c. Mr. Singh can enroll in a stand-alone prescription drug plan and continue to be covered for Part A and Part B services through Original Fee-for-Service Medicare. c. I, II, III, and IV If the Medicare Advantage plan is a Private Fee-for-Service (PFFS) plan that does not offer drug coverage or a Medical Savings Account plan, Mrs. Berkowitz can do this. c. You must submit your materials to the plan you represent, so CMS can review and approve the materials to ensure they are accurate. a. Correct. Mr. Singh can enroll in a stand-alone prescription drug plan and continue to be covered for Part A and Part B services through Original Fee-for-Service Medicare. d. TrOOP refers to true out-of-pocket expenses paid by drug manufacturers on behalf of Medicare Part D beneficiaries. Mr. Singh would like drug coverage but does not want to be enrolled in a medicare advantage plan. c. If the drug coverage he has is not expected to pay, on average, at least as much as Medicare's standard Part D coverage expects to pay, then he will need to enroll in Medicare Part D during his initial eligibility period to avoid the late enrollment penalty. c. Part D covers prescription drugs and she should look at her premiums, formulary, and cost-sharing among other factors to see if they have changed. d. Yes. (The Medicare Advantage Open Enrollment Period (MA OEP) is only available to those who have enrolled in Medicare Advantage. (Cost plans offering Part D coverage may only make this benefit available during the enrollment periods available under the Part D program, and they are required to accept Part D enrollments during these periods.). Tell Mr. Anderson that you cannot accept any enrollment forms until the annual election period begins. She would also like to enroll in a Medicare Supplement (Medigap) plan. Mrs. Radford asks whether there are any special eligibility requirements for Medicare Advantage. Therefore, this type of statement would be prohibited. Mr. Wu may still qualify for help in paying Part D costs through his State Pharmaceutical Assistance Program. Learn about formularies, tiers of coverage, name brand and generic drug coverage. Tell her that the Medicare agency does not endorse or recommend any plan. What types of vegetation are found in the northernmost region of the Scandinavian Peninsula? You are visiting with Mr. Tully and his daughter at her request. Mrs. Paterson is concerned about the deductibles and co-payments associated with Original Medicare. She is in excellent health and will have considerable income when she retires. Smallcap has a workforce of 15 employees and offers employer-sponsored healthcare coverage. She must immediately drop her ABC MA plan and enroll in Original Medicare. c. You could suggest he call the doctor who performed the surgery to complain about the costs and ask for a discount on the charges. Mrs. Quinn recently turned 66 and decided after many years of work to begin receiving Social Security benefits. d. 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. He asks you what costs he would generally expect to encounter when enrolling into a standard Medicare Part D prescription drug plan. b. c. Mr. Singh can enroll in a stand-alone prescription drug plan and continue to be covered for Part A and Part B services through Original Fee-for-Service Medicare. If he still wants to do so, he can make any sort of change he likes at that point. Agent Lopez helps Ralph to enroll in Top Choice Medicare Advantage plan during the Annual Open Enrollment Period. b. As long as he has any sort of employer coverage, regardless of the level of coverage, he will incur no penalty if he does not enroll in a Part D plan when first eligible. What should you keep in mind to comply with the marketing requirements for MA plans? c. Most individuals who are citizens and age 65 or over are covered under Part A by virtue of having paid Medicare taxes while working, though some may be covered as a result of paying monthly premiums. What should you tell her? What could you tell her? Correct. c. Mr. Tully's daughter can do so only, if she is authorized under state law as a court-appointed legal guardian, has a durable power of attorney for health care decisions, or is authorized under state surrogate consent laws to make health decisions. The company has added Medicare Advantage and Part D plans and you will begin marketing those plans this fall. He should apply for coverage under his state's Medicaid program to access the extra help with his drug costs. His friend has mentioned that the SNP charges very low cost-sharing amounts and Mr. Greco would like to join that plan. Correct. Web-Mr. Singh can enroll in a stand-alone prescription drug plan and continue to be covered for Part A and Part B services through Original Fee-for-Service Medicare. b. Mrs. Berkowitz can apply for any Medicare Advantage plan and, if it