-
You are meeting with Ms. Blum and she has completed an
enrollment form for a MA-PD plan you represent. You notice that her handwriting
is illegible and as a result, the spelling of her street looks incorrect. She
asks you to fill in the corrected street name. What should you do?
- You
- may correct this information as long as you add your initials and date next to
- the correction
-
Ms. Gardner is currently enrolled in an MA-PD plan. However,
she wants to disenroll from the MA-PD plan and instead enroll in a Part D only
plan and go back to Original Medicare. According to Medicare's enrollment
guidelines, when could she do this?
- She
- may make such a change during the Annual Election Period that runs from Oct. 15
- to December 7, or during the MA Disenrollment Period that runs from January 1
- to February 14 of each year
-
Mrs. Brown 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?
- If
- the Medicare Advantage plan is a Private Fee-for-Service (PFFS) plan that does
- not offer drug coverage or a Medical Savings Account, Mrs. Brown can do this
-
After a sales presentation, Mr. Buffet announces that he is
ready to enroll in the plan you represent. He would like to know if he can have
his plan premiums deducted from his Social Security check. What should you tell
him?
- He
- may choose withholding from his Social Security check when he completes the
- enrollment form
-
Ms. O'Donnell learned about a new MA-PD plan that her
neighbor suggested and that you represent. She plans to switch from her old MA
HMO plan to the new MA-PD plan during the Annual Election Period. However, she
wants to make sure she does not end up paying premiums for two plans. What can
you tell her?
- . She only needs to enroll in the new MA-PD plan
- and she will automatically be disenrolled from her old MA plan
-
You are visiting with Mr. Thomas and his daughter at her
request. He has advanced Alzheimer's and is incapable of understanding the
implications of choosing a Medicare Advantage or prescription drug plan. Can
his daughter fill out the enrollment form and sign it for him?
- Mr.
- Thomas’ daughter can do so only, if she is authorized under state law as a
- court-appointed legal guardian, has durable power of attorney for health care
- decisions, or is authorized under state surrogate consent laws to make health
- decisions
-
Mrs. Townsend would like her daughter, who lives in another
state, to meet with you during the Annual Election Period to help her complete
her enrollment in a Part D plan. She asked you when she should have her
daughter plan to visit. What could you tell her?
- Her
- daughter should come in November
-
Ms. Claggett, who has been covered under Original Medicare
for the last six years due to her disability, has never been enrolled in a
Medicare Advantage or a Part D plan before. She wants to enroll in a Part D
plan. She knows that there is such a thing as the "Part D Initial
Enrollment Period" and has concluded that, since she has never enrolled in
such a plan before, she should be eligible to enroll under this period. What
should you tell her about how the Part D Initial Enrollment Period applies to
her situation?
- It occurs three months before
- and three months after the month when a beneficiary meets the eligibility
- requirements for Part B, so she will not be able to use it as a justification
- for enrolling in a Part D plan now.------------------------------------------------------------------------------------------------------------------------------
-
Mr. Bublitz had surgery recently 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?
- You
- can offer to review the plans appeal process to help him ask the plan to review
- the coverage decision
-
Mr. Pintok is interested in joining a MA-PD plan and wants
advice as to whether or not he can select a primary care physician. What do you
tell him?
- He has a right to select or
- change his primary care provider from within the plan’s network without
- interference.
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