Mr. Carlini has heard that Medicare prescription drug plans are only provided through private
businesses under a program referred to as Medicare Advantage (MA), now not via the
government. He likes Original Medicare and does not need to sign up for an MA product,
however he also needs prescription drug insurance. What ought to you tell him? - ANSMr.
Carlini can stay with Original Medicare and also join in a Medicare prescription drug plan
thru a non-public enterprise that has shrunk with the government to provide simplest such
drug coverage to eligible Medicare beneficiaries.
During a sales presentation to Ms Daley for a Medicare Advantage plan that has a
five-celebrity score in customer support and care coordination, and obtained an standard
plan overall performance of a 4-superstar, which of the subsequent could be the precise
assertion to mention to her? - ANSThe Medicare Advantage plan acquired a 5-superstar
score in customer service and care coordination with an normal performance score of
4-stars
Mrs. Pena is sixty six years antique, has insurance under an organization plan and could
retire subsequent year. She heard she ought to enroll in Part B at the start of the yr to make
sure no hole in coverage. What are you able to tell her? - ANSShe may additionally sign up
at any time whilst she is covered under her organisation plan, however she will have a
special 8-month enrollment period that differs from the standard standard enrollment
duration, during which she may additionally join in Medicare Part B
Mr. Bickford did not quite qualify for the more assist low-profits subsidy below the Medicare
Part D Prescription Drug program and he is wondering if there may be every other
alternative he has for acquiring assist together with his significant drug fees. What must you
inform him? - ANSHe may want to take a look at with the producers of his medicinal drugs to
look in the event that they provide an help software to assist human beings with restrained
method gain the medications they want. Alternatively, he should check to see whether or not
his state has a pharmacy assistance software to assist him along with his expenses.
Alice is a advertising and marketing consultant employed with the aid of a health plan. Betty
is a captive agent of a fitness plan who markets to a couple of plans and sponsors. Carl is a
captive agent who markets to handiest one plan/sponsor. Denise is an unbiased agent who
markets to distinct sorts of agencies. Edward is an unbiased agent who markets most
effective to organisation and union agencies. CMS advertising representative compensation
regulations typically practice to: - ANSBetty and Denise, however no longer Alice (the
worker) or Carl or Edward (to whom exceptions apply).
Mrs. Valentino is presently enrolled in a Medicare Cost plan. This plan is no longer meeting
her needs, but it is now mid-12 months and past the annual election period (AEP). What
could you are saying to Mrs. Valentino concerning her alternatives? - ANSMrs. Valentino can
, submit a written request to Medicare to be disenrolled from the Cost plan and join in Original
Medicare.
When Myra first have become eligible for Medicare, she enrolled in Original Medicare (Parts
A and B). She is now sixty seven and could turn 68 on July 1. She might now like to enroll in
a Medicare Advantage (MA) plan and processes you about her options. What
recommendation would you supply her? - ANSShe must continue to be in Original Medicare
until the yearly election length jogging from October 15 to December 7, during which she can
pick out an MA plan.
Mrs. Tanner is enrolled in a Medicare Advantage HMO that offers a point of service
alternatives. This lets in Mrs. Tanner to do which of the subsequent? - ANSMrs. Tanner can
visit non-plan doctors for positive services without receiving prior approval
Agent Harriet Walker has currently started advertising and marketing Medicare Advantage
and associated merchandise aimed at assembly the needs of senior citizens. Client Mildred
Jones has expressed hobby in a Medicare Advantage plan. It is now the beginning of
September. If you had been in Agent Walker's position, what might you do? - ANSInquire
whether the client qualifies for a special enrollment length, and if not, solicit an enrollment
utility once the once a year open enrollment election period starts offevolved on October
15th.
Mrs. Chen may be 65 soon, has been a citizen for twelve years, has been hired full time, and
paid taxes all through that complete duration. She is concerned that she will be able to not
qualify for coverage beneath element A due to the fact she changed into now not born in the
United States. What ought to you inform her? - ANSMost folks who are residents and over
age 65 are covered underneath Part A via distinctive feature of having paid Medicare taxes
even as operating, even though a few may be blanketed as a result of paying
month-to-month premiums.
Mr. Katz reached the Part D coverage hole in August final year. His prescriptions have no
longer been modified, he's keeping the same Part D plan and the blessings, cost-sharing,
and insurance of his capsules are all the same as remaining year. He asked what to expect
for this 12 months approximately his out-of-pocket fees. What ought to you inform him? -
ANSBecause he reached the coverage hole last 12 months, he'll probable reah it once more
this yr close to the equal time.
ABC is a Medicare Advantage (MA) plan sponsor. It would really like to use its enrollees'
included fitness information to market non-fitness associated products along with lifestyles
coverage and annuities. To achieve this it need to obtain authorization from the enrollees.
Which declaration fine describes the authorization method? - ANSAuthorization may be
received by using directing a beneficiary to a internet site to provide consent
Mrs. Henderson believes that she will qualify for Medicare coverage when she turns 65, with
out paying any premiums, due to the fact she has been running for forty years and paying
Medicare taxes. What have to you tell her? - ANSIn order to reap Part B insurance, she
should pay a general month-to-month top rate, although it is better for individuals with higher
earning.
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller Rosedocs. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $12.99. You're not tied to anything after your purchase.