Mr. Bauer is 49 years old, but eighteen months ago he was declared disabled by the Social
Security Administration and has been receiving disability payments. He is wondering whether
he can obtain coverage under Medicar
...
Mr. Bauer is 49 years old, but eighteen months ago he was declared disabled by the Social
Security Administration and has been receiving disability payments. He is wondering whether
he can obtain coverage under Medicare. What should you tell him?
After receiving such disability payments for 24 months, he will be automatically enrolled in
Medicare, regardless of age
Mr. Davis is 49 years old and has been receiving disability benefits from the Social Security
Administration for 12 months. Can you sell him a Medicare Advantage or Part D Prescription
Drug policy?
No, he cannot purchase a Medicare Advantage or Part D policy because he has not received
Social Security or Railroad Retirement disability benefits for 24 months.
Ms. Henderson believes that she will qualify for Medicare coverage when she turns 65, without
paying any premiums, because she has been working for 40 years and paying Medicare taxes.
What should you tell her?
In order to obtain Part B coverage, she must pay a standard monthly premium, though it is
higher for individuals with higher incomes
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?
Prescription drug coverage can be obtained by enrolling in a Medicare Advantage plan that
includes Part D coverage
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?
Medicare health plans must cover all benefits available under Medicare Part A and Part B. Many
also cover Part D prescription drugs
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?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 MedicareMrs. 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?
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
Mr. Meoni’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 could you tell Mr.Meoni?
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. Chen will be 65 soon, has been a citizen for twelve years, has been employed full time,
and paid taxes during that entire period. She is concerned that she will not qualify for coverage
under part A because she was not born in the United States. What should you tell her?
Most individuals who are citizens and over age 65 are covered under Part A by virtue of having
paid Medicare taxes while working, though some may be covered as a result of paying monthly
premiums
Mr. Schmidt would like to plan for retirement and has asked you what is covered under Original
Fee-for-Service (FFS) Medicare? What could you tell him?
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. 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 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
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