MEDICARE AHIP MODULE 2 WITH

MEDICARE AHIP MODULE 2 WITH

ACCURATE SOLUTIONS

Mrs. Wang wants to know generally how the benefits under Original Medicare might compare to the benefits package of a Medicare Advantage Plan before she starts looking at specific plans. What could you tell her? - ANSWER-Medicare Advantage Plans may offer extra benefits that Original Medicare does not offer such as vision, hearing, and dental services. It must include a maximum out-of-pocket limit on Part A and Part B services.Mr. Barker enjoys a comfortable retirement income. He recently had surgery 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 some services and items he thought would be fully covered. He called you to ask what he could do? What could you tell him? - ANSWER-You can offer to review the plans appeal process to help him ask the plan to review the coverage decision.Mrs. Ramos is considering a Medicare Advantage PPO and has questions about which providers she can go to for her health care. What should you tell her? - ANSWER-Mrs.Ramos can obtain care from any provider who participates in Original Medicare, but generally will have a higher cost-sharing amount if she sees a provider who/that is not a part of the PPO network Which of the following statement(s) is/are correct about a Medicare Savings Account (MSA) Plans? -

• MSAs may have either a partial network, full network, or no network of providers.

II. MSA plans cover Part A and Part B benefits but not Part D prescription drug benefits.III. An individual who is enrolled in an MSA plan is responsible for a minimal deductible of $500 indexed for inflation.IV. Non-network providers must accept the same amount that Original Medicare would pay them as payment in full. - ANSWER-I, II and IV only

• MSAs may have either a partial network, full network, or no network of providers.

II. MSA plans cover Part A and Part B benefits but not Part D prescription drug benefits.IV. Non-network providers must accept the same amount that Original Medicare would pay them as payment in full.Mr. Greco is in excellent health, lives in his own home, and has a sizeable income from his investments. He has a friend enrolled in a Medicare Advantage Special Needs Plan (SNP). His friend has mentioned that the SNP charges very low cost-sharing amounts and Mr. Greco would like to join that plan. What should you tell him? - ANSWER-SNPs

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