When you market Medicare Advantage and Part D plans, what may you offer as a gift to induce
enrollment in a plan?
You may provide gifts or prizes to all potential enrollees during an event that does not exceed
$15 i
...
When you market Medicare Advantage and Part D plans, what may you offer as a gift to induce
enrollment in a plan?
You may provide gifts or prizes to all potential enrollees during an event that does not exceed
$15 in retail value.
By contacting plans available in your area, you have learned that the plan you represent has a
significantly lower monthly premium than the others. Furthermore, you see that the plan you
represent has a unique benefits package. What should you do to make sure your clients know
about these pieces of information?
You may make comparisons between plans if you can support them by studies or statistical data
and such comparisons are factually based.
Mr. Cole has been a Medicaid beneficiary for some time, and recently qualified for Medicare as
well. He is concerned about changes in his cost-sharing. What should you tell him?
He should know that Medicaid will pay cost sharing only for services provided by Medicaid
participating providers.
If a beneficiary is enrolled in a stand-alone prescription drug plan and wants to keep that plan,
what type of Medicare health plan could the individual also enroll in, without being
automatically disenrolled from the stand-alone prescription drug plan?
The beneficiary could enroll in a private fee-for-service (PFFS) plan that does not include
prescription drug coverage; a cost plan; or a Medicare Medical Savings Account (MSA) plan.
Which of the following statements about Medicare Part D are correct?
I. Part D plans must enroll any eligible beneficiary who applies regardless of health status except
in limited circumstances.
II. Private fee-for-service (PFFS) plans are not required to use a pharmacy network but may
choose to have one.
III. Beneficiaries enrolled in a MA-Medical Savings Account (MSA) plan may only obtain Part
D benefits through a standalone PDP.
IV. Beneficiaries enrolled in a MA-PPO may obtain Part D benefits through a standalone PDP or
through their plan.
I, II, and III only
Mr. Olsen is concerned that a Medicare Advantage plan will not cover the same range of services
that would be covered under Original fee-for-service Medicare. What should you tell him?
Though their cost-sharing may differ from Original Medicare’s, Medicare Advantage plans are
required to cover all services covered by original Medicare.
Mrs. Sanchez lives in a state located near Canada. She has recently become eligible for Medicare
and is considering enrollment in Part D prescription drug coverage. One of her friends has told
her that she needs to be aware of something called TrOOP. What should you tell her when she
asks you about TrOOP?
TrOOP are out-of-pocket costs that count toward the annual out-of-pocket threshold to move into
catastrophic coverage and generally include the annual deductible(s) and costs for drugs on the
plan's formulary purchased at a plan's participating pharmacy. In some instances, amounts not
directly paid by the enrollee (like manufacturer discounts) count toward TrOOP
[Show More]
, 6e by Russell Hoye, Katie Misener, Michael Naraine, Catherine Ordway.png)
