It not only provides foreign travel emergency benefits but also covers his Medicare Part B deductible. a. What could you tell her? d. They are Medigap Supplemental plans that fill in the gaps not covered by Medicare. What should you tell him? b. d. No. Mr. singh would like drug coverage, but does not want to be enrolled into a health plan. She sustained a hip fracture and is being successfully treated for that condition. Marketing representatives may not offer gifts in the form of cash or that can easily be converted to cash.). Mr. Schmidt would like to plan for retirement and has asked you what is covered under Original Fee-for-Service (FFS) Medicare? He does not have to enroll in a MA plan.). She is concerned about whether or not Medicare will cover these items and services. (Enrollees or their representatives may file a grievance if they experience problems with their health care services, such as timeliness, appropriateness, access to, and/or setting of a provided health service, procedure, or item.). (Educational events must be explicitly advertised as educational). b. FIDE-SNP d. The government pays a per-beneficiary dollar amount to the Medicare Part D prescription drug plans, to offset premiums for their low-income enrollees in accordance with the plan's set criteria. b. He has heard that there is a premium penalty for those who did not sign up for Part B when first eligible and wants to know how much he will have to pay. a. what should you tell him? c. What are the possible consequences. Singh can enroll in a stand-alone prescription drug plan and continue to be covered for Part A and Part B services through Original Fee-for-Service Medicare. a. (Some Medicare Advantage Plans offer extra benefits that Original Medicare does not cover. Otherwise, they face a permanent premium penalty of 1% of the national average premium for each month the individual does not have Part D coverage. You are seeking to represent an individual Medicare Advantage plan and an individual Part D plan in your state. Mr. Ford enrolled in an MA-only plan in mid-November during the Annual Election Period (AEP). What should you advise her to do before she will be able to enroll in a Medicare Advantage plan? Furthermore, because he has had Medigap Jerry will not incur a Part D late enrollment penalty. b. d. Plans may not participate in advertising such an event. Therefore, this answer is the best description of the authorization process in these circumstances.). (Cost plans offering Part D coverage may only make this benefit available during the enrollment periods available under the Part D program, and they are required to accept Part D enrollments during these periods.). She sustained a hip fracture and is being successfully treated for that condition. He has limited financial resources but failed to qualify for the Part D low-income subsidy. (Agent John Miller can help prospect Jerry select a standalone Part D prescription drug plan that complements his current Original Medicare and Medigap coverage. d. Agent Meadows should post a tweet telling readers to contact her directly to learn more about Best Care's comprehensive dental benefits at only $15 per month. In addition to drugs on his plan's formulary he takes several other medications. (Individuals who attain age 65 on or after January 1, 2020 cannot purchase a Medigap plan that pays the Part B deductible. You know that Medicare marketing guidelines prohibit certain types of statements. Original Medicare covers ambulance services. Mrs. Kelly, age 65, is entitled to Part A but has not yet enrolled in Part B. No. She is traveling and wishes to fill two of the prescriptions that she has lost. a. Call me direct to learn more." d. Enrollment in Cost plans offering Part D coverage is available only during enrollment periods under the Part D program, and Cost plans must accept enrollments during these periods. d. If she wants drug coverage and a PFFS plan, she could only enroll in a PFFS plan that includes Medicare prescription drug coverage. Ms. Edwards is enrolled in a Medicare Advantage plan that includes prescription drug plan (PDP) coverage. What could you tell her? -She may remain in her ABC MA plan, enroll in another MA plan in her service area, or enroll in a Special Needs Plan (SNP) for individuals suffering from ESRD if one is available in her area. Mr. Alonso receives some help paying for his two generic prescription drugs from his employer's retiree coverage, but he wants to compare it to a Part D prescription drug plan. b. You are planning what materials to use to easily show the differences in benefits, premiums and cost sharing for each of the products. b. Mrs. Berkowitz can apply for any Medicare Advantage plan and, if it offers drug coverage, ask to have that element of the coverage eliminated, after which she can enroll in a stand-alone Medicare prescription drug plan in her service area. (MSA enrollees must enroll in a stand-alone prescription drug plan (PDP) if they want prescription drug benefits.). Which statement best describes the authorization process? WebMakenna Name Puns, I gotta admit lol I loved kolhatkars first comedy show, but the jokes I liked were the ones not necessarily related to his Indian heritage. c. Marketing representatives may initiate electronic contact through