A covered entity… A covered entity (CE) must have an established complaint process. True

A Medicare beneficiary…. A Medicare beneficiary has walked into your office and requested that you sit down with her and discuss her options under the MA program. Before engaging in such a discussion, what should you do? You must have her sign a scope of appointment form, indicating which products she wishes to discuss, and … Read more

Any person who… Any person who knowingly submits false claims to the Government is liable for five times the Government’s damages caused by the violator plus a penalty. False

You work for… You work for a company that has marketed Medigap products for many years. The company has added Medicare Advantage and Part D plans and you will begin marketing those plans this fall. You are planning what materials to use to easily show the differences in benefits, premiums and cost sharing for each … Read more

Ordinarily, you provide… Ordinarily, you provide clients who purchase various types of insurance products from you with a gift when they enroll and you let them know that they will receive it their enrollment is complete. When you market MA and Part D plans, what may you offer as a gift to induce enrollment in … Read more

Mr. Robinson was… Mr. Robinson was quite ill recently and forgot to pay his monthly premium for his MA-PD plan. He is worried that he will lose his coverage now when he needs it the most. He is certain his plan will disenroll him because that is what happened to a friend of his in … Read more

Mrs. Ridgeway enrolled… Mrs. Ridgeway enrolled in Original Medicare and Medigap coverage following her retirements several years ago. Four months ago, Mrs. Ridgeway dropped her Medigap policy to enroll in a Medicare Advantage (MA) plan for the first time. Unfortunately, Mrs. Ridgeway has found that many of her providers are not in the MA plan’s … Read more