Answered

Canada, Kaysey 08/02/2024 10:06 AM • Agent Roderick enrolls retiree Mrs. Martinez in a medical savings account (MSA) Medicare health plan. The MSA plan does not offer prescription drug coverage, so Agent Roderick also enrolls Mrs. Martinez in a standalone prescription drug plan (PDP). What CMS compensation rules apply to this situation?
Question 50Answer
a.
This situation is considered a “dual enrollment,” and CMS compensation rules are applied to the two plans at once and independently of each other.
b.
MSA Medicare health plans are subject to special rules limiting initial year compensation to 50 percent of the fair market value (FMV) published annually by CMS. Regular initial year enrollment rules apply to the PDP.
c.
Regular CMS and renewal compensation rules apply to the PDP enrollment, but compensation is limited to $100 for the MSA health plan enrollment to recompense CMS for contributions made to the enrollee’s MSA account.
d.
When an MSA Medicare health plan is combined with a PDP, initial and renewal year(s) compensation is paid only for the MSA enrollment to recompense CMS for contributions made to the enrollee’s MSA account.