offers drug coverage, ask to have that element of the coverage eliminated, after which she can enroll in a stand-alone Medicare prescription drug plan in her service area. Why do you think Seamus Heaney might have chosen this rhyme scheme for a poem about a couples relationship In addition, some states have assistance programs specifically for their residents. During 2017, many people experienced significant problems with deductions from their Social Security check for their Part D premium. Mrs. Lu is turning 65 in November and called to ask for your help deciding on a Medicare Advantage plan. b. , ches of government? His co-actors and directors have referred him as one of the most energetic guys of the industry. (Part D plans are not required to cover all prescriptions on the market. He asks you what costs he would generally expect to encounter when enrolling into a standard Medicare Part D prescription drug plan. However, these prescriptions are typically filled at a higher cost to these enrollees.). Learn more about Medicare advantage plan here:brainly.com/question/25122967, This site is using cookies under cookie policy . What should you tell Mrs. Quinn? What should you tell him? She should be able to enroll in a Medicare prescription drug plan that covers the medications she needs. He wants to know whether he might qualify. Ms. Claggett is sixty-six (66) years old. c. Mr. Zachow could immediately disenroll from the Part D plan and select a new Part D plan that covers the drug that works for him. d. The cost of the prescription drugs that are not on his plan's formulary as well as the cost of the drug(s) to reduce joint swelling from the Canadian pharmacy will count toward TrOOP but the other medications in question will not count toward TrOOP. -Medicare prescription drug plans are not permitted to cover the prescription medications the Vaughns are interested in under Part D coverage, however, plans may cover them as supplemental benefits and the Vaughn's could look into that possibility. b. He also left a substantial estate which provides Madeline with an annual income of approximately $130,000. Mrs. Kelly, age 65, is entitled to Part A but has not yet enrolled in Part B. The government allows Part D plans to adopt any benefit structure as long as the list of covered drugs meets their approval. What do you say? Mr. Singh would like drug coverage but does not want to be enrolled in a medicare advantage plan. What can you do in this situation? Mr. Singh would like drug coverage but does not want to be enrolled in a Medicare Advantage plan. c. Guy, who has illegally crossed the Canadian border. What should you tell him? a. d. Part D plans do not have to cover all medications. Mrs. Quinn has just turned 65, is in excellent health and has a relatively high income. One of your colleagues argues that it is better to focus your time and energy exclusively in neighborhoods with single-family homes. She has come to you for advice? Newer models of cell phones contain a myriad of applications and can do many of the things that a personal computer (PC) can do. Authorization may be obtained by directing a beneficiary to a website to provide consent as long as the website includes a mechanism for an electronic signature that is valid under applicable law. Web39 ANMs successfully completed 12-days induction training at ANMTC Chandausi. What should you tell her? b. Mr. Singh can enroll in a stand-alone prescription drug plan a. Medicare will cover a total of 190 days of inpatient psychiatric care during Mr. Rainey's entire lifetime. Mr. Barker enjoys a comfortable retirement income. Advertisement Okjaanu504 is waiting for your help. b. Medicare Advantage is a way of covering all the Original Medicare benefits through private health insurance companies. What should you tell him? You must ensure that the advertisements indicate it is an educational event, otherwise it will be considered a marketing event. This site is using cookies under cookie policy . a. Mr. Schultz should seek to continue employer group coverage through COBRA because it is likely to have superior benefits at a more reasonable price. Jerry is currently enrolled in Medicare Parts A and B. Jerry has also purchased a Medicare Supplement (Medigap) plan which he has had for several years. b. Medicare prescription drug plans are permitted to cover vitamins, but not drugs for cosmetic purposes. The extra help is available to beneficiaries whose income and assets do not exceed annual limits specified by the government. -Part D plans do not have to cover all medications. What do you need to do with your materials before using them for marketing purposes? She is interested in selecting a Medicare Part D prescription drug plan. Ralph disenrolls on February 12th because he discovers that the plan does not cover services furnished by several of his longtime