1. Mr.Wells is trying to understand the difference between Original Medicareand
Medicare Advantage. What would be the correct description?
Answer: Medicare Advantage is a way of covering all the Original Medicare
benefits through private health insurance companies.
2. 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?
Answer: They areMedicare health plans such as HMOs, PPOs, PFFS, and MSAs.
3. Mr. Kumar is considering a Medicare Advantage HMO and has questions about
his ability to access providers. What should you tell him?
Answer: In most Medicare Advantage HMOs, Mr.Kumar must generally obtain his
services only fromproviders who have a contractual relationship with the plan (except
in an emergencyor where care is unavailable within the network).
4. Mr.Castillo, a naturalized citizen, previously enrolled in Medicare Part B buthas
recently stopped paying his Part B premium. Mr. Castillo is still covered by Part A.
He would like to enroll in a Medicare Advantage (MA) plan and is still covered by
Part A. What should you tell him?
Answer: He is not eligible to enroll ina Medicare Advantage plan until he re-enrolls
in Medicare Part B.
5. Mrs. Walters is enrolled in her state's Medicaid program in addition to Medicare.
What should she be aware of when considering enrollment in a Medicare
Advantage (MA) plan?
Answer: She cannot enroll in an MA Medical SavingsAccount (MSA) plan.
6. Daniel is a middle-income Medicare beneficiary. He has chronic bronchitis,
putting him at severe risk for pneumonia. Otherwise, he has no problems functioning.
Which type of SNP is likely to be most appropriate for him?
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