement to both Medicare Part A and Part B. Correct. No. WebThe answer that you can give to Mr. Singh would be that he can enroll in a stand-alone prescription drug plan and be receiving Part A and B services. She is interested in selecting a Medicare Part D prescription drug plan. What is the difference between a sign and a symptom? Most of them - 27968462 Which of the following statements best describes the impact of Ralph's action upon Agent Lopez's compensation? (Most individuals who are citizens and age 65 or older may qualify for coverage either because they pay a monthly premium or because they paid Medicare taxes while working for a specific duration.). Her husband worked for many years and contributed into the Medicare system. d. Only scripts and marketing practices must be approved by CMS, so you do not need to do anything further with your marketing materials, so long as you make them available to anyone who attends your marketing event(s). Mr. Zachow has a condition for which three drugs are available. She is concerned that she will not qualify for coverage under part A because she was not born in the United States. The standalone plan got this name due to the fact that the drug coverage is a separate plan that the beneficiaries may be able to purchase. a. Medicare Part D drug plans may have different benefit structures, but on average, they must all be at least as good as the standard model established by the government. Mrs. Shields is covered by Original Medicare. Daniel is a middle-income Medicare beneficiary. -Every Part D drug plan is required to cover a single one-month fill of her existing medications sometime during a 90-day transition period. d. As long as he fills out the paperwork to begin withholding from his Social Security check at least 63 days before such withholding should begin, he can change his method of Part D premium payment and withholding will begin the month after his savings account is exhausted. a. a. I and II only d. They are Medigap Supplemental plans that fill in the gaps not covered by Medicare. As long as he has any sort of employer coverage, regardless of the level of coverage, he will incur no penalty if he does not enroll in a Part D plan when first eligible. c. Mrs. Radford must be entitled to Part A and enrolled in Part B to enroll in Medicare Advantage. What should you tell him? How would you respond? Mr. Shultz was still working when he first qualified for Medicare. Mrs. Ramos is considering a Medicare Advantage PPO and has questions about which providers she can go to for her health care. b. What should you tell her? Part B primarily covers physician services. She can enroll in the PPO and purchase drug coverage through a Medigap plan. b. Medicare will cover Mrs. Shield's skilled nursing services provided during the first 20 days of her stay, after which she would have a copay until she has been in the facility for 100 days. Mr. Moy's wife has a Medicare Advantage plan, but he wants to understand what coverage Medicare Supplemental Insurance provides since his health care needs are different from his wife's needs. WebMr. Mrs. Pea is 66 years old, has coverage under an employer plan and will retire next year. Mrs. Turner is comparing her employer's retiree insurance to Original Medicare and would like to know which of the following services Original Medicare will cover if the appropriate criteria are met? He has limited financial resources but failed to qualify for the Part D low-income subsidy. b. d. Medicare prescription drug plans are allowed to restrict their coverage to generic drugs. a. As a result, this method of payment is no longer an option for Part D premium payments. You need to include a statement that the plans you are marketing are approved by CMS and the Department of Health and Human Services. She currently does not have creditable coverage. c. Yes. (TrOOP takes into account not only expenditures by a Part D beneficiary but can also includes expenses not paid by a beneficiary such as drug manufacturer discounts.). c. She can enroll in the PPO, but she will not be able to purchase a stand-alone Medicare Part D prescription drug plan. Mrs. Gonzalez is enrolled in Original Medicare and has a Medigap policy as well, but it provides no drug coverage. On the other hand, during the annual open enrollment period, an individual may make as many changes to his MA enrollment as he wants but the last choice before the end of the period will be the effective one.). d. Part A, which covers hospital, skilled nursing facility, hospice, and home health services and Part B, which covers professional services such as those provided by a doctor are covered under Original Medicare. In addition to drugs on his plan's formulary he takes several other medications. c. Most individuals who are citizens and age 65 or over are covered under Part A by virtue of having paid Medicare taxes while working, though some may be covered as a result of paying monthly premiums. Mr. Bauer is 49 years old, but eighteen months ago he was declared disabled by the Social Security Administration and has been receiving disability payments. c. In general, he must select a single Part D premium payment mechanism that will be used throughout the year. 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