Mr. Lopez has heard that he can sign up for a product called "Medicare
Advantage" but is not sure about what type of plan designs are available
through this program. What should you tell him about the types of health
plans that are available through the Medicare Advantage program? ------
Correct Answer--------They are Medicare health plans such as HMOs,
PPOs, PFFS, SNPs, and MSAs
(W) Mr. Wells is trying to understand the difference between Original
Medicare and Medicare Advantage. What would be a correct description? -
-----Correct Answer--------Medicare Advantage is a way of covering all of
the Original Medicare benefits through private health insurance companies.
During a sales presentation in Ms. Sullivan's home, she tells you that she
has heard about a type of Medicare health plan known as Private Fee-forService (PFFS). She wants to know if this would be available to her. What
should you tell her about PFFS plans? ------Correct Answer--------A PFFS
plan is one of various types of Medicare Advantage plans offered by private
entities and she may enroll in one if it is available in her area.
(W) Mrs. Radford asks whether there are any special eligibility
requirements for Medicare Advantage. What should you tell her? ------
Correct Answer--------Mrs. Radford must be entitled to Part A and enrolled
in Part B to enroll in Medicare Advantage
Mr. Castillo, a naturalized citizen, previously enrolled in Medicare Part B
but has recently stopped paying his Part B premium. He would like to enroll
in a Medicare Advantage (MA) plan and is still covered by Part A. What
should you tell him? ------Correct Answer--------He is not eligible to enroll in
a Medicare Advantage plan until he re-enrolls in Medicare Part B
(W) Mrs. Billings enrolled in the ABC Medicare Advantage (MA) plan
several years ago. Her doctor recently confirmed a diagnosis of end-stage
renal disease (ESRD). What options does Mrs. Billings have in regard to
her MA plan during the next open enrollment season? ------Correct Answer-
-------She may remain in her ABC MA plan or enroll in a Special Needs
Plan (SNP) for individuals suffering from ESRD if one is available in her
area
Mr. Kumar is considering a Medicare Advantage HMO and has questions
about his ability to access providers. What should you tell him? ------Correct
Answer--------In most Medicare Advantage HMOs, Mr. Kumar must obtain
his services only from providers who have a contractual relationship with
the plan (except in an emergency).
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