Agent Harriet Walker has recently begun marketing Medicare Advantage and related products aimed at
meeting the needs of senior citizens. Client Mildred
... [Show More] Jones has expressed interest in a Medicare
Advantage plan. It is now the beginning of September. If you were in Agent Walker's position, what
would you do? Correct Answer: Inquire whether the client qualifies for a special enrollment period, and
if not, solicit an enrollment application once the annual open enrollment election period begins on
October 15th.
Mrs. Fields wants to know whether applying for the Part D low income subsidy will be worth the time to
fill out the paperwork. What could you tell her? Correct Answer: The Part D low income subsidy could
substantially lower her overall costs. She can apply by contacting her state Medicaid office, or calling the
Social Security Administration
Mr. Wendt suffers from diabetes which has gotten progressively worse during the last year. He is
currently enrolled in Original Medicare (Parts A and B) and a Part D prescription drug plan and did not
enroll in a Medicare Advantage (MA) plan during the last annual open enrollment period (AEP) which has
just closed. Mr. Wendt has heard certain MA plans might provide him with more specialized coverage for
his diabetes and wants to know if he must wait until the next annual open enrollment period (AEP)
before enrolling in such a plan. What should you tell him? Correct Answer: If there is a special needs
plan (SNP) in Mr. Wendt's area that specializes in caring for individuals with diabetes, he may enroll in
the SNP at any time under a special election period (SEP)
Ms. Moore plans to retire when she turns 65 in a few months. She is in excellent health and will have
considerable income when she retires. She is concerned that her income will make it impossible for her
to qualify for Medicare. What could you tell her to address her concern? Correct Answer: Medicare is a
program for people age 65 or older and those under age 65 with certain disabilities, end stage renal
disease or Lou Gehrig's disease, so she will be eligible for Medicare
Mr. Schmidt would like to plan for retirement and has asked you what is covered under Original Fee-forService (FFS) Medicare? What could you tell him? Correct Answer: Part A, which covers hospital, skilled
nursing facility, hospice and home health services and Part B, which covers professional services such as
those provided by a doctor are covered under Original Medicare.
Mr. Hernandez is concerned that if he signs up for a Medicare Advantage plan, the health plan may, at
some time in the future, reduce his benefits below what is available in Original Medicare. What should
you tell him about his concern? Correct Answer: Medicare health plans must cover all benefits available
under Medicare Part A and Part B. Many also cover Part D prescription drugs.
Mrs. Raskin is a widow who will attain aged 65 and enroll in Medicare in just a few weeks. She concerned
about having prescription drug coverage. Which of the following statements provides the best advice?
Correct Answer: Prescription drug coverage can be obtained by enrolling in a Medicare Advantage plan
that includes Part D coverage.
Mrs. Willard wants to know generally how the benefits under Original Medicare might compare to the
benefit package of a Medicare Health Plan before she starts looking at specific plans. What could you tell
her? Correct Answer: Medicare Health Plans may offer extra benefits that Original Medicare does not
offer such as vision, hearing, and dental services and must include a maximum out-of-pocket limit on
Part A and Part B services. [Show Less]