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    mr. bickford did not quite qualify for the extra help low-income subsidy under the medicare part d prescription drug program and he is wondering if there is any other option he has for obtaining help with his considerable drug costs. what should you tell him?

    James

    Guys, does anyone know the answer?

    get mr. bickford did not quite qualify for the extra help low-income subsidy under the medicare part d prescription drug program and he is wondering if there is any other option he has for obtaining help with his considerable drug costs. what should you tell him? from EN Bilgi.

    Extra Help with Medicare Prescription Drug Plan Costs

    Learn about receiving Extra Help with Medicare Prescription Drug Plan Costs.

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    Social Security

    Extra Help with Medicare Prescription Drug Plan Costs (En español)

    Medicare beneficiaries can qualify for Extra Help paying for their monthly premiums, annual deductibles, and co-payments related to Medicare prescription drug coverage.

    We estimate the Extra Help is worth about $5,100 per year. To qualify for Extra Help, you must be receiving Medicare and have limited resources and income. You must also reside in one of the 50 states or the District of Columbia.

    Find Out if You Qualify

    Apply for Extra Help

    Apply Online

    The application for Extra Help does not enroll you in a Medicare Prescription Drug Plan. You do not need to be enrolled in a Medicare Prescription Drug Plan to file for Extra Help. However, the Extra Help assistance does not start until you’re enrolled with an approved Medicare prescription drug provider.

    Apply Online for Extra Help

    Other Ways to Apply

    You can call us at 1-800-772-1213 (TTY 1-800-325-0778) to apply over the phone. You can also request a paper application, or you can schedule an appointment to apply at your local Social Security office.

    For help completing your application, see Instructions for Completing the Application for Extra Help with Medicare Prescription Drug Plan Costs (SSA-1020-INST). The instructions are only guidelines and not to be used as applications.

    These instructions are also available in other languages in our Multilanguage Gateway.

    Appeal A Decision

    If you disagree with the decision we made about your eligibility for Extra Help, complete an Appeal of Determination for Extra Help with Medicare Prescription Drug Plan Costs. We also provide Instructions for Completing the Appeal.

    Once You Receive Extra Help

    If you are already receiving Extra Help, we must review your eligibility periodically. We’ll ask you to complete the Review of Your Eligibility for Extra Help (SSA-1026B) to ensure you’re still eligible for Extra Help and receiving all the benefits you deserve.

    Medicare Savings Programs (MSP)

    With the Medicare Savings Programs, you can get help from your state, paying your Medicare premiums. In some cases, MSPs may also pay Medicare Part A (hospital insurance) and Medicare Part B (medical insurance) deductibles, coinsurance, and copayments if you meet certain conditions. If you qualify for certain MSPs, you automatically qualify to get Extra Help paying for Medicare prescription drug coverage. To learn more, read Get help with your Medicare costs (CMS Product No. 10126).

    Related Information

    Understanding The Extra Help With Your Medicare Prescription Drug Plan (Publication No. 05-10508)

    Your Guide to Medicare Prescription Drug Coverage (CMS Product No. 11109)

    Quick Facts about Medicare Plans and Protecting Your Personal Information (CMS Product No. 11147)

    Other CMS Medicare Publications

    State Health Insurance Counseling and Assistance Program (SHIP)

    Extra Help program guide for organizations

    Medicare for Older Adults (National Council on Aging)

    Medicare Rx - Connect

    Share Your Feedback

    Source : www.ssa.gov

    AHIP 2018 Module 3

    Study with Quizlet and memorize flashcards terms like Mr. Katz reached the Part D coverage gap in August last year. His prescriptions have not changed, he is keeping the same Part D plan and the benefits, cost-sharing, and coverage of his drugs are all the same as last year. He asked what to expect for this year about his out-of-pocket costs. What could you tell him? Choose one answer. a. Because he reached the coverage gap in August last year, he probably will reach it much earlier this year. b. Because he reached the coverage gap last year, he will probably reach it again this year close to the same time. c. Because he reached the coverage gap last year, he will not have to go through it again this year. d. Because he reached the coverage gap in August last year, he probably won't reach it until much later this year., Mrs. Grant uses several very expensive drugs and anticipates that she will enter catastrophic coverage at some point during the year. To help her determine when she is likely to qualify for catastrophic coverage, she asked which expenses count toward the out-of-pocket limit that qualifies her for catastrophic coverage. Which one of the following would count? Choose one answer. a. Prescription drugs she purchases on her vacation to Canada. b. Prescription drugs she purchases when in the Part D coverage gap. c. Prescription drugs she purchases on her own that are not on her Part D plan's formulary. d. Non-prescription, over-the-counter medications she purchases., Mr. Shapiro gets by on a very small fixed income. He has heard there may be extra help paying for Part D prescription drugs for Medicare beneficiaries with limited income. He wants to know whether he might qualify. What should you tell him? Choose one answer. a. He must apply for the extra help at the same time he applies for enrollment in a Part D plan. If he missed this opportunity, he will not be able to apply for the extra help again until the next annual enrollment period. b. The extra help is available only to Medicare beneficiaries who are enrolled in Medicaid. He should apply for coverage under his state's Medicaid program to access the extra help with his drug costs. c. The extra help is available to beneficiaries whose income and assets do not exceed annual limits specified by the government. 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. Mr. Shapiro should check with his plan to see if he qualifies. and more.