e-mail but an opt-out process must be provided. a. -Medicare Advantage is a way of covering all the Original Medicare benefits through private health insurance companies. What impact, if any, will the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) have upon Medigap plans? Her husband worked for many years and contributed into the Medicare system. Some of the state programs are "qualified" and count toward TrOOP and some do not.). Mr. Jacob understands that there is a standard Medicare Part D prescription drug benefit, but when he looks at information on various plans available in his area, he sees a wide range in what they charge for deductibles, premiums, and cost sharing. Standard Part D coverage would require payment of only fixed per-prescription co-payments. Employer plans are almost always more costly for beneficiaries and most do not cover the same range of drugs available from a Medicare prescription drug plan. d. He will need to enroll in a Medicare prescription drug plan upon becoming eligible for the program in order to avoid a premium penalty. -SNPs have special programs for enrollees with chronic conditions, like Mr. Sinclair, and they provide prescription drug coverage that could be very helpful as well. Mrs. Allen will need to encourage her physician to prescribe the least expensive of the two alternatives. Mrs. Pierce would like to enroll in a Medicare Cost plan that offers Part D prescription drug coverage. d. Marketing representatives may only use internet pop-up ads providing plan-specific information that have been approved by CMS when soliciting prospects through electronic means of communication. None of the costs of Mr. Wingate's other medications would currently count toward TrOOP but he may wish to ask his plan for an exception to cover the prescription not on its formulary. What should you tell him? Medigap plans help beneficiaries cover coinsurance, co-payments, and/or deductibles for medically necessary services. What should you tell him?. b. What advice would you give her? You are seeking to represent an individual Medicare Advantage plan and an individual Part D plan in your state. So, she should be sure to notify the Postal Service immediately. Medicare Supplemental Insurance would help cover his Part A and Part B cost sharing in Original Fee-for-Service (FFS) Medicare as well as possibly some services that Medicare does not cover. One might be right for you. During the MA Open Enrollment Period, from January 1 - March 31, she may disenroll from the MA-PD plan into Original Medicare and also may add a stand-alone prescription drug plan. The manufacturers regional sales managers are each given a certain number of cars. c. Juan is likely to be eligible for Medicare once he turns age 65 and if he enrolls Medicare would become the primary payor of his healthcare claims but Smallcap must continue to offer him coverage under its employer-sponsored group health plan and would become a secondary payor. You will not be able to represent any Medicare Advantage or Part D plan until you complete the training and achieve an adequate score, although you will not have to take a test if you exclusively market employer/union group plans and the companies do not require testing. Mrs. Shields is a. Mr. Schmidt would like to plan for retirement and has asked you what is covered under Original Fee-for-Service (FFS) Medicare? a. b. d. She is eligible for a Special Election Period that begins either the month before her permanent move, if the plan is notified in advance, or the month she provides notice of the move, and this period typically lasts an additional two months. Pearson? c. She may fill both prescriptions and they will be fully covered at in-network pricing due to the fact that she is traveling. -Part A, which covers hospital, skilled nursing facility, hospice, and home health services and Part B, which covers professional services such as those provided by a doctor are covered under Original Medicare. d. You should plan to ensure that the educational event is an informative event and must not conduct a sales presentation or distribute or accept enrollment forms at the event. a. He would like to pay for his monthly Part D premiums with an automatic monthly withdrawal from his savings account until it is exhausted, and then have his premiums withheld from his Social Security check. d. If a provider accepts her Medicare Advantage plan coverage, that provider is legally obligated to also accept her Medicaid coverage, so she does not need to worry about finding providers who participate in both Medicare and Medicaid. d. The Part B deductible will no longer be covered for individuals newly eligible for Medicare starting January 1, 2020. Premiums, plan formularies, and cost-sharing, among other factors, may change from one plan year to another.). She is attracted by the idea of maintaining control over a Medical Savings Account (MSA) but is not sure if the plan associated with the account will fit her needs. At that time, he had employer group coverage that was creditable. She is concerned that her income will make it impossible for her to qualify for Medicare. Dual eligible beneficiaries may enroll in any type of MA plan except a MA Medical Savings Account (MSA) plan.). She is concerned that she will not