Mrs. Davenport enrolled in the ABC Medicare Advantage (MA) plan several years ago. In mid-February of 2021, her doctor confirms a diagnosis of end-stage renal disease (ESRD). What options will Mrs. Davenport have regardi
...
Mrs. Davenport enrolled in the ABC Medicare Advantage (MA) plan several years ago. In mid-February of 2021, her doctor confirms a diagnosis of end-stage renal disease (ESRD). What options will Mrs. Davenport have regarding her MA plan during the next open enrollment season?
Choose one a. She may remain in her ABC MA
answer. plan, enroll in another MA plan in her Correct: Mrs. Davenport has three clear service area, or enroll in a Special choices: (1) remain in the ABC MA plan, (2)
Needs Plan (SNP) for individuals enroll in another MA plan in her service area, or suffering from ESRD if one is available (3) enroll in a Special Needs Plan (SPN) for
in her area. persons suffering from ESRD if one is available in her area.
b. She must immediately drop her ABC MA plan and enroll in Original Medicare.
c. She must immediately drop her ABC MA plan and enroll in a Special Needs Plan (SNP) for individuals suffering from ESRD if one is available in her area.
d. She must remain enrolled in her ABC MA plan unless the plan terminates.
Source: Module 2, Slide – Individuals with ESRD Beginning in 2021, Slide - Medicare Advantage Eligibility: SNPs
Correct
Marks for this submission: 1/1.
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Marks: 1
Mrs. Kelly, age 65, is entitled to Part A but has not yet enrolled in Part B. She is considering enrollment in a Medicare Advantage plan (Part C). What should you advise her to do before she will be able to enroll in a Medicare Advantage plan?
Choose one a. In order to join a Medicare Advantage answer. plan, she must be enrolled in Parts A, B, and
D.
b. 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.
c. In order to join a Medicare Advantage plan,
she also must enroll in Part B. Correct: Eligibility to enroll in a Medicare
Advantage plan requires entitlement to
benefits under Part A and enrollment in Part B.
d. To enroll in a Medicare Advantage plan, she need only be entitled to Part A, so she does not need to take any further steps.
Source: Module 2, Slide – Medicare Advantage Eligibility Correct
Marks for this submission: 1/1.
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Mr. Barker enjoys a comfortable retirement income. He recently had surgery and expected that he would have certain services and items covered by the plan with minimal out-of-pocket costs because his MA-PD coverage has been very good. However, when he received the bill, he was surprised to see large charges in excess of his maximum out-of-pocket limit that included a number of services and items he thought would be fully covered. He called you to ask what he could do? What could you tell him?
Choose one a. You can offer to review the
answer. plans appeal process to help Correct: Medicare Advantage (MA) plan enrollees have
him ask the plan to review a right to obtain a review (appeal) to certain decisions the coverage decision. about health care payment, coverage of services, or
prescription drug coverage. Medicare health plans must
provide enrollees with a written description of the appeals process.
b. You could suggest he call the doctor who performed the surgery to complain about the costs and ask for a discount on the charges.
c. You could reassure him that such charges are typical, but if he needs assistance in paying, he should apply to the state for Medicaid assistance.
d. You could remind him that he cannot do anything until
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