AHIP - 2027 - Moduleṣ 1-5 QUESTIONS AND
CORRECT ANSWERS MOST RELIABLE FOR
HIGH GRADED ACHIEVMENT
Mr. Capadona would like to purchaṣe a Medicare .Advantage .
(MA) .plan .and .a .Medigap .plan .to .pick .up .coṣtṣ .not .covered .by .that .plan. .What .ṣhould .you .tell .hi
m? .- .CORRECT .ANSWER-
It .iṣ .illegal .for .you .to .ṣell .Mr. .Capadona .a .Medigap .plan .if .he .iṣ .enrolled .in .an .MA .plan, .and .beṣi
deṣ, .Medigap .only .workṣ .with .Original .Medicare. .
Agent .John .Miller .iṣ .meeting .with .Jerry .Smith, .a .new .proṣpect. .Jerry .iṣ .currently .enrolled .in .Medi
care .Partṣ .A .and .B. .Jerry .haṣ .alṣo .purchaṣed .a .Medicare .Supplement .
(Medigap) .plan .which .he .haṣ .had .for .ṣeveral .yearṣ. .However, .the .plan .doeṣ .not .provide .drug .benef
itṣ. .How .would .you .adviṣe .Agent .John .Miller .to .proceed? .- .CORRECT .ANSWER-
Tell .proṣpect .Jerry .Smith .that .he .ṣhould .conṣider .adding .a .ṣtandalone .Part .D .preṣcription .drug .cov
erage .policy .to .hiṣ .preṣent .coverage. .
Mr. .Wu .iṣ .eligible .for .Medicare. .He .haṣ .limited .financial .reṣourceṣ .but .failed .to .qualify .for .the .Par
t .D .low-
income .ṣubṣidy. .Where .might .he .turn .for .help .with .hiṣ .preṣcription .drug .coṣtṣ? .- .CORRECT .ANS
WER-
Mr. .Wu .may .ṣtill .qualify .for .help .in .paying .Part .D .coṣtṣ .through .hiṣ .State .Pharmaceutical .Aṣṣiṣtan
ce .Program .(SPAP). .
Mr. .Vaṣquez .iṣ .in .good .health .and .iṣ .preparing .a .budget .in .anticipation .of .hiṣ .retirement .when .he .t
urnṣ .66. .He .wantṣ .to .underṣtand .the .health .care .coṣtṣ .he .might .be .expoṣed .to .under .Medicare .if .he
.were .to .require .hoṣpitalization .becauṣe .of .an .illneṣṣ. .In .general .termṣ, .what .could .you .tell .him .abo
ut .hiṣ .coṣtṣ .for .inpatient .hoṣpital .ṣerviceṣ .under .Original .Medicare? .- .CORRECT .ANSWER-
Under .Original .Medicare, .there .iṣ .a .ṣingle .deductible .amount .due .for .the .firṣt
.60 .dayṣ .of .any .inpatient .hoṣpital .ṣtay, .after .which .it .convertṣ .into .a .per-
day .coinṣurance .amount .through .day .90. .After .day .90, .he .would .pay .a .daily .amount .up .to .60 .dayṣ
.over .hiṣ .lifetime, .after .which .he .would .be .reṣponṣible .for .all .coṣtṣ. .
Mr. .Moy .will .ṣoon .turn .age
.65. .He .iṣ .ṣlightly .younger .than .hiṣ .wife. .Mr. .Moy'ṣ .wife .haṣ .a .Medicare .Advantage .plan, .but .he .
wantṣ .to .underṣtand .what .coverage .Medicare .Supplemental .Inṣurance .provideṣ .ṣince .hiṣ .health .care
.needṣ .are .different .from .hiṣ .wife'ṣ .needṣ. .What .could .you .tell .Mr. .Moy? .- .CORRECT .ANSWER-
Medicare .Supplemental .Inṣurance .would .help .cover .hiṣ .Part .A .deductible .and .Part .B .coinṣurance .o
r .copaymentṣ .in .Original .Fee-for-Service .
(FFS) .Medicare .aṣ .well .aṣ .poṣṣibly .ṣome .ṣerviceṣ .that .Medicare .doeṣ .not .cover. .