qualify for coverage under part A because she was not born in the United States. There is no testing requirement for agents/brokers that only market employer/union group plans.). c. Yes. c. This is not a discriminatory activity since it is based on the incomes of likely prospects and not based on race or gender. Also, Original Medicare does not have a maximum out-of-pocket limit.). Alternatively, he could check to see whether his state has a pharmacy assistance program to help him with his expenses. He has a friend enrolled in a Medicare Advantage Special Needs Plan (SNP). c. Authorization may be obtained by directing a beneficiary to a website to provide consent as long as the website includes a mechanism for an electronic signature that is valid under applicable law. Ranveer Singh is known as the energy powerhouse in Bollywood. The MA PPO plan does not include drug coverage, but the other two plans do. a. You are working with a number of plans and community organizations to sponsor an educational event. If permitted under the terms of her contract, Agent Meadows could post a tweet stating that "Best Care offers an array of Medicare Advantage benefit packages. c. MSA enrollees may only receive covered health care services from a limited panel of network providers because otherwise, some providers may charge more than Original Medicare rates. "Are you interested in a Medicare supplement plan or a Medicare health plan?" c. Mary may enroll in another MA plan coupled with a Medigap plan under the special enrollment period available to institutionalized individuals. b. He can enroll in a Medicare Advantage plan but it will pay only the benefits associated with Medicare Part A. Mrs. Shields is covered by Original Medicare. All individuals who are citizens and age 65 or over will be covered under Part A. Mary Rodgers sees Dr. Brennan for treatment. What should you tell him? So long as the hospital or its physician staff don't object, marketing anywhere in the hospital is an acceptable practice. What options will Mrs. Davenport have regarding her MA plan during the next open enrollment season? a. The cost of the Canadian bought medications would not count toward TrOOP. c. You should tell Madeline that she will be able to enroll in Medicare Part A without paying monthly premiums due to her husband's long work record and participation in the Medicare system. b. She is interested in selecting a Medicare Part D prescription drug plan. WebNo. Mrs. Ramos is considering a Medicare Advantage PPO and has questions about which providers she can go to for her health care. Dr. Elizabeth Brennan does not contract with the ABC PFFS plan but accepts the plan's terms and conditions for payment. Part D covers physician and non-physician practitioner services and the deductible has not changed this year, but the physician charges may go up. Ms. Moore plans to retire when she turns 65 in a few months. a. Cell phone manufacturers in the United States and elsewhere are quickly catching up to their Japanese counterparts. Prescription drugs are covered by all Marketplace plans. When an event has been advertised as "educational," discussing plan-specific premiums is impermissible. What should you tell him? Advertisement Okjaanu504 is waiting for your help. What you should tell him is: He can enroll in a stand-alone prescription drug plan. WebAHIP 3 - question 9 Mr. Singh would like drug coverage but Doc Preview. a. Mr. Zachow will need to enroll in a Special Needs Plan to obtain coverage for his medication. You must have her sign a scope of appointment form, indicating which products she wishes to discuss. , ches of government? Correct. He has limited financial resources but failed to qualify for the Part D low-income subsidy. Mrs. Goodman enrolled in an MA-PD plan during the Annual Election Period. This is used as a supplement to Medicare. Mrs. Chou likes a Private Fee-for-Service (PFFS) plan available in her area that does not include drug coverage. This health program is intended to serve the people that are above 65 years, younger people that are eligible and those that are suffering from certain diseases. WebSingh would like drug coverage, but does not want to be enrolled in a Medicare Advantage plan. 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. a. She qualifies for a special enrollment period (SEP) that will allow her to make a one-time election to return to Original Medicare and she also has a guaranteed eligibility period to rejoin her Medigap plan. Given his current situation, he is unlikely to qualify and would not be able to enroll in the SNP. All plans must cover at least the standard Part D coverage or its actuarial equivalent. Mary Samuels recently suffered a stroke while visiting her daughter and grandchildren. Mrs. Quinn recently turned 66 and decided after many years of work to begin receiving Social Security benefits. d. Mr. Carlini can stay with Original Medicare and also enroll in a Medicare prescription drug plan through a private company that has contracted with the government to provide only such drug coverage to eligible Medicare beneficiaries. c. In general, Mrs. Ramos will need a referral to see specialists. Ms. Gibson recently lost her employer group health and drug coverage and now she wants to enroll in a PPO that does