1 Mrs Shields is covered by Original
Medicare She sustained a hip fracture and is
being successfully treated for that condition
However, she and her physici feel that after
her lengthy hospital stay, she will need a
month
or two of nursing and rehabilitative care
What should you tell them about Original
Medicare's coverage of care in a skilled
nursing facility? Medicare will cover Mrs
Shield's skilled nursing services provided
during the first 20 days of her stay, after
1
,which she would have a copay until she has
been in the facility for 100 days
2 Mrs West wears glasses and dentures
and has enjoyed considerable pain relief
from arthritis through massage therapy She
is concerned about whether or not
Medicare will cover these items and
services What should you tell her?
Medicare does not cover massage therapy,
or, in general, glasses or dentures
3 Mrs Park is an elderly retiree Mrs Park
has a low fixed income What could you tell
Mrs Park that might be of assistance? She
should contact her state Medicaid agency
to see if she qualifies for one of several
programs that can help with Medicare costs
for which she is responsible
2
,4 Mr Alonso receives some help paying for
his two generic prescription drugs from his
employer's retiree coverage, but he wants
to compare it to a Part D prescription drug
plan He asks you what costs he would
generally expect to encounter when
enrolling into a standard Medicare Part D
prescription drug plan What should you tell
him? He generally would pay a monthly
premium, annual deductible, and per-
prescription cost-sharing
5 Mrs Gonzalez is enrolled in Original
Medicare and has a Medigap policy as well,
but it provides no drug coverage She would
like to keep the coverage she has but
replace her existing Medigap plan with one
that provides drug coverage What should
3
, you tell her? Mrs Gonzalez cannot purchase
a Medigap plan that covers drugs, but she
could keep her Medigap policy and enroll in
a Part D prescription drug plan
6 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?
He may sign-up for Medicare at any time
however coverage usually begins on the
fourth month after dialysis treatments start
7 Mrs Duarte is enrolled in Original
Medicare Parts A and B She has recently
reviewed her Medicare Summary Notice
(MSN) and disagrees with a determi- nation
that partially denied one of her claims for
4
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