Ms.

Stuart has heard about a special needs

plan (SNP) that one of her friends is
enrolled in and is interested in
that product. She wants to be sure she also
has coverage for prescription drugs. Would
she be able to obtain
drug coverage if she enrolled in the SNP?
Yes. All SNPs are required to provide Part
D coverage for prescription drugs.
Ms. Edwards is enrolled in a Medicare
Advantage plan that includes prescription
drug plan (PDP) coverage.
She is traveling and wishes to fill two of
the prescriptions that she has lost. How
would you advise her?
She may fill prescriptions for covered
drugs at non-network pharmacies, but
likely at
a higher cost than paid at an in-network
pharmacy.
You meet with Mrs. Wilson to complete
her enrollment in a Medicare Advantage
plan. You tell her that there will
be an enrollment verification process to
confirm that she is enrolled in the plan that
she requested and
understands the plan features and rules.
What should Mrs. Wilson expect regarding
the verification process?
Mrs. Wilson will be contacted by the plan
sponsor within 15 calendar days of receipt
of the enrollment request.
Julia Harris is turning 66 in July, at which
time she will retire. She has contacted your
office and requested a
meeting so that she can learn about
Medicare and the products you represent.
How should you respond?
Tell Julia that you will meet with her to
explain Medicare and should she be
interested you can accept and submit an
enrollment request, since this is an initial
enrollment qualifying her for a special
enrollment period.
Mrs. Schmidt is moving and a friend told
her she might qualify for a "Special
Enrollment Period" to enroll in a
new Medicare Advantage plan. She
contacted you to ask what a Special
Enrollment Period is. What could you
tell her?
It is a time period, outside of the Annual
Election Period, when a Medicare
beneficiary can select a new or different
Medicare Advantage and/or Part D
prescription drug plan. Typically the
Special Enrollment Period is beneficiary
specific
and results from events, such as when the
beneficiary moves outside of the service
area.
You plan to participate in an educational
event sponsored by a large regional health
care system. One of your
colleagues suggests that you do a
presentation on one of the Medicare Health
plans you market and modify it
to include information about preventive
screening tests showcased at the event.
How should you respond to
your colleague's suggestion?
You should tell your colleague no because
participation in an educational event may
not include a sales presentation.