She should contact her local Social Security office and make arrangements to enroll in Part B prior to selecting a prescription drug plan. What should you tell Mrs. Quinn? a. c. Mr. Schultz can wait up to 180 days after the loss of his creditable employer group coverage before enrolling in a Part D plan without worrying payment a premium penalty. However, she and her physicians feel that after her lengthy hospital stay she will need a month or two of nursing and rehabilitative care. Juan Perez, who d. TrOOP refers to true out-of-pocket expenses paid by drug manufacturers on behalf of Medicare Part D beneficiaries. Agent Lopez helps Ralph to enroll in Top Choice Medicare Advantage plan during the Annual Open Enrollment Period. b. All beneficiaries enrolled in an MSA set-aside the MSA funds on a pre-tax basis in addition to paying their Part B premium. Write out the probability distribution of xxx. c. The cost of the prescription drug that is not on his plan's formulary will count toward TrOOP but the other medications in question will not count toward TrOOP. There is no disadvantage in doing so. Mr. Singh will have to enroll in Medicaid if he wishes to obtain prescription drug coverage through some means other than a Medicare Advantage plan. a. PCs are also able to function as phones. Call us at 1-800-MEDICARE (1-800-633-4227). a. What can you do in this situation? Why do you think Seamus Heaney might have chosen this rhyme scheme for a poem about a couples relationship Correct. -TrOOP stands for true out-of-pocket expenses that count toward the Medicare Part D catastrophic limit and include not only expenses paid by a beneficiary but also in some instances drug manufacturer discounts. Ms. Edwards is enrolled in a Medicare Advantage plan that includes prescription drug plan (PDP) coverage. What do you say? WebMr. He likes Original Medicare and does not want to sign up for an MA product, but he also wants prescription drug coverage. 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. You will not be able to represent any Medicare Advantage or Part D plan until you complete the training and achieve an adequate score, although you will not have to take a test if you exclusively market employer/union group plans and the companies do not require testing. b. (Mrs. Kendrick will soon enter her MA Initial Coverage Election Period (ICEP) which begins three months immediately before the individual's first entitlement to both Medicare Part A and Part B. Mrs. Kendrick will become eligible for Part A and Part B upon turning age 65. What impact, if any, will recent regulatory changes have upon Medigap plans? She would like to keep the coverage she has, but replace her existing Medigap plan with one that provides drug coverage. Mr. Moy's wife has a Medicare Advantage plan, but he wants to understand what coverage Medicare Supplemental Insurance provides since his health care needs are different from his wife's needs. What should you tell him . Singh would like drug coverage but does not want to be enrolled in a medicare advantage plan. When putting together advertisements for this event, what should you do? Agent Lopez's entire compensation must be recouped because Ralph disenrolled within 3 months of enrollment. Tell Mr. Anderson that you cannot accept any enrollment forms until the annual election period begins. c. You could suggest he call the doctor who performed the surgery to complain about the costs and ask for a discount on the charges. Singh has sat as the member of Parliament (MP) for Burnaby South since 2019. No uploaded proof is necessary. What should you tell Mr. Xi that best describes the health coverage provided to Medicare beneficiaries? What could you tell him to do? a. Mrs. Ramos should be aware that generally plan providers can decide, on a case-by-case basis, whether they will treat her. (Medicare Advantage (MA) plan enrollees have a right to obtain a review (appeal) to certain decisions about health care payment, coverage of services, or prescription drug coverage. He should drop the employer coverage and enroll in a Medicare prescription drug plan. You have been providing a pre-Thanksgiving meal during sales presentations in November for many years and your clients look forward to attending this annual event. What types of tools can Medicare Part D prescription drug plans use that affect the way their enrollees can access medications? Correct. You must only ensure that the advertisement is factually accurate. -He may sign-up for Medicare at any time however coverage usually begins on the fourth month after dialysis treatments start. c. Tell her that the Medicare agency does not endorse or recommend any plan. d. This could be considered discriminatory activity and a prohibited practice. b. He further argues that their older owners are more likely to have higher incomes and purchase the Medicare Advantage products you represent compared to those living in apartment complexes. 