    AHIP 2018 Module 3 - Part D Enrollee Costs and Assistance Programs

    7 studiers in the last hour

    Mr. Katz reached the Part D coverage gap in August last year. His prescriptions have not changed, he is keeping the same Part D plan and the benefits, cost-sharing, and coverage of his drugs are all the same as last year. He asked what to expect for this year about his out-of-pocket costs. What could you tell him?

    Choose one answer.

    a. Because he reached the coverage gap in August last year, he probably will reach it much earlier this year.

    b. Because he reached the coverage gap last year, he will probably reach it again this year close to the same time.

    c. Because he reached the coverage gap last year, he will not have to go through it again this year.

    d. Because he reached the coverage gap in August last year, he probably won't reach it until much later this year.

    Click card to see definition 👆

    b. Because he reached the coverage gap last year, he will probably reach it again this year close to the same time.

    Click again to see term 👆

    Mrs. Grant uses several very expensive drugs and anticipates that she will enter catastrophic coverage at some point during the year. To help her determine when she is likely to qualify for catastrophic coverage, she asked which expenses count toward the out-of-pocket limit that qualifies her for catastrophic coverage. Which one of the following would count?

    Choose one answer.

    a. Prescription drugs she purchases on her vacation to Canada.

    b. Prescription drugs she purchases when in the Part D coverage gap.

    c. Prescription drugs she purchases on her own that are not on her Part D plan's formulary.

    d. Non-prescription, over-the-counter medications she purchases.

    Click card to see definition 👆

    b. Prescription drugs she purchases when in the Part D coverage gap.

    Click again to see term 👆

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    Terms in this set (5)

    Mr. Katz reached the Part D coverage gap in August last year. His prescriptions have not changed, he is keeping the same Part D plan and the benefits, cost-sharing, and coverage of his drugs are all the same as last year. He asked what to expect for this year about his out-of-pocket costs. What could you tell him?

    Choose one answer.

    a. Because he reached the coverage gap in August last year, he probably will reach it much earlier this year.

    b. Because he reached the coverage gap last year, he will probably reach it again this year close to the same time.

    c. Because he reached the coverage gap last year, he will not have to go through it again this year.

    d. Because he reached the coverage gap in August last year, he probably won't reach it until much later this year.

    b. Because he reached the coverage gap last year, he will probably reach it again this year close to the same time.

    Mrs. Grant uses several very expensive drugs and anticipates that she will enter catastrophic coverage at some point during the year. To help her determine when she is likely to qualify for catastrophic coverage, she asked which expenses count toward the out-of-pocket limit that qualifies her for catastrophic coverage. Which one of the following would count?

    Choose one answer.

    a. Prescription drugs she purchases on her vacation to Canada.

    b. Prescription drugs she purchases when in the Part D coverage gap.

    c. Prescription drugs she purchases on her own that are not on her Part D plan's formulary.

    d. Non-prescription, over-the-counter medications she purchases.

    b. Prescription drugs she purchases when in the Part D coverage gap.

    Mr. Shapiro gets by on a very small fixed income. He has heard there may be extra help paying for Part D prescription drugs for Medicare beneficiaries with limited income. He wants to know whether he might qualify. What should you tell him?

    Choose one answer.

    a. He must apply for the extra help at the same time he applies for enrollment in a Part D plan. If he missed this opportunity, he will not be able to apply for the extra help again until the next annual enrollment period.

    b. The extra help is available only to Medicare beneficiaries who are enrolled in Medicaid. He should apply for coverage under his state's Medicaid program to access the extra help with his drug costs.

    c. The extra help is available to beneficiaries whose income and assets do not exceed annual limits specified by the government.

    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. Mr. Shapiro should check with his plan to see if he qualifies.

    c. The extra help is available to beneficiaries whose income and assets do not exceed annual limits specified by the government.

    Mrs. Fields wants to know whether applying for the Part D low income subsidy will be worth the time to fill out the paperwork. What could you tell her?

    Choose one answer.

    a. The Part D low income subsidy could substantially lower her overall costs. She can apply by contacting her state Medicaid office, or calling the Social Security Administration.

    b. The Part D low income subsidy will not help her once she reaches the coverage gap, so she need not take the time to apply.

    c. Those who qualify for the Part D low income subsidy pay nothing for any of their medications. She should definitely apply if she believes there is any chance of her qualifying.

