An older adult asks a nurse, I saw an advertisement and went to a ...

[mynx]

An older adult asks a nurse, I saw an advertisement and went to a free breakfast to hear about Medicare Advantage Plans. They sound really good, but I am not sure. Are there benefits to joining one?
 
  The nurse relies on which of the following information when formulating a response? (Select all that apply.)
  a. All Medicare advantage plans have pre-scription drug coverage.
  b. Medicare advantage plans must cover all services traditionally covered by Medicare Parts A and B.
  c. There are no deductibles in Medicare Ad-vantage plans.
  d. Medicare advantage plans may provide a cost savings to the member.
  e. Members must obtain a referral to see a specialist from an assigned primary care provider.

Question 2

When educating an older adult about Medicare Part D, which information will be included? (Se-lect all that apply.)
 
  a. It is an elective prescription drug plan with associated out-of-pocket premiums.
  b. All persons with either Medicare Part A or B can voluntarily purchase a Medicare Part D prescription drug plan.
  c. The plan covers all costs of drugs after a deductible is paid.
  d. The plan is not available for individuals who are receive both Medicaid and Med-icare.
  e. This prescription drug plan requires client co-payments.

[Viet Thy]

Answer to Question 1

ANS: B, D, E
Medicare Advantage Plans (MAPs), or Medicare Part C, use a prospective payment system and includes traditional health maintenance organizations (HMOs) and other managed care plans. All traditional services covered by Medicare Parts A and B must be provided, and additional ser-vices, co-pays, and deductibles are predetermined. Medicare Advantage Plans may or may not provide prescription drug benefits. MAPs may provide a cost savings to the member as well as extra benefits. However, special rules must be followed, including the requirement that no care is obtained without a referral from an assigned primary care provider.

Answer to Question 2

ANS: A, B, E
An individual with Medicare Part D prescription drug coverage pays a deductible and co-payments. The other options represent inaccurate information regarding Medicare Part D.