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State RegulationsFL specificDifficulty 2/5

A Florida consumer has Medicaid benefits that already pay her Medicare deductibles and coinsurance. Her agent proposes to sell her a Medicare supplement policy. What is the primary problem?

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Answer & full 3-part explanation (select an option above, or peek)

Why A is correct

Medicaid is the government health coverage program for people with limited income and resources, and for qualifying recipients it can pay Medicare cost-sharing — the very deductibles and coinsurance a Medicare supplement policy would cover. Under Chapter 627, Florida Statutes, and the sales practice standards enforced by the Department of Financial Services, selling a Med Supp that duplicates existing coverage is inappropriate. The agent should verify what coverage the consumer already has before recommending a supplement.

Why the other options are wrong

  • B) Medicaid does not prohibit recipients from owning insurance; the issue is duplication of benefits, not ownership.
  • C) A Medicare supplement policy does not replace or affect Medicaid eligibility.
  • D) Medicare supplement policies are tied to Medicare enrollment, not to Medicaid receipt.

Memory hook

Medicaid filling the gap? A Med Supp buys nothing.

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