    Source : quizlet.com

    Test 3 Flashcards

    Study Test 3 flashcards. Create flashcards for FREE and quiz yourself with an interactive flipper.

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    Test 3

    25cards Desireé S. Pharmacy Pharmacy

    Mr Carini has heard that PDP's are only offered through private companies under a program known as MA, not by the government

    He can stay with original Medicare and also enroll in Medicare pDP through a private company that has contracted with the government to provide only such drug coverage to Medicare eligibles

    Mrs. Mulcahy is concerned that she may not qualify for enrollments in a PDP because she is not enrolled in Medicare part B

    Everyone who is entitled to part a or in rolled in part B is eligible for a PDP. As long as they're entitled to part A, they do not need to enroll under part B before enrolling in a PDP

    Mrs. Lopez has enrolled in a MA-cost plan. She recently lost credible coverage previously available through her husband's employer. She's interested in a PDP.

    If part D benefit is offered through her plans she may choose to enroll in that plan or a standalone PDP

    All plans must cover at least the standard part D coverage or it's equivalent. What costs would a beneficiary incur for prescription drugs in 2018 and under standard coverage?

    Part D coverage would require payment of an annual deductible, 25% cost sharing up to the coverage gap, a portion of costs for both generics and brand-name drugs in the gap, and co-pays or coinsurance after the coverage gap.

    Mrs. Andrews is preparing a budget for next year because she takes quite a few prescription drugs. She wants to be sure she has enough money set-aside for those months. She got help calculating her expenses from her pharmacist, but thinks the calculations are incorrect because her out-of-pocket expense would be lower than last year

    It would not be unusual for her cost to be last because each year until 2020 the share of drug costs in coverage gap decrease

    Mr. Jacob understands that there is a standard Medicare part D prescription drug benefit, but when he looks at information on various plans he sees a wide range of deductibles, premiums, and Cost sharing . Explain.

    Medicare part D drug plans may have different benefits fractures, but on average, they must all be at least as good as the standard model established by the government

    Miss Edwards is in rolled in a Medicare advantage plan that includes a PDP. She's traveling and wishes to fill her two prescriptions, how do you advise her?

    She may fill prescriptions for covered drugs at non-network pharmacies, but likely at a higher cost

    What types of tools can Medicare part D prescription drug plans use that affect the way their enrollees Can access medication

    Part D plans do not have to cover all medications. As a result, their formularies, or list of all the coverage, will Gary from Planned to Planned. In addition, they can use cost containment techniques such as tiered copayments and prior authorization

    Mrs. Allen has a rare condition for which two different brand-name drugs are the only available treatment. She is concerned that since no generic prescription drug is available and these drugs are very expensive she will not be able to find Medicare part D prescription drug plan that covers either one of them.

    Medicare prescription drug plans are required to cover drugs in each therapeutic category. She should be able to enroll and he Medicare prescription drug plan that covers the medications she needs

    Under what conditions can Medicare prescription drug plan reduce its coverage for a given drug midway through the year

    When a new generic drug for the same condition becomes available or when the FDA or manufacture withdraws the drug from the market, a brand-name drug can be replaced.

    Mrs. Roswell is a new Medicare recipient and is interested in selecting part D prescription drug plan. She takes a number of medications and is concerned that she’s not been able to identify the plan that covers all of her medications. She does not want to make an abrupt change to new drugs that would be covered and asked what she should do.

    Every part D plan is required to cover a 30 day supply of existing locations sometime during a 90 day transition period

    Mr Zachow Has a condition for which three drugs are available. He has tried to, but had an allergic reaction to them. Only the third drug works for him and it is not on his part D formulary.

    He has a right to request a formulary exception to obtain coverage for this drug. He or his position could’ve changed the standardized request from the Planned website fill it out and submit it to the carrier

    Mr. and Mrs.Vaughn both take a specialized multivitamin prescription each day. Mr. von also takes a prescription for hair growth. They are anxious to have their Medicare drug plan cover these drugs

    Medicare prescription drug plans are not permitted to cover the prescription medications Vons are interested in under part D coverage, however, Planned may cover them as supplemental benefits

    Mr. Katz reached the part D coverage gap in August last year. His prescriptions have not changed, he is keeping the same plan and benefits, Katherine, and coverage as last year. He asked what to expect for this year regarding his out-of-pocket expenses

    Because he reach the coverage gap last year, he will probably reach it again this year close to the same time

    Mr. Schapiro gets by on a very low income. He has heard there may be extra help paying for prescription drugs he wants to know whether or not he will qualify

    Source : www.chegg.com

    Do you want to see answer or more ?
    James 9 day ago
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    Guys, does anyone know the answer?

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