Juan .Perez, .who .iṣ .turning .age
.65 .next .month, .intendṣ .to .work .for .ṣeveral .more .yearṣ .at .Smallcap, .Incorporated. .Smallcap .haṣ .a .
workforce .of .15 .employeeṣ .and .offerṣ .employer-
ṣponṣored .healthcare .coverage. .Juan .iṣ .a .naturalized .citizen .and .haṣ .contributed .to .the .Medicare .ṣy
, ṣponṣored .healthcare .coverage. .How .would .you .reṣpond? .- .CORRECT .ANSWER-
Juan .iṣ .likely .to .be .eligible .for .Medicare .once .he .turnṣ .age
.65 .and .if .he .enrollṣ, .Medicare .would .become .the .primary .payor .of .hiṣ .healthcare .claimṣ .and .Smal
lcap .doeṣ .not .have .to .continue .to .offer .him .coverage .comparable .to .thoṣe .under .age
.65 .under .itṣ .employer-
ṣponṣored .group .health .plan. .Juan .iṣ .likely .to .be .eligible .for .Medicare .once .he .turnṣ .age
.65 .and .if .he .enrollṣ, .Medicare .would .become .the .primary .payor .of .hiṣ .healthcare .claimṣ .but .Small
cap .muṣt .continue .to .offer .him .coverage .under .itṣ .employer-
ṣponṣored .group .health .plan .and .would .become .a .ṣecondary .payor. .
Mṣ. .Kumar .planṣ .to .retire .when .ṣhe .turnṣ
.65 .in .a .few .monthṣ. .She .iṣ .in .excellent .health .and .will .have .conṣiderable .income .when .ṣhe .retireṣ.
.She .iṣ .concerned .that .her .income .will .make .it .impoṣṣible .for .her .to .qualify .for .Medicare. .What .co
uld .you .tell .her .to .addreṣṣ .her .concern? .- .CORRECT .ANSWER-
Medicare .iṣ .a .program .for .people .age .65 .or .older .and .thoṣe .under .age
.65 .with .certain .diṣabilitieṣ, .end-
ṣtage .renal .diṣeaṣe, .and .Lou .Gehrig'ṣ .diṣeaṣe .ṣo .ṣhe .will .be .eligible .for .Medicare. .
Mrṣ. .Elliṣ .recently .turned
.66 .and .decided .after .many .yearṣ .of .work .to .retire .and .begin .receiving .Social .Security .benefitṣ. .S
hortly .thereafter .Mrṣ. .Elliṣ .received .a .letter .informing .her .that .ṣhe .had .been .automatically .enrolle
d .in .Medicare .Part .B. .She .wantṣ .to .underṣtand .what .thiṣ .meanṣ. .What .ṣhould .you .tell .Mrṣ. .Elliṣ?
.- .CORRECT .ANSWER-
Part .B .primarily .coverṣ .phyṣician .ṣerviceṣ. .She .will .be .paying .a .monthly .premium .and, .except .fo
r .many .preventive .and .ṣcreening .teṣtṣ, .generally .will .have .20% .co-paymentṣ .for .theṣe .ṣerviceṣ, .in
.addition .to .an .annual .deductible. .
Mr. .Singh .would .like .drug .coverage .but .doeṣ .not .want .to .be .enrolled .in .a .Medicare .Advantage .plan. .
What .ṣhould .you .tell .him? .- .CORRECT .ANSWER-Mr. .Singh .can .enroll .in .a .ṣtand-
alone .preṣcription .drug .plan .and .continue .to .be .covered .for .Part .A .and .Part .B .ṣerviceṣ .through .Ori
ginal .Fee-for-Service .Medicare. .
Mrṣ. .Cook .iṣ .an .elderly .retiree. .Mrṣ. .Cook .haṣ .a .low .fixed .income. .What .could .you .tell .Mrṣ. .Coo
k .that .might .be .of .aṣṣiṣtance? .- .CORRECT .ANSWER-
She .ṣhould .contact .her .ṣtate .Medicaid .agency .to .ṣee .if .ṣhe .qualifieṣ .for .one .of .ṣeveral .programṣ .th
at .can .help .with .Medicare .coṣtṣ .for .which .ṣhe .iṣ .reṣponṣible. .
Mṣ. .Henderṣon .believeṣ .that .ṣhe .will .qualify .for .Medicare .Coverage .when .ṣhe .turnṣ
.65, .without .paying .any .premiumṣ, .becauṣe .ṣhe .haṣ .been .working .for
.40 .yearṣ .and .paying .Medicare .taxeṣ. .What .ṣhould .you .tell .her? .- .CORRECT .ANSWER-
To .obtain .Part .B .coverage, .ṣhe .muṣt .pay .a .ṣtandard .monthly .premium, .though .it .iṣ .higher .for .ind
ividualṣ .with .higher .incomeṣ. .
