1. Mr.Capadonawouldliketopurchase aMedicareAdvantage(MA)plananda Medigapplantopickupcostsnotcovered bythatplan.Whatshouldyoutellhim?
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AgentJohnMillerismeetingwithJerry Smith,anewprospect.Jerryiscurrently enrolledinMedicarePartsAandB.JerryhasalsopurchasedaMedicareSupplement(Medigap)planwhichhehashad forseveralyears.However,theplandoes notprovidedrugbenefts.Howwouldyou adviseAgentJohnMillertoproceed?
3 Mr.WuiseligibleforMedicare.Hehas limitedfnancialresourcesbutfailedto qualifyforthePartDlow-incomesubsidy. Wheremightheturnforhelpwithhisprescriptiondrugcosts?
4 Mr.Vasquezisingoodhealthandis preparingabudgetinanticipationofhis retirementwhenheturns66.Hewantsto understandthehealthcarecostshemight beexposedtounderMedicareifhewere torequirehospitalizationbecauseofanillness.Ingeneralterms,whatcouldyoutell himabouthiscostsforinpatienthospital servicesunderOriginalMedicare?
ItisillegalforyoutosellMr.Capadonaa MedigapplanifheisenrolledinanMA plan,andbesides,Medigaponlyworkswith OriginalMedicare.
TellprospectJerrySmiththatheshouldconsideraddingastandalonePartDprescriptiondrugcoveragepolicytohispresentcoverage.
Mr.Wumaystillqualifyforhelpinpaying PartDcoststhroughhisStatePharmaceuticalAssistanceProgram(SPAP).
UnderOriginalMedicare,thereisasingle deductibleamountdueforthefrst60days ofanyinpatienthospitalstay,afterwhichit convertsintoaper-daycoinsuranceamount throughday90.Afterday90,hewouldpaya dailyamountupto60daysoverhislifetime, afterwhichhewouldberesponsibleforall costs.
5 Mr.Moywillsoonturnage65.Heisslightly youngerthanhiswife.Mr.Moy'swifehasa MedicareSupplementalInsurancewould helpcoverhisPartAdeductibleandPart
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MedicareAdvantageplan,buthewantsto understandwhatcoverageMedicareSupplementalInsuranceprovidessincehis healthcareneedsarediferentfromhis wife'sneeds.WhatcouldyoutellMr.Moy?
BcoinsuranceorcopaymentsinOriginal Fee-for-Service(FFS)Medicareaswellas possiblysomeservicesthatMedicaredoes notcover.
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JuanPerez,whoisturningage65next month,intendstoworkforseveralmore yearsatSmallcap,Incorporated.Smallcap hasaworkforceof15employeesandoffersemployer-sponsoredhealthcarecoverage.Juanisanaturalizedcitizenandhas contributedtotheMedicaresystemfor over20years.Juanasksyouifhewillbe entitledtoMedicareandifheenrollshow thatwillimpacthisemployer-sponsored healthcarecoverage.Howwouldyourespond?
JuanislikelytobeeligibleforMedicare onceheturnsage65andifheenrolls, Medicarewouldbecometheprimarypayor ofhishealthcareclaimsandSmallcapdoes nothavetocontinuetooferhimcoverage comparabletothoseunderage65under itsemployer-sponsoredgrouphealthplan. JuanislikelytobeeligibleforMedicare onceheturnsage65andifheenrolls, Medicarewouldbecometheprimarypayor ofhishealthcareclaimsbutSmallcapmust continuetooferhimcoverageunderits employer-sponsoredgrouphealthplanand wouldbecomeasecondarypayor.
7. Ms.Kumarplanstoretirewhensheturns 65inafewmonths.Sheisinexcellent healthandwillhaveconsiderableincome whensheretires.Sheisconcernedthat herincomewillmakeitimpossibleforher toqualifyforMedicare.Whatcouldyoutell hertoaddressherconcern?
Medicareisaprogramforpeopleage65or olderandthoseunderage65withcertain disabilities,end-stagerenaldisease,and LouGehrig'sdiseasesoshewillbeeligible forMedicare.
8 Mrs.Ellisrecentlyturned66anddecided aftermanyyearsofworktoretireand beginreceivingSocialSecuritybenefts. PartBprimarilycoversphysicianservices. Shewillbepayingamonthlypremiumand, exceptformanypreventiveandscreening