providers. a. Medicare Health Plans may offer extra benefits that Original Medicare does not offer such as vision, hearing, and dental services and must include a maximum out-of-pocket limit on Part A and Part B services. He is wondering whether he can obtain coverage under Medicare. Mr. and Mrs. Vaughn both take a specialized multivitamin prescription each day. a. Correct. c. Marketing in health care facilities is an acceptable practice, as long as it takes place in common areas where patients are not receiving health care services. Given his current situation, he is unlikely to qualify and would not be able to enroll in the SNP. b. Below we countdown to Simmi Singh upcoming birthday. b. II and III only a. (Mrs. Lopez is enrolled in a Cost plan. What should you tell him?. He called you to ask what he could do? A signature is not necessary since Mr. Tully is not physically or mentally capable of filling out and signing the form. In Medicare Advantage HMO plans, services provided by primary care physicians are covered at 100%, but those of specialists are covered at 80%. b. You must have her sign a scope of appointment form, indicating which products she wishes to discuss. -He could check with the manufacturers of his medications to see if they offer an assistance program to help people with limited means to obtain the medications they need. Furthermore, because he has had Medigap Jerry will not incur a Part D late enrollment penalty. What enrollment rules would apply in this case? Mrs. Davenport enrolled in the ABC Medicare Advantage (MA) plan several years ago. XYZ Agency maintains a website marketing the MA plans with which it has contracts. (Marketing representatives must not engage in any activity that would be considered discriminatory such as attempting to recruit Medicare beneficiaries from higher-income areas without making comparable efforts to recruit Medicare beneficiaries from lower-income areas.). Anita Magri will turn age 65 in August 2020. How can businesses utilize this technology to attract more customers, sell more products, advertise their products, facilitate the sale of products, and conduct and manage their businesses more efficiently and effectively? a. II, III, and IV only d. There is no limitation on meals. (Sales presentations and distribution or acceptance of enrollment forms are prohibited when an event is advertised as educational.). This could be considered discriminatory activity, but it is not a prohibited practice. Correct. -If she does not sign up for a Medicare prescription drug plan as soon as she is eligible to do so, and if she does sign up at a later date, her premium will be permanently increased by 1% of the national average premium for every month that she was not covered. What should you tell her? d. Part D plans do not have to cover all medications. She comes to you for advice. The My Damn channel web series DailyGrace They are anxious to have their Medicare prescription drug plan cover these drug needs. ABC is a Medicare Advantage (MA) plan sponsor. Correct. You must have her sign a scope of appointment form, indicating which products she wishes to discuss, and note on the form that she is a "walk in. " a. a. She will need to have her physician help her select a new drug that is covered. b. Mr. Diaz will not pay any penalty because he had continuous coverage under his employer's plan. d. During the MA-OEP, Miguel can have one-on-one meetings with beneficiaries who have requested such meetings. Singh would like drug coverage, but does not want to be enrolled into a health plan. b. c. You may provide light snacks, but a Thanksgiving style meal would be prohibited, regardless of who provides or pays for the meal. b. When expanded it provides a list of search options that will switch the search inputs to match the current selection. Part B primarily covers physician services. WebCorporate and commercial > Commercial contracts Tier 1 Addleshaw Goddards dedicated commercial group provides strong commercially focused advice, and demonstrates a keen willingness to get into the operational side of the business, covering a varied range of high-value contract agreements.Leveraging its expertise across the retail, financial services, XYZ Agency maintains a website marketing the MA plans with which it has contracts. Her that the SNP charges very low cost-sharing amounts and mr. Greco would like drug coverage a! More about Medicare Advantage mr singh would like drug coverage here: brainly.com/question/25122967, this type of statement would be prohibited in Part B requested! Is wondering whether he can make any sort of change he likes at that.... Considered a marketing event out-of-pocket expenses paid by drug manufacturers on behalf of Part... That plan are prohibited when an event is advertised as educational. ) ABC is a Medicare D! 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