Module 1- Final Review
Mr. Moy'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. Moy? a. Medicare Supplemental Insurance would cover all of his IRS approved health care expenditures not covered under Original Fee-for-Service (FFS) Medicare. b. Medicare Supplemental Insurance would cover his dental, vision and hearing services only. c. 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. d. Medicare Supplemental Insurance would cover his long-term care services.
C. . 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. Correct: Medicare Supplement Insurance (Medigap) helps to cover Part A and Part B cost-sharing in Original Medicare as well as possibly offering some services such as medical care when a beneficiary travels outside the United States.
Mr. Xi will soon turn age 65 and has come to you for advice as to what services are provided under Original Medicare. What should you tell Mr. Xi that best describes the health coverage provided to Medicare beneficiaries? a. Beneficiaries under Original Medicare have no cost-sharing for most preventive services which include immunizations such as annual flu shots. b. Medicare Part A generally covers medically necessary physician and other health care professional services. c. Benefits covered by Medicare Parts A and B include routine dental care, hearing aids, and routine eye care. d. Medicare Part B generally provides prescription drug coverage.
a. Beneficiaries under Original Medicare have no cost-sharing for most preventive services which include immunizations such as annual flu shots. Correct: Beneficiaries enrolled in both Original Medicare (Parts A and B) have no cost-sharing for most preventive services. These services include immunizations such as annual flu shots.
Mrs. Turner is comparing her employer's retiree insurance to Original Medicare and would like to know which of the following services Original Medicare will cover if the appropriate criteria are met? What could you tell her? a. Original Medicare covers ambulance services. b. Original Medicare covers cosmetic surgery. c. Original Medicare covers routine dental care. d. Original Medicare covers routine long-term custodial care.
a. Original Medicare covers ambulance services. Correct: Original Medicare does cover ambulance services.
Juan Perez, who is turning age 65 next month, intends to work for several more years at Smallcap, Incorporated. Smallcap has a workforce of 15 employees and offers employer-sponsored healthcare coverage. Juan is a naturalized citizen and has contributed to the Medicare system for over 20 years. Juan asks you if he will be entitled to Medicare and if he enrolls how that will impact his employer-sponsored healthcare coverage. How would you respond? a. Juan is likely to be ineligible for Medicare since he was born outside the United States and has only contributed to the Medicare system for 20 years. b. Juan is likely to be eligible for Medicare once he turns age 65 and if he enrolls Medicare would become the primary payor of his healthcare claims and Smallcap does not have to continue to offer him coverage comparable to those under age 65 under its employer-sponsored group health plan. c. Juan is likely to be eligible for Medicare once he turns age 65 and if he enrolls his employer-sponsored coverage would continue to be the primary payor while Medicare would be considered a secondary payor of his healthcare claims. d. Juan is likely to be eligible for Medicare once he turns age 65 and if he enrolls Medicare would become the primary payor of his healthcare claims but Smallcap must continue to offer him coverage under its employer-sponsored group health plan and would become a secondary payor.
b. Juan is likely to be eligible for Medicare once he turns age 65 and if he enrolls Medicare would become the primary payor of his healthcare claims and Smallcap does not have to continue to offer him coverage comparable to those under age 65 under its employer-sponsored group health plan. Correct: Medicare is the primary payor for individuals who have group health coverage as a result of their or their spouse's employment with a company that is not a large group health plan (GHP) (basically, one with fewer than 20 employees). Furthermore, small GHPs do not have to continue to offer their age 65 and over employees and their spouses the same benefits under the GHP as individuals under age 65.
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? a. Eligibility for Medicare is based on whether or not a person has ever been employed by the federal government. If she or her husband were ever employed by the federal government, she can enroll in Medicare. b. Medicare is a program for people age 65 or older and those under age 65 with certain disabilities, end-stage renal disease, and Lou Gehrig's disease so she will be eligible for Medicare. c. Medicare is a program for people who have incomes and assets below specific limits, so you will have to find out her exact financial situation before telling her whether she can obtain Medicare coverage. d. Medicare is a program for people of all ages with specific mental health disabilities. Since she is in excellent health, she would not qualify, but should instead look into her state's Medicaid program if she wants further coverage.
b. Medicare is a program for people age 65 or older and those under age 65 with certain disabilities, end-stage renal disease, and Lou Gehrig's disease so she will be eligible for Medicare. Correct: Individuals that meet these criteria may be eligible to participate in Medicare. It is not based on income.
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? a. Part C, which always covers dental and vision services, is covered under Original Medicare. b. Part D, which covers prescription drug services, is covered under Original Medicare. c. 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. d. Part A, which covers long term custodial care services, is covered under Original Medicare.
c. 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. Correct: Original Medicare consists of Part A and Part B.
Anita Magri will turn age 65 in August 2020. Anita intends to enroll in Original Medicare Part A and Part B. She would also like to enroll in a Medicare Supplement (Medigap) plan. Anita's older neighbor Mel has told her about the Medigap Part F plan in which he is enrolled. It not only provides foreign travel emergency benefits but also covers his Medicare Part B deductible. Anita comes to you for advice. What should you tell her? a. You would be happy to help Anita enroll in a Medigap plan but before she can do so, she must also enroll in a Medicare Part D prescription drug plan. b. You are sorry to disappoint Anita but Medigap plans are no longer available to those who turn age 65 after January 1, 2020. Anita should instead consider a Medicare Advantage plan. c. You are sorry to disappoint Anita but a Medigap Part F plan is no longer available to those who turn age 65 after January 1,2020. Anita might instead consider other Medigap plans that offer foreign travel benefits but do not cover the Part B deductible. d. You would be happy to help Anita enroll in a Medigap Part F plan will provide foreign travel benefits as a well as cover her Part B deductible.
c. You are sorry to disappoint Anita but a Medigap Part F plan is no longer available to those who turn age 65 after January 1,2020. Anita might instead consider other Medigap plans that offer foreign travel benefits but do not cover the Part B deductible. Correct: Individuals who attain age 65 on or after January 1, 2020 cannot purchase a Medigap plan that pays the Part B deductible. Generally, these are plans C, F, or high deductible F. Anita can still purchase a Medigap plan that provides foreign travel emergency benefits such as plan G.
Mrs. Quinn recently turned 66 and decided after many years of work to begin receiving Social Security benefits. Shortly thereafter Mrs. Quinn received a letter informing her that she has been automatically enrolled in Medicare Part B. She wants to understand what this means. What should you tell Mrs. Quinn? a. She will need to pay no premiums for Part B as she qualifies for premium-free coverage due to the number of quarters she has worked. b. She should disenroll if she does not want to pay the monthly premiums. There is no disadvantage in doing so. c. Part B will cover her dental and vision needs. d. Part B primarily covers physician services. She will be paying a monthly premium and, with the exception of many preventive and screening tests, generally will have 20% coinsurance for these services, in addition to an annual deductible.
d. Part B primarily covers physician services. She will be paying a monthly premium and, with the exception of many preventive and screening tests, generally will have 20% coinsurance for these services, in addition to an annual deductible. Correct: Medicare Part B primarily covers physician services. Enrollees pay a monthly premium based on their income level and have 20 percent coinsurance cost-sharing with the exception of preventive benefits.