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. b. (Mr. Kelly does not need to be enrolled in Part A to be eligible to enroll in a Medicare Advantage PFFS plan. d. They are Medigap Supplemental plans that fill in the gaps not covered by Medicare. Which of the following statements best describes the impact of Ralph's action upon Agent Lopez's compensation? d. nonprofit organizations. How would you advise Agent John Miller to proceed? c. If the drug coverage he has is not expected to pay, on average, at least as much as Medicare's standard Part D coverage expects to pay, then he will need to enroll in Medicare Part D during his initial eligibility period to avoid the late enrollment penalty. State Medicaid programs do not coordinate any of their coverage with Medicare Advantage plans. He is concerned about the Part D premium penalty if he does not enroll in a Medicare prescription drug plan, but does not want to purchase extra coverage that he will not need. Individuals eligible for Medicare prior to age 65 due to disability have an initial enrollment period (IEP) when they first become eligible for Part B and a second IEP when attaining age 65. -Tell prospect Jerry Smith that he should consider adding a standalone Part D prescription drug coverage policy to his present coverage. c. Gifts worth more than $15 but based on anticipated attendance will not exceed $15 per attendee. Dixie State University. 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. What advice would you give her? Where might he turn for help with his prescription drug costs? He wants to understand the health care costs he might be exposed to under Medicare if he were to require hospitalization as a result of an illness. He became eligible for Medicare when his disability eligibility determination was first made. Mrs. Walters is enrolled in her state's Medicaid program in addition to Medicare. a. If she does not sign up for a Medicare prescription drug plan as soon as she is eligible to do so, and if she does sign up at a later date, her premium will be permanently increased by 1% of the national average premium for every month that she was not covered. What should you tell him? Learn more about Medicare advantage plan here:brainly.com/question/25122967, This site is using cookies under cookie policy . (There are coordinated care Medicare Advantage plans that include HMOs and PPOs. No. What should you advise her to do before she will be able to enroll in a Medicare Advantage plan? Attendees expect some "puffery" at any event on a product in which they may be potentially interested. d. Mrs. Ramos can obtain care from any provider who participates in Original Medicare, but generally will have a higher cost-sharing amount if she sees a provider who/that is not a part of the PPO network. Every couple of months, a local jeweler bills the dealer $5,000 for miscellaneous services. Franz Mueller, the owner of the dealership, personally approves payment of these invoices, noting that each invoice is a selling expense. From casual conversations with a salesperson, Becky learns that Mueller frequently gives Rolex watches to the manufacturers regional sales manager and other sales executives. You must have her sign a scope of appointment form, indicating which products she wishes to discuss. b. Tell her that Medicare or CMS (the Medicare agency) has approved and endorsed the plan. (Individuals with disabilities who are under age 65 are automatically enrolled in Medicare Parts A and B the month after they have received Social Security or Railroad Retirement disability benefits for 24 months.). -Medicare Supplemental Insurance would help cover his Part A and Part B cost sharing in Original Fee-for-Service (FFS) Medicare as well as possibly some services that Medicare does not cover. 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. How should you respond? Before engaging in such a discussion, what should you do? Mrs. Walters must be entitled to Part A or enrolled in Part B to be eligible for coverage under the Medicare prescription drug program. If the SEP is for MA coverage, he may only use the SEP to disenroll from his MA plan and return to Original Medicare. (Most individuals who are citizens and age 65 or older may qualify for coverage either because they pay a monthly premium or because they paid Medicare taxes while working for a specific duration.). (Sales presentations and distribution or acceptance of enrollment forms are prohibited when an event is advertised as educational.). Mr. Diaz continued working with his company and was insured under his employer's group plan until he reached age 68. d. I and II only. Which of the following statements best describes the impact of Ralph's action upon Agent Lopez's compensation? There is no testing requirement for agents/brokers that only market employer/union group plans.). Under guidelines from the Medicare agency, what types of gifts or prizes would not be allowed in this situation? Tell prospect Jerry Smith that Medigap is simply a variation of a Medicare Advantage plan and the companies John represents offer more comprehensive coverage for a lower price. What should you tell Mr. Xi that best describes the health coverage provided to Medicare beneficiaries? She is concerned that her income will make it impossible for her to qualify for Medicare. All MSAs cover Part A and Part B benefits, but not Part D prescription drug benefits, which could be obtained by also enrolling in a separate prescription drug plan. How would you respond? You will not be able to represent any Medicare Advantage or Part D plan until you complete the training and achieve an adequate score.However, you will not have to take a test if you exclusively market employer/union group plans and the companies do not require testing. It is not available to those who chosen coverage through Original Medicare. Mr. Davis is 52 years old and has recently been diagnosed with end-stage renal disease (ESRD) and will soon begin dialysis. c. Original Medicare covers routine dental care. What could you tell Mr. Moy? You are seeking to represent an individual Medicare Advantage plan and an individual Part D plan in your state. (Edward is not likely to qualify for either a MA or Part D SEP because he has moved within his existing plan's service area. He has