COMPREHENSIVE QUESTIONS AND VERIFIED
ANSWERS MOST TESTED QUESTIONS COMPLETE
STUDE GUIDE GET IT RIGHT GRADE A+
Mrs. Walters is entitled to Part A and has medical coverage
without drug coverage through an employer retiree plan. She
is not enrolled in Part B. Since the employer plan does not
cover prescription drugs, she wants to enroll in a Medicare
prescription drug plan. Will she be able to?
Yes. Mrs. Walters must be entitled to Part A or enrolled in Part B
to be eligible for coverage under the Medicare prescription drug
program.
Mrs. Goodman enrolled in an MA-PD plan during the Annual
Election Period. In mid-January of the following year, she
wants to switch back to Original Medicare and enroll in a
stand-alone prescription drug plan. What should you tell
her?
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.
Mrs. Berkowitz wants to enroll in a Medicare Advantage plan
that does not include drug coverage and also enroll in a
stand-alone Medicare prescription drug plan. Under what
circumstances can she do this?
If the Medicare Advantage plan is a Private Fee-for-Service
(PFFS) plan that does not offer drug coverage or a Medical
Savings Account plan, Mrs. Berkowitz can do this.
,Mr. Garcia was told he qualifies for a Special Enrollment
Period (SEP), but he lost the paper that explains what he
could do during the SEP. What can you tell him?
If the SEP is for MA coverage, he will generally have one
opportunity to change his MA coverage.
Ms. Lee is enrolled in an MA-PD plan but will be moving out
of the plan's service area next month. She is worried that she
will not be able to enroll in another plan available in her new
residence until the Annual Election Period. What should you
tell her?
She is eligible for a Special Election Period that begins either the
month before her permanent move, if the plan is notified in
advance, or the month she provides notice of the move, and this
period typically lasts an additional two months.
You are doing a sales presentation for Mrs. Pearson. You
know that Medicare marketing guidelines prohibit certain
types of statements. Apply those guidelines to the following
statements and identify which would be prohibited.
"If you're not in very good health, you will probably do better with
a different product."
Mr. Anderson is a very organized individual and has filled out
and brought to you an enrollment form on October 10 for a
new plan available January 1 next year. He is currently
enrolled in Original Medicare. What should you do?
Tell Mr. Anderson that you cannot accept any enrollment forms
until the annual election period begins.
You are visiting with Mr. Tully and his daughter at her
request. He has advanced Alzheimer's and is incapable of
understanding the implications of choosing a Medicare
Advantage or prescription drug plan. Can his daughter fill
out the enrollment form and sign it for him?
Mr. Tully's daughter can do so only, if she is authorized under
state law as a court-appointed legal guardian, has a durable
,power of attorney for health care decisions, or is authorized under
state surrogate consent laws to make health decisions.
Ms. Gonzales decided to remain in Original Medicare (Parts A
and B) and Part D during the Annual Enrollment Period
(AEP). At the beginning of January, her neighbor told her
about the Medicare Advantage (MA) plan he selected. He also
told her there was an open enrollment period that she might
be able to use to enroll in a MA plan. Ms. Gonzales comes to
you for advice shortly after speaking to her neighbor. What
should you tell her?
There is a MA Open Enrollment Period (OEP) that takes place
between January 1 and March 31, but Ms. Gonzales cannot use it
because eligibility to use the OEP is available only to MA
enrollees.
Ms. Claggett is sixty-six (66) years old. She has been covered
under Original Medicare for the last six years due to her
disability and has never been enrolled in a Medicare
Advantage or a Part D plan before. She wants to enroll in a
Part D plan. She knows that there is such a thing as the "Part
D Initial Enrollment Period" (IEP) and has concluded that,
since she has never enrolled in such a plan before, she
should be eligible to enroll under this period. What should
you tell her about how the Part D Initial Enrollment Period
applies to her situation?
Ms. Claggett has had two IEPs and missed them both. The first
occurred three months before and three months after the month
when she was first entitled to Part A OR enrolled in Part B.
Because she was eligible for Medicare before age 65, Ms.
Claggett had a second IEP based on turning age 65, which has
also expired.
Mary Samuels recently suffered a stroke while visiting her
daughter and grandchildren. As a result, Mary has been
admitted to a rehabilitation hospital where she is expected to
reside for several months. The rehabilitation hospital is
located outside the geographic area served by her current
, Medicare Advantage (MA) plan. What options are available to
Mary regarding her health plan coverage?
Mary may make an unlimited number of MA enrollment requests
and may disenroll from her current MA plan.
Mrs. Pierce would like to enroll in a Medicare Cost plan that
offers Part D prescription drug coverage. She comes to you
for advice about when she can enroll in a plan you have
previously discussed. What should you tell her?
Enrollment in Cost plans offering Part D coverage is available
only during enrollment periods under the Part D program, and
Cost plans must accept enrollments during these periods.
Mr. Ford enrolled in an MA-only plan in mid-November during
the Annual Election Period (AEP). On December 1, he calls
you up and says that he has changed his mind and would
like to enroll into a MA-PD plan. What enrollment rules would
apply in this case?
He can make as many enrollment changes as he likes during the
Annual Election Period and the last choice made prior to the end
of the period will be the effective one as of January 1.
Which of the following individuals is most likely to be eligible
to enroll in a Medicare Advantage (MA) or Part D Plan?
Jose, a grandfather who was granted asylum and has worked in
the United States for many years.
Which of the following individuals are likely to qualify for a
special enrollment period (SEP) for either a MA and/or Part D
due to a change of residence?
I. Edward (enrolled in MA and Part D) moves to a new home
within the same neighborhood in his existing plan's service
area.II. Fiona (enrolled in MA and Part D) moves cross-
country to an area outside her existing plan's service area.III.
Gilbert moves into a plan service area where there is now a
Part D plan available to him from a service area where no
Part D plan was available.IV. Henry makes a permanent move
to a new state providing him with new MA and Part D
options.
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