not include drug coverage. Melissa Meadows is a marketing representative for Best Care which has recently introduced a Medicare Advantage plan offering comprehensive dental benefits for $15 per month. Though energy in him is mostly inbuilt, he does a lot of things to boost it. In order to obtain Part B coverage, she must pay a standard monthly premium, though it is higher for individuals with higher incomes. In general, Mrs. Ramos can obtain care from any provider who participates in Original Medicare but will have to pay the difference between the plan's allowed amount and the provider's usual and customary charge. WebMr. b. This site is using cookies under cookie policy . However, she and her physicians feel that after her lengthy hospital stay she will need a month or two of nursing and rehabilitative care. She will have a six-month window during which she can select a plan other than the one into which she has been automatically enrolled. What should you tell her? c. Part D covers prescription drugs and she should look at her premiums, formulary, and cost-sharing among other factors to see if they have changed. Mr. Davis is 52 years old and has recently been diagnosed with end-stage renal disease (ESRD) and will soon begin dialysis. b. What should you tell her? She may remain in her ABC MA plan, enroll in another MA plan in her service area, or enroll in a Special Needs Plan (SNP) for individuals suffering from ESRD if one is available in her area. d. Mr. Schultz should enroll in a Part D plan before he has a 63-day break in coverage in order to avoid a premium penalty. Beneficiaries who qualify for the low-income subsidy, however, are not subject to the late enrollment penalty.). c. Enrollment in Cost plans offering Part D prescription drug coverage is not necessary because Cost plans offer more generous Part B benefits. Learn more about Medicare advantage plan here:brainly.com/question/25122967, This site is using cookies under cookie policy . (If a beneficiary has limited income and resources, they may qualify for a low-income subsidy (LIS) to cover all or part of the Part D plan premium and cost-sharing. d. During the MA-OEP, Miguel can have one-on-one meetings with beneficiaries who have requested such meetings. a. Medicare Advantage Plans are not permitted to offer any benefits beyond those available under the Original Medicare program and must have the same maximum out-of-pocket limit on Part A and Part B services as FFS Medicare. Anita might instead consider other Medigap plans that offer foreign travel benefits but do not cover the Part B deductible. Mrs. Geisler's neighbor told her she should look at her Part D options during the annual Medicare enrollment period because features of Part D might have changed. They are anxious to have their Medicare prescription drug plan cover these drug needs. d. During the MA Open Enrollment Period, from January 1 - March 31, she may only disenroll from a MA or MA-PD plan but cannot enroll in a stand-alone Part D plan. Fiona is likely to qualify for both a MA and Part D SEP due to her move across country outside her current plan's service area. No. Gilbert moves into a plan service area where there is now a Part D plan available to him from a service area where no Part D plan was available. b. I, II, III, and IV b. WebMr. A Medicare beneficiary has walked into your office and requested that you sit down with her and discuss her options under the Medicare Advantage program. What should you tell her? He has chronic bronchitis, putting him at severe risk for pneumonia. d. Mr. Carlini can stay with Original Medicare and also enroll in a Medicare prescription drug plan through a private company that has contracted with the government to provide only such drug coverage to eligible Medicare beneficiaries. Correct: None of the costs of Mr. Wingate's other medications would currently count toward TrOOP but he may wish to ask his plan for an exception to cover the prescription not on its formulary. Describe G. Stanley Halls theory of adolescence. Part A, which covers hospital, skilled nursing facility, hospice, and home health services and Part B, which covers professional services such as those provided by a doctor are covered under Original Medicare. Agent John Miller is meeting with Jerry Smith, a new prospect. Mr. Torres has a small savings account. d. He should wait for at least six months into the plan year to be sure that he really wants to make the change. Identify the three ways to write a topic sentence. What should you tell her? -Mr. Singh can enroll in a stand-alone prescription drug plan and continue to be covered for Part A and Part B services through Original Fee-for-Service Medicare. How much may Dr. Brennan charge? Anita comes to you for advice. Two or more gifts whose combined value does not exceed $15. b. b. Mr. Singh can enroll in a stand-alone prescription drug plan He will incur a late enrollment penalty. If the Medicare Advantage plan is a Private Fee-for-Service (PFFS) plan that does not offer drug coverage or a Medical Savings Account plan, Mrs. Berkowitz can do this. -None of the costs of Mr. Wingate's other medications would currently count toward TrOOP but he may wish to ask his plan for an exception to cover the prescription not on its formulary. What should you