NABIP Medicare case studies
NABIP Medicare · Put your knowledge to work in context.
The NABIP Medicare Advantage Certification - marketed by NABIP as the "2027 Medicare, Medicare Products & FWA Certification" - is a professional development credential offered through NABIP's Professional Development and Medicare Portal resources. NABIP states the program is designed to help agents "stay compliant, earn CE credits, and prepare for a successful Medicare selling season" and to "confidently serve Medicare beneficiaries and meet compliance requirements." It is aimed at licensed health insurance agents and brokers who sell or service Medicare products, particularly Medicare Advantage, and who need to demonstrate current knowledge of Medicare rules, product structures, and fraud, waste and abuse (FWA) standards. The NABIP Medicare case studies are 5 cases and about 2,533 words.
1Delaying Medicare While Contributing to an HSA
Lena is 64 years and 10 months old. She works full time for a private employer with 40 employees and is covered by the company’s HDHP; her spouse is on the same plan.
450 words, about 2 min2MA-PD vs Medigap for a Traveling Beneficiary With COPD
Ruth is 71, has COPD and type 2 diabetes, and has been in a Medicare Advantage-PD plan for four years. Her plan has a 0 premium, a 4,900 in-network out-of-pocket maximum, and an 8,000 combined in/out-of-network maximum.
439 words, about 2 min3Pharmacy Referral Payments and Copay Waivers
A local pharmacy owner asks agent Marcus to attend a senior fair and steer beneficiaries to the pharmacy’s “Medicare help desk.” The owner offers Marcus 40 for each beneficiary who lists Marcus’s name on an enrollment form and says the pharmacy will routinely waive the 30 copay for a preferred Medicare Advantage-PD plan’s tier 3 drug. Separately, a plan marketing representative tells Marcus that the plan will pay a $100 “referral bonus” for every dual-eligible beneficiary who enrolls in its D-SNP, even if Marcus is not the agent of record.
539 words, about 3 min4September Seminar, Lunch, and a Gift Card Raffle
Agent Priya wants to hold a “Medicare 101” seminar on September 20 at a restaurant. She plans to serve a 22 plated lunch and raffle one 100 grocery gift card.
535 words, about 3 min5Mid-Year Move From an MA Plan to Medigap
Ethan is 68 and enrolled in a Medicare Advantage HMO in Ohio. On June 1 he moves permanently to Arizona to live near his son.
570 words, about 3 min