1. Mrs. Imelda Diaz is a Medicare beneficiary enrolled in a MA-PD plan you
represent. Her neighbor recently suffered from a painful case of shingles. Mrs. Diaz
hopes to avoid such an illness through vaccination. She a
...
1. Mrs. Imelda Diaz is a Medicare beneficiary enrolled in a MA-PD plan you
represent. Her neighbor recently suffered from a painful case of shingles. Mrs. Diaz
hopes to avoid such an illness through vaccination. She asks you whether the cost of
shingles vaccination will be covered under the plan you represent. What should you
say?
Answer: Yes, there is no cost sharing for the shingles vaccine even in the deductible
phase of her prescription drug plan because it is anadult vaccine recommended by
the Advisory Committee on Immunization Practices(AICP).
2. Mrs. Fields wants to know whether applying for the Part D low-income subsidy
will be worth the time to fill out the paperwork. What could you tell her?
Answer: The Part D low-income subsidy could substantially lower her overall
costs. She can apply by contacting her state Medicaid office or calling the Social
SecurityAdministration.
3. 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.Sincethe
employer plan does not cover prescription drugs, she wants to enroll in a Medicare
prescription drug plan.Will she be able to?
Answer: Yes. Mrs.Walters mustbe entitled to Part A and/or enrolled in Part B to be
eligible for coverage under the Medicare prescription drug program.
4. 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: If the Medicare Advantage plan is a Private Fee-for-Service (PFFS) plan
that does not offer drug coverageor a Medical Savings Account plan, Mrs. Berkowitz
can do this.
5. Mr.Torres has a smallsavings account. He would like to pay for his monthlyPart D
premiums with an automatic monthly withdrawal from his savings account until it is
exhausted, and then have his premiums withheld from his Social Security check.
What should you tell him?
Answer: In general, he must select a single Part D premium payment mechanism
that will be used throughout the year
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