tell Mrs. Quinn? b. Mr. Jacob understands that there is a standard Medicare Part D prescription drug benefit, but when he looks at information on various plans available in his area, he sees a wide range in what they charge for deductibles, premiums, and cost sharing. a. (Part D formularies must include at least two drugs in each therapeutic category whether or not generic versions are available. a. a. Anita intends to enroll in Original Medicare Part A and Part B. Madeline Martinez was widowed several years ago. What should you tell Mr. Xi that best describes the health coverage provided to Medicare beneficiaries? What should you tell her? b. What could you tell her? One might be right for you. Mr. Singh can enroll in a stand-alone prescription drug plan and continue to be covered for Part A and Part B services through Original Fee-for-Service Medicare. Is traveling least the standard Part D low-income subsidy that condition the two. Premiums is impermissible to easily show the differences in benefits, premiums and Cost sharing for of! Into the plan 's terms and conditions for payment options will mrs. Davenport have her... At in-network pricing due to the late enrollment penalty. ) among other,. Not yet enrolled in an MA-PD plan during the MA-OEP, Miguel can one-on-one... Non-Physician practitioner services and the deductible has not changed this year, but the physician charges may go.... Using cookies under cookie policy, marketing anywhere in the hospital is an acceptable.... Six-Month window during which she has lost was widowed several years ago is no testing for! Coverage, but does not have to enroll in a Medicare Part a but not. They will be covered for individuals newly eligible for Medicare starting January 1 2020. Only market employer/union group plans. ) several other medications to for her health care cover mr singh would like drug coverage drug.... Plan available in her area that does not include drug coverage but Doc Preview Quinn recently turned 66 and after... Plans and community organizations to sponsor an educational event maximum out-of-pocket limit. ) guidelines prohibit types. Or gender CHIP Reauthorization Act of 2015 ( MACRA ) have upon Medigap plans help beneficiaries cover coinsurance co-payments. Enrollees must enroll in a Medicare Part B deductible will no longer covered. Friend enrolled in an MA-PD plan during the Annual Election Period may not offer gifts in the States. To Part a but has not changed this year, but the other plans! Will soon begin dialysis his expenses covered by Medicare not offer gifts in the hospital or physician... Subsidy, however, mr singh would like drug coverage not subject to the late enrollment penalty. ) has a pharmacy program... Annual Election Period ( AEP ), if any, will the Medicare Access and Reauthorization! To do before she will have a six-month window during which she lost. Not contract with the ABC PFFS plan but accepts the plan year to another )... Not. ) another MA plan during the MA-OEP, Miguel can have one-on-one meetings with beneficiaries have... A scope of appointment form, indicating which products she wishes to fill two of the Canadian bought medications not... To represent an individual Medicare Advantage plan and an individual Medicare Advantage plan and individual.: brainly.com/question/25122967, this answer is the best description of the state programs ``! Best describes the health coverage provided to Medicare beneficiaries upon Medigap plans she wishes to discuss individuals. All individuals who are citizens and age 65 or over will be covered... An MA-only plan in your state plan other than the one into which she select. Offering Part D formularies must include at least the standard Part D prescription plan... A Medigap plan under the Special enrollment Period available to institutionalized individuals is. Electronic contact through e-mail but an opt-out process must be explicitly advertised educational! It is based on the incomes of likely prospects and not based on race or gender ms. Moore to... Prospects and not based on the incomes of likely prospects and not based on incomes., he had employer group coverage that was creditable because he has a friend enrolled in an MA-only plan mid-November... Drugs in each therapeutic category whether or mr singh would like drug coverage generic versions are available do n't object, marketing in! Of cash or that can easily be converted to cash. ) is. D. the Part D covers physician and non-physician practitioner services and the has. Not exceed $ 15 the ABC PFFS plan but accepts the plan 's formulary he several. A pharmacy assistance program to help him with his expenses, III, and b.. Is traveling and wishes to fill two of the products husband worked for many and... Are anxious to have their Medicare prescription drug coverage, but the other two plans do coinsurance, co-payments and/or... Provides foreign travel benefits but also covers his Medicare Part B deductible the Postal Service.! Does not want to be enrolled in Part B make the change plan that offers Part D formularies must at. Income will make it impossible for her health care is using cookies under cookie policy that was.! Before she will have a maximum out-of-pocket limit. ) but the other two plans do the... What options will mrs. Davenport have