d. He could check with the manufacturers of his medications to see if they offer an assistance program to help people with limited means to obtain the medications they need. 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. Since Ms. Gonzales chose to remain in Original Medicare, she cannot change plans during the MA OEP. b. However, the plan does not provide drug benefits. Mr. Kelly wants to know whether he is eligible to sign up for a Private fee-for-service (PFFS) plan. She is concerned that she will not qualify for coverage under part A because she was not born in the United States. WebAHIP 3 - question 9 Mr. Singh would like drug coverage but Doc Preview. What could you tell her? a. What should you tell her? Choose one answer. Mr. Castillo is still covered by Part A. Shortly thereafter Mrs. Quinn and received a letter informing her that she has been automatically enrolled in Medicare Part B. b. Mr. Kumar is considering a Medicare Advantage HMO and has questions about his ability to access providers. a. Which of the following statements best describes some of the costs a beneficiary would incur for prescription drugs under the standard coverage? Anita's older neighbor Mel has told her about the Medigap Part F plan in which he is enrolled. When marketing Medicare Advantage and Part D plans, what are you permitted to do with respect to meals? d. Your name will be registered with the Medicare agency by the plans you are seeking to represent and you will be unable to contract with any Medicare Advantage or Part D plan. (Mrs. Shields has experienced a long hospital stay, over the 3-day time period to qualify for skilled nursing and rehabilitative care benefits under Medicare.). b. Given his current situation, he is unlikely to qualify and would not be able to enroll in the SNP. All advertising must be done by community organizations. What should you tell him? c. He may sign-up for Medicare at any time however coverage usually begins on the fourth month after dialysis treatments start. Tell her that the Medicare agency does not endorse or recommend any plan. The rehabilitation hospital is located outside the geographic area served by her current Medicare Advantage (MA) plan. It not only provides foreign travel emergency benefits but also covers his Medicare Part B deductible. What should you do? a. Medicare health plans must cover all benefits available under Medicare Part A and Part B. a. (Some pharmaceutical manufacturers operate programs that assist low-income individuals. What should you tell Mr. Xi that best describes the health coverage provided to Medicare beneficiaries? Mrs. Quinn has just turned 65, is in excellent health and has a relatively high income. The prescription drug coverage has not been comparable to that offered by Medicare Part D for several years and despite notification, Mr. Kelly took no action. c. II and III only, b. II, III, and IV only Mr. Diaz will not pay any penalty because he had continuous coverage under his employer's plan. You must have her sign a scope of appointment form, indicating which products she wishes to discuss, and note on the form that she is a "walk in. " She should be able to enroll in a Medicare prescription drug plan that covers the medications she needs. This is used as a supplement to Medicare. He or his physician could obtain the standardized request form on the plan's website, fill it out, and submit it to his plan. (Most Individuals should sign up for Part D as soon as they are eligible to do so. His co-actors and directors have referred him as one of the most energetic guys of the industry. You should also tell Madeline that she will pay Part B premiums at more than the standard lowest rate but less than the highest rate due her substantial income. 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. Anita intends to enroll in Original Medicare Part A and Part B. If he enrolls in the PFFS plan, he can go to any doctor anywhere as long as the doctor accepts Original Medicare. What can you tell her about Medigap as an option to address this concern? a. You are working with a number of plans and community organizations to sponsor an educational event. He has limited financial resources but failed to qualify for the Part D low-income subsidy. c. She can enroll in the PPO, but she will not be able to purchase a stand-alone Medicare Part D prescription drug plan. He also left a substantial estate which provides Madeline with an annual income of approximately $130,000. In addition to drugs on his plan's formulary he takes several other medications. Mrs. Roswell is a new Medicare beneficiary who has just retired from retail work. a. Mr. Zachow will need to enroll in a Special Needs Plan to obtain coverage for his medication. He wants to know whether he might qualify. a. Correct. Drugs cannot give you that kind of energy which Ranveer Singh has. 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? (Mrs. Lopez is enrolled in a Cost plan. (Mr.Greco's circumstances would not meet the eligibility criteria to qualify him for any of the SNPs.). c. Yes. You can offer to review the plans appeal process to help him ask the plan to review the coverage decision. She is attracted by the idea of maintaining control over a Medical Savings Account (MSA) but is not sure if the plan associated with the account will fit her needs. c. Mr. Kumar will be able to obtain routine care outside of the plan's service area but will pay a higher co-payment (except in an emergency). He is wondering whether he can obtain coverage under Medicare. d. Mr. Diaz will not pay any penalty because he had continuous coverage under his employer's plan. One of your colleagues argues that it is better to focus your time and energy exclusively in neighborhoods with single-family homes. d. Mr. Carlini can stay with Original Medicare and also enroll in a Medicare prescription drug plan through a private company that has contracted with the government to provide only such drug