You are meeting with Ms. Berlin and she has completed an enrollment
form for a MA-PD plan you represent. You notice that her handwriting
is illegible and as a result, the spelling of her street looks incorrect. She
asks you to fill in the corrected street name. What should you do? –
ANSWER- You may correct this information as long as you add your
initials and date next to the correction.
Mr. Roberts is enrolled in an MA plan. He recently suffered
complications following hip replacement surgery. As a result, he has
spent the last three months in Resthaven, a skilled nursing facility. Mr.
Roberts is about to be discharged. What advice would you give him
regarding his health coverage options? – ANSWER- His open enrollment
period as an institutionalized individual will continue for two months
after the month he moves out of the facility.
Mr. Ziegler is turning 65 next month and has asked you what he can do,
and when he must do it, with respect to enrolling in Part D. What could
you tell him? – ANSWER- He is currently in the Part D Initial
Enrollment Period (IEP) and, during this time, he may make one Part D
enrollment choice, including enrollment in a stand-alone Part D plan or
an MA-PD plan.
Mr. Block is currently enrolled in a Medicare Advantage plan that
includes drug coverage. He found a stand-alone Medicare prescription
drug plan in his area that offers better coverage than that available
through his MA-PD plan and in addition, has a low premium. It won’t
cost him much more and, because he has the means to do so, he wishes
to enroll in the stand-alone prescription drug plan in addition to his MAPD plan. What should you tell him? – ANSWER- If Mr. Block enrolls in
the stand-alone Medicare prescription drug plan, he will be disenrolled
from the Medicare Advantage plan.
Mrs. Margolis contacts you in August because she will become eligible
for Medicare for the first time in November. She would like to meet and
discuss plan choices with you. What advice should you give her? –
ANSWER- Tell her to wait until October to discuss plan choices with
you so that you can share plan benefits for the current year as well as
any changes for the following year that may impact her choice.
Mr. and Mrs. Nunez attended one of your sales presentations. They’ve
asked you to come to their home to clear up a few questions. During the
presentation, Mrs. Nunez feels tired and tells you that her husband can
finish things up. She goes to bed. At the end of your discussion, Mr.
Nunez says that he wants to enroll both himself and his wife. What
should you do? – ANSWER- As long as she can do so, only Mrs. Nunez
can sign her enrollment form. Mrs. Nunez will have to wake up to sign
her form or do so at another time.
When Myra first became eligible for Medicare, she enrolled in Original
Medicare (Parts A and B). She is now 67 and will turn 68 on July 1. She
would now like to enroll in a Medicare Advantage (MA) plan and
approaches you about her options. What advice would you give her? –
ANSWER- She should remain in Original Medicare until the annual
election period running from October 15 to December 7, during which
she can select an MA plan.
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?
- 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)
A client wants to give you an enrollment application on October 1
before the beginning of the Annual Election Period because he is leaving
on vacation for two weeks and does not want to forget about turning it
in. What should you tell him? – ANSWER- You must tell him you are
not permitted to take the form. If he sends the form directly to the plan,
the plan will process the enrollment on the day the Annual Election
Period begins
Mrs. Walters is entitled to Part A and has medical coverage without drug
coverage through an employer retiree plan. She is not enrolled in Part B.
Since the employer plan does not cover prescription drugs, she wants to
enroll in a Medicare prescription drug plan. Will she be able to? –
ANSWER- d. Yes. Mrs. Walters must be entitled to Part A or enrolled in
Part B to be eligible for coverage under the Medicare prescription drug
program. Correct
Mr. Sanchez is entitled to Part A, but has not enrolled in Part B because
he has coverage through an employer plan. If he wants to enroll in a
Medicare Advantage plan, what will he have to do? – ANSWER- b. He
will have to enroll in Part B. Correct
Mr. Kelly wants to know whether he is eligible to sign up for a Private
fee-for-service (PFFS) plan. What questions would you need to ask to
determine his eligibility? – ANSWER- c. You would need to ask Mr.
Kelly if he is enrolled in Part A and Part B and if he lives in the PFFS
plan’s service area. Correct
Mr. Gonzalez is entitled to Part A, but has not yet enrolled in Part B. If
he wants to enroll in a Private Fee-for-Service (PFFS) plan, what will he
have to do? – ANSWER- c. He will have to enroll in Part B prior to
enrolling in the PFFS plan. Correct
Mrs. Berkowitz wants to enroll in a Medicare Advantage plan that does
not include drug coverage and also enroll in a stand-alone Medicare
prescription drug plan. Under what circumstances can she do this? –
ANSWER- b. If the Medicare Advantage plan is a Private Fee-forService (PFFS) plan that does not offer drug coverage or a Medical
Savings Account, Mrs. Berkowitz can do this. Correct
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