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
... [Show More] this program. What
should you tell him about the types of health plans that are available through the
Medicare Advantage program? - ✔✔They are Medicare health plans such as HMOs,
PPOs, PFFS, SNPs, and MSAs
(W) Mr. Wells is trying to understand the difference between Original Medicare and
Medicare Advantage. What would be a correct description? - ✔✔Medicare Advantage is
a way of covering all of the Original Medicare benefits through private health insurance
companies.
During a sales presentation in Ms. Sullivan's home, she tells you that she has heard
about a type of Medicare health plan known as Private Fee-for-Service (PFFS). She
wants to know if this would be available to her. What should you tell her about PFFS
plans? - ✔✔A PFFS plan is one of various types of Medicare Advantage plans offered
by private entities and she may enroll in one if it is available in her area.
(W) Mrs. Radford asks whether there are any special eligibility requirements for
Medicare Advantage. What should you tell her? - ✔✔Mrs. Radford must be entitled to
Part A and enrolled in Part B to enroll in Medicare Advantage
Mr. Castillo, a naturalized citizen, previously enrolled in Medicare Part B but has
recently stopped paying his Part B premium. He would like to enroll in a Medicare
Advantage (MA) plan and is still covered by Part A. What should you tell him? - ✔✔He
is not eligible to enroll in a Medicare Advantage plan until he re-enrolls in Medicare Part
B
(W) Mrs. Billings enrolled in the ABC Medicare Advantage (MA) plan several years ago.
Her doctor recently confirmed a diagnosis of end-stage renal disease (ESRD). What
options does Mrs. Billings have in regard to her MA plan during the next open
enrollment season? - ✔✔She may remain in her ABC MA plan or enroll in a Special
Needs Plan (SNP) for individuals suffering from ESRD if one is available in her area
Mr. Kumar is considering a Medicare Advantage HMO and has questions about his
ability to access providers. What should you tell him? - ✔✔In most Medicare Advantage
HMOs, Mr. Kumar must obtain his services only from providers who have a contractual
relationship with the plan (except in an emergency).
Mrs. Ramos is considering a Medicare Advantage PPO and has questions about which
providers she can go to for her health care. What should you tell her? - ✔✔Mrs. Ramos
can obtain care from any provider who participates in Original Medicare, but generally
will be charged a lower co-payment if she goes to one of the plan's preferred providers. [Show Less]