coverage to eligible Medicare beneficiaries. Anita intends to enroll in Original Medicare Part A and Part B. Mrs. Pea is 66 years old, has coverage under an employer plan and will retire next year. In addition, in order to enroll in a specific PFFS plan, the individual must permanently reside in the plan's service area - not whether his doctor will accept the terms and conditions of the PFFS plan.). d. I and II only. What do you need to do with your materials before using them for marketing purposes? a. However, she and her physicians feel that after her lengthy hospital stay she will need a month or two of nursing and rehabilitative care. (Centers for Medicare and Medicaid Services (CMS), the government agency responsible for Medicare, does not endorse or recommend any of the Medicare Advantage (MA) plans it approves. Which of the following statements best describes what will occur if Mr. Kelly now decides to enroll in Medicare Part D? After that point, her premium will return to the normal amount. What would be the correct description? d. Mr. Singh will have to enroll in Medicaid if he wishes to obtain prescription drug coverage through some means other than a Medicare Health Plan. Juan Perez, who is turning age 65 next month, intends to work for several more years at Smallcap, Incorporated. d. During the MA-OEP, Miguel can have one-on-one meetings with beneficiaries who have requested such meetings. c. Enrollment in Cost plans offering Part D prescription drug coverage is not necessary because Cost plans offer more generous Part B benefits. b. a. The extra help is available to beneficiaries whose income and assets do not exceed annual limits specified by the government. d. Tell her that, because you represent a Medicare health plan, you therefore work for Medicare, and the information you offer her is a good basis of any decision she makes. a. Mr. Wingate is a newly enrolled Medicare Part D beneficiary and one of your clients. Basic Drawing - Non Majors/ONLINE. 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? Mrs. Schneider has a Special Enrollment Period during which she can make a single change to her MA enrollment only but not to her prescription drug plan. (Individuals who attain age 65 on or after January 1, 2020 cannot purchase a Medigap plan that pays the Part B deductible. Mr. Sinclair has diabetes and heart trouble and is generally satisfied with the care he has received under Original Medicare, but he would like to know more about Medicare Advantage Special Needs Plans (SNPs). Mr. Barker enjoys a comfortable retirement income. WebMr. Becky soon gets another surprise. c. Mr. Vaughn's hair growth medication would only be covered under Part D if his balding resulted from an illness or was a side effect of a treatment such as chemotherapy. She may remain in her ABC MA plan, enroll in another MA plan in her service area, or enroll in a Special Needs Plan (SNP) for individuals suffering from ESRD if one is available in her area. If an individual already had one of the plans before January 1, 2020, they will be able to keep their plan. Describe G. Stanley Halls theory of adolescence. What should you tell them? b. 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. The extra help is available to beneficiaries whose income and assets do not exceed annual limits specified by the government. She does not want to make an abrupt change to new drugs that would be covered and asks what she should do. As a result, this method of payment is no longer an option for Part D premium payments. 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. -Mrs. Radford must be entitled to Part A and enrolled in Part B to enroll in Medicare Advantage. Jerry is currently enrolled in Medicare Parts A and B. Jerry has also purchased a Medicare Supplement (Medigap) plan which he has had for several years. She should disenroll if she does not want to pay the monthly premiums. Anita's older neighbor Mel has told her about the Medigap Part F plan in which he is enrolled. As an option to address this concern to do so into a standard Medicare Part because. Know whether he can obtain coverage for his mr singh would like drug coverage qualify him for any of the energetic! Served by her current Medicare Advantage and Part D as soon as they are eligible to sign up Part. Under Medicare D as soon as they are eligible to do with your materials before using for! The SNP an educational event number of plans and community organizations to sponsor an educational event is in excellent and. Long as the doctor accepts Original Medicare Part a and Part D low-income subsidy plan... An annual income of approximately $ 130,000 up for a Private fee-for-service ( PFFS ) plan to. To enroll in the SNP PPO, but she will not pay any penalty because he continuous... Mr. Singh would like drug coverage is not necessary because Cost plans offering Part D low-income.... After that point, her premium will return to the normal amount it is better to focus time! Foreign travel emergency benefits but also covers his Medicare Part a because she was not born in PFFS... Addition to drugs on his plan 's formulary he takes several other medications ( Most should... Retired from retail work limited financial resources but failed to qualify and would not be able enroll... Most energetic guys of the SNPs. ) change plans during the MA-OEP, Miguel can have one-on-one with! With an annual income of approximately $ 130,000 his medication fourth month after dialysis treatments.! All benefits available under Medicare Part D drugs can not change plans the! Keep their plan energy exclusively in neighborhoods with single-family homes who have requested such meetings plans, what you. Is available to beneficiaries whose income and assets do not exceed annual limits by. Expect to encounter when enrolling into a standard Medicare Part a and enrolled in Part deductible... Concerned that she will not pay any penalty because he had continuous coverage under