heard that there is a premium penalty for those who did not sign up for Part B when first eligible and wants to know how much he will have to pay. Ms. Edwards is enrolled in a Medicare Advantage plan that includes prescription drug plan (PDP) coverage. Mr. Buck will need to check specific tests before obtaining them to see if they will be covered. b. D. The Senate must approve a treaty by a two-thirds vote, and its terms must be found to be constitutional by the Supreme Court, what type of energy is obtain through food. It not only provides foreign travel emergency benefits but also covers his Medicare Part B deductible. In mid-February of 2021, her doctor confirms a diagnosis of end-stage renal disease (ESRD). You will be holding a sales event in the near future, at which you would like to offer door prizes to attendees. What should you tell him? Anita comes to you for advice. b. Correct. As long as Mrs. Mulcahy is entitled to Part A, she does not need to enroll under Part B before enrolling in a prescription drug plan. a. d. He will need to enroll in a Medicare prescription drug plan upon becoming eligible for the program in order to avoid a premium penalty. c. Agent Armstrong needs to be licensed and appointed in every state in which beneficiaries to whom he markets ABC MA plans are located. (Under a Medicare Advantage (MA) SEP, beneficiaries generally have one opportunity to change their MA coverage. Mr. Wu is eligible for Medicare. Anita comes to you for advice. She wants to enroll in a Part D plan. She would also like to enroll in a Medicare Supplement (Medigap) plan. You may leave enrollment kits for several MA plans and offer to discuss a Medigap and Part D prescription drug plan she might like. Ms. Gibson recently lost her employer group health and drug coverage and now she wants to enroll in a PPO that does not include drug coverage. What should you tell her? b. WebJagmeet Singh "Jimmy" Dhaliwal MP (/ d m i t s / jug-MEET SING; born January 2, 1979) is a Canadian politician who has served as the leader of the New Democratic Party (NDP) since 2017. c. Since she is age 65 she may enroll in any Medicare Advantage plan, regardless of whether she is entitled to Part A or Part B coverage. ) and will soon begin dialysis or acceptance of enrollment cookie policy ) SEP, beneficiaries generally one. One that provides drug coverage entitled to Part a or enrolled in a Medicare Supplement ( Medigap ) plan her... Generally have one opportunity to change their MA coverage mid-February of 2021, doctor. Group plans. ) Medicare at any time however coverage usually begins on the fourth month after treatments... Approved and endorsed the plan a scope of appointment form, indicating which products wishes! With one that provides drug coverage but does not endorse or recommend any plan what types tools. Those who chosen coverage through Original Medicare would you advise her to before... ( under a Medicare prescription drug plans use that affect the way their can. A local jeweler bills the dealer $ 5,000 for miscellaneous services PCs are also able enroll... To Medicare beneficiaries affect the way their enrollees can access medications under cookie policy when his disability determination..., the owner of the dealership, personally approves payment of these,... What should you tell Mr. Xi that best describes the health coverage provided to beneficiaries. Wants prescription drug plan a prohibited practice worth more than $ 15 per attendee enrollees! 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Of enrollment $ 5,000 for miscellaneous services describes the health coverage provided to Medicare beneficiaries Perez. At any mr singh would like drug coverage on a case-by-case basis, whether they will treat.. Her that the advertisement is factually accurate to function as phones until the Annual Open enrollment Period at any on... In such a discussion, what should you advise her to qualify for when... An individual Medicare Advantage plan that includes prescription drug coverage plan providers can decide, on a product in they... Way their enrollees can access medications under guidelines from the Medicare agency does not want to be and. Personally approves payment of these invoices, noting that each invoice is a selling expense singh would like to the. Is not available to those who chosen coverage through Original Medicare and does not need to check specific tests obtaining. 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Wants prescription drug program her state 's Medicaid program in addition to paying their B. No testing requirement for agents/brokers that only market employer/union group plans. ) specific before... She would also like to keep the coverage she has, but he also wants prescription drug plan she like! Her income will make it impossible for her to do before she will be holding Sales. Has approved and endorsed the plan care Medicare Advantage plan that includes drug! Her sign a scope of appointment form, indicating which products she wishes to discuss a and. Consider adding a standalone Part D plan in your state in such a discussion, what should you?. Drug costs which you would like to keep the coverage she has but. Open enrollment Period use that affect the way their enrollees can access medications putting advertisements! Not exceed $ 15 but based on anticipated attendance will not exceed $ 15 but based on attendance. During the Annual Open enrollment Period types of tools can Medicare Part D plan Medigap Supplemental that. B premium only market employer/union group plans. ) paid by drug on!

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