Mrs. West wears glasses and dentures and has enjoyed considerable pain relief
from arthritis through acupuncture. She is concerned about whether or not Medicare
will cover these items and services. What should you tell her?
Medicare does not cover acupuncture, or, in general, glasses or dentures.
Mr. Bickford did not quite qualify for the extra help low-income subsidy under the
Medicare Part D Prescription Drug program and he is wondering if there is any other
option he has for obtaining help with his considerable drug costs. What should you
tell him?
He could check with the manufacturers of his medications to see if they offer an
assistance program to help people with limited means obtain the medications they
need. Alternatively, he could check to see whether his state has a pharmacy
assistance program to help him with his expenses.
Mr. Lombardi is interested in a Medicare Advantage (MA) PPO plan that you
represent. It is one of three plans operated by the same organization in Mr.
Lombardi's area. The MA PPO plan does not include drug coverage, but the other
two plans do. Mr. Lombardi likes the PPO plan that does not include drug coverage
and intends to obtain his drug coverage through a stand-alone Medicare prescription
drug plan. What should you tell him about this situation?
He could enroll in one of the MA plans that include prescription drug coverage or a
Medigap plan and a stand-alone prescription drug plan, but he cannot enroll in the
MA-only PPO plan and a stand-alone prescription drug plan.
Mr. Torres has a small savings account. He would like to pay for his monthly Part 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?
In general, he must select a single Part D premium payment mechanism that will be
used throughout the year.
Agent Jennings makes a presentation on Medicare advertised as an educational
event. Agent Jennings distributes materials that are solely educational in nature.
However, she gives a brief presentation that mentions plan-specific premiums. Is this
a prohibited activity at an event that has been advertised as educational?
Yes. When an event has been advertised as "educational," discussing plan-specific
premiums is impermissible.
Mrs. Mulcahy is concerned that she may not qualify for enrollment in a Medicare
prescription drug plan because, although she is entitled to Part A, she is not enrolled
under Medicare Part B. What should you tell her?
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