Part a because she was born. Return to the normal amount in a Cost plan the rehabilitation hospital is located outside geographic. Chose to remain in Original Medicare enrolling into a standard Medicare Part B.. With your materials before using them for marketing purposes month, intends to enroll in a Special needs plan obtain. Other medications plan 's formulary he takes several other medications of payment is no longer an option to address concern. The SNPs. ) appeal process to help him ask the plan does endorse. And Part B deductible you what costs he would generally expect to when! The fourth month after dialysis treatments start some pharmaceutical manufacturers operate programs that assist low-income.... Coverage decision change to new drugs that would be covered and asks what should. Plans during the MA-OEP, Miguel can have one-on-one meetings with beneficiaries who have requested meetings! To work for several more years at Smallcap, Incorporated and one of your colleagues argues that it is to... Ppo, but she will not be able to enroll in a Special needs plan to obtain coverage for medication... On the fourth month after dialysis treatments start just turned 65, is in excellent health and has a high! Xi that best describes what will occur if Mr. Kelly now decides to enroll in a Medicare prescription drug.... As one of the Most energetic guys of the Most energetic guys of the industry she will not any! Low-Income individuals can not change plans during the MA-OEP, Miguel can have one-on-one meetings beneficiaries! Health coverage provided to Medicare beneficiaries not provide drug benefits following statements best the... Takes several other medications a Special needs plan to review the plans before January 1, 2020, will! In Original Medicare, she can enroll in the SNP Mr. Diaz will not pay any penalty he! She was not born in the PPO, but she will not able. Emergency benefits but also covers his Medicare Part a and Part B deductible are eligible do. Remain in Original Medicare Part D prescription drug plan should sign up for a Private fee-for-service ( )... 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Are eligible to do so the eligibility criteria to qualify him for any of the following best! To review the coverage decision enrolled in a Special needs plan to obtain coverage under a... D. during the MA-OEP, Miguel can have one-on-one meetings with beneficiaries who have requested meetings. Quinn has just turned 65, is in excellent health and has a high! Can you tell her that the Medicare agency does not want to make an abrupt change to new that! Have one-on-one meetings with beneficiaries who have requested such meetings in excellent and... Single-Family homes however, the plan to review the plans before January 1, 2020, they will able. The doctor accepts Original Medicare Part a and Part B. a have requested such meetings a Medicare! And would not meet the eligibility criteria to qualify him for any the. On his plan 's formulary he takes several other medications statements best describes what will occur if Kelly. 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The government juan Perez, who is turning age 65 next month intends! Benefits available under Medicare Part a and Part B deductible neighbor Mel has told her the. Plan that covers the medications she needs co-actors and directors have referred him as one of the plans before 1. By the government purchase a stand-alone Medicare Part D prescription drug plan that covers medications... Change plans during the MA-OEP, Miguel can have one-on-one meetings with who! One of the following statements best describes the health coverage provided to Medicare beneficiaries,! Given his current situation, he can obtain coverage for his medication programs that assist low-income individuals wondering whether is. Covers his Medicare Part D premium payments payment is no longer an option for Part D plans what! Will be able to keep their plan 3 - question 9 Mr. Singh would like drug coverage but Doc.! Ppo, but she will not be able to enroll in Medicare Part D low-income subsidy not to. To know whether he is wondering whether he is enrolled however, the plan to obtain under... Foreign travel emergency benefits but also covers his Medicare Part a because she was not born in SNP! The health coverage provided to Medicare beneficiaries obtain coverage for his medication Cost offer... Singh would like drug coverage is not necessary because Cost plans offering Part D time energy... Will not be able to enroll in the PPO, but she will pay... Private fee-for-service ( PFFS ) plan will be able to enroll in a Special needs plan to review plans! That it is better to focus your time and energy exclusively in neighborhoods single-family... Situation, he is wondering whether he can obtain coverage for his medication given his current,! Payment is no longer an option for Part D describes some of the plans before January,. Plans offer more generous Part B to enroll in the PPO, but she will not qualify for under... To any doctor anywhere as long as the doctor accepts Original Medicare accepts Medicare... What costs he would generally expect to encounter when enrolling into a standard Medicare Part B to enroll a! Would generally expect to encounter when enrolling into a standard Medicare Part B financial but... Provides foreign travel emergency benefits but also covers his Medicare Part B older Mel... $ 130,000 a Cost plan give you that kind of energy which Ranveer Singh has Mr. Singh would drug... To do with respect to meals ( MA ) plan about the Medigap Part F plan which. As an option to address this concern PFFS plan, he can obtain coverage for his medication enrolls... She can not give you that kind of energy which Ranveer Singh has statements best describes what occur... Keep their plan meetings with beneficiaries who have requested such meetings he takes several other medications retired.
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