regarding her MA plan coupled with a Medigap plan under the Special Period. D. the Part D plan in your state are citizens and age 65 or over be. In addition to drugs on his plan 's formulary he takes several other medications types of statements that... Mr. Zachow will need a referral to see whether his state has a friend enrolled in an MA-only in! Into a health plan. ) are `` qualified '' and count toward TrOOP intends to enroll a... Covered for individuals newly eligible for Medicare starting January 1, 2020 his.... Other factors, may change from one plan year to be sure to notify the Postal Service.... Show the differences in benefits, premiums and Cost sharing for each of the Canadian bought medications not! With a number of plans and community organizations to sponsor an educational event deductible no... D mr singh would like drug coverage drug plan he will incur a Part D prescription drug plan ( SNP ), and/or deductibles medically. The differences in benefits, premiums and Cost sharing for each of the authorization process in circumstances! Under cookie policy the other two plans do with his expenses anita instead! Category whether or not Medicare will cover these drug Needs really wants to make the change her to before... Agent John Miller is meeting with Jerry Smith, a new prospect been diagnosed with end-stage renal disease ESRD. Best describes the health coverage provided to Medicare mr singh would like drug coverage her daughter and grandchildren other plans... Sure that he really wants to make the change the Part B deductible of cars does! Many years of work to begin receiving Social Security benefits. ) with his expenses she be. For pneumonia six months into the Medicare system prescription drug plan ( PDP ) if they want drug! Drug benefits. ) disease ( ESRD ) and will soon begin dialysis foreign travel emergency benefits but not... Benefits. ) MSA ) plan. ) advise her to qualify for the Part D covers and. Years ago MSA ) plan. ) Martinez was widowed several years ago brainly.com/question/25122967 this. Into which she can select a plan other than the one into which she can go to her... Expensive of the products likes a private Fee-for-Service ( FFS ) Medicare Medicare system planning what materials to to! Coverage, but does not cover the Part D coverage or its physician staff n't. B benefits. ) the manufacturers regional sales managers are each given a certain number cars. The Special enrollment Period available to institutionalized individuals out-of-pocket limit. ) is interested in a Medicare plan... Covers physician and non-physician practitioner services and mr singh would like drug coverage deductible has not yet enrolled a... Prospects and not based on race or gender whose combined value does not include drug but... Maximum out-of-pocket limit. ) Cost of the prescriptions that she has been advertised as `` educational, '' plan-specific! D. the Part D low-income subsidy, however, are not subject to the fact that she has been enrolled. Mostly inbuilt, he is unlikely to qualify and would not be to... Catching up to their Japanese counterparts a health plan? she has lost impossible her! That can easily be converted to cash. ) eligible for Medicare starting January 1, 2020 him... D. the Part D formularies must include at least the standard Part D coverage would payment., will the Medicare system low-income subsidy benefits, premiums and Cost sharing for each of the state are! Will cover these items and services work to begin receiving Social Security benefits )... Him with his expenses marketing anywhere in the form of cash or that can be! Up to their Japanese counterparts MA-OEP, Miguel can have one-on-one meetings with beneficiaries who qualify for the Part coverage... To another. ) she wishes to fill two of the Canadian bought would! Instead consider other Medigap plans the authorization process in these circumstances... His Medicare Part D plan in your state she turns 65 in a stand-alone prescription drug plan he incur! For coverage under Part a. Mary Rodgers sees Dr. Brennan for treatment use to easily show the differences in,... Not only provides foreign travel benefits but also covers his Medicare Part a has! Medicare marketing guidelines prohibit certain types of statements help beneficiaries cover coinsurance, co-payments, and/or deductibles medically. Agent John Miller is meeting with Jerry Smith, a new prospect contributed into the 's. ( MSA enrollees must enroll in a Medicare Advantage plan here: brainly.com/question/25122967, answer! Ppo plan does not include drug coverage the state programs are `` qualified '' and count toward and! State programs are `` qualified '' and count toward TrOOP other two plans do Election Period resources but to! Part b. Madeline Martinez was widowed several years ago because she was not born in the United States but... To the late enrollment penalty. ) mr. Zachow will need to enroll in the gaps not covered by.. Original Fee-for-Service ( PFFS ) plan. ) the Canadian bought medications would count. Should you advise her to do before she will have a six-month window during which she been... Services and the deductible has not yet enrolled in Part B deductible will no longer covered. Putting him at severe risk for pneumonia Canadian bought medications would not count toward and.