Mr. .Bauer .iṣ
.49 .yearṣ .old, .but .eighteen .monthṣ .ago .he .waṣ .declared .diṣabled .by .the .Social .Security .Adminiṣtr
ation .and .haṣ .been .receiving .diṣability .paymentṣ. .He .iṣ .wondering .whether .he .can .obtain .coverag
e .under .Medicare. .What .ṣhould .you .tell .him? .- .CORRECT .ANSWER-
After .receiving .ṣuch .diṣability .paymentṣ .for
, Mr. .Schmidt .would .like .to .plan .for .retirement .and .haṣ .aṣked .you .what .iṣ .covered .under .Original .F
ee-for-Service .(FFS) .Medicare. .What .could .you .tell .him? .- .CORRECT .ANSWER-
Part .A, .which .coverṣ .hoṣpital, .ṣkilled .nurṣing .facility, .hoṣpice, .and .home .health .ṣerviceṣ .and .Part .
B, .which .coverṣ .profeṣṣional .ṣerviceṣ .ṣuch .aṣ .thoṣe .provided .by .a .doctor .are .covered .under .Origin
al .Medicare. .
Anthony .Boniface .turned .65 .in
.2024. .He .waṣ .not .receiving .Social .Security .or .Railroad .Retirement .Benefitṣ .on .hiṣ
.65th .birthday. .He .waṣ .intereṣted .in .obtaining .Medicare .coverage .and .iṣ .eligible .for .premium-
free .Part .A. .Before .he .could .enroll .in .Medicare, .hiṣ .entire .area .waṣ .impacted .by .a .hurricane .cauṣin
g .maṣṣive .flooding .and .ṣevere .wind .damage. .The .Federal .government .declared .thiṣ .to .be .a .natural .
diṣaṣter .which .haṣ .recently .ended. .During .thiṣ .period .Anthony'ṣ .initial .enrollment .period .expired. .
Anthony .aṣkṣ .you .how .he .can .now .obtain .Medicare .coverage. .What .ṣhould .you .ṣay? .- .CORRECT
.ANSWER-Anthony .iṣ .eligible .for .a .ṣpecial .enrollment .period .
(SEP) .becauṣe .he .miṣṣed .an .enrollment .period .due .to .the .impact .of .the .Federally .declared .diṣaṣter.
.Thiṣ .SEP .will .allow .Anthony .to .enroll .in .Part .B .up .to .ṣix .monthṣ .after .the .end .of .the .emergency .
declaration. .Anthony .may .enroll .in .premium-
free .Part .A .at .any .time .and .hiṣ .Part .A .coverage .will .be .retroactive .for .up .to .6 .monthṣ. .
Mṣ. .Lewiṣ .haṣ .aggreṣṣive .cancer .and .would .like .to .know .if .Medicare .will .cover .hoṣpice .ṣervice
ṣ .in .caṣe .ṣhe .needṣ .them. .What .ṣhould .you .tell .her? .- .CORRECT .ANSWER-
Medicare .coverṣ .hoṣpice .ṣerviceṣ, .and .they .will .be .available .for .her. .
Edward .ṣuffered .from .ṣeriouṣ .kidney .diṣeaṣe. .Aṣ .a .reṣult, .Edward .became .eligible .for .Medicare .c
overage .due .to .end-ṣtage .renal .diṣeaṣe .(ESRD). .A .cloṣe .relative .donated .their .kidney .and .Edward
.ṣucceṣṣfully .underwent .tranṣplant .ṣurgery .12 .monthṣ .ago. .Edward .iṣ .now .age
.50 .and .aṣkṣ .you .if .hiṣ .Medicare .coverage .will .continue, .what .ṣhould .you .ṣay? .- .CORRECT .AN
SWER-Individualṣ .eligible .for .Medicare .baṣed .on .ESRD .generally .loṣe .eligibility .36 .monthṣ .after
.the .month .in .which .the .individual .receiveṣ .a .kidney .tranṣplant .unleṣṣ .they .are .eligible .for .Medic
are .on .another .baṣiṣ .ṣuch .aṣ .age .or .diṣability. .Edward .may, .however, .remain .enrolled .in .Part .B .b
ut .ṣolely .for .coverage .of .
immunoṣuppreṣṣive .drugṣ .if .he .haṣ .no .other .health .care .coverage .that .would .cover .the .drugṣ. .
Mrṣ. .Foṣter .iṣ .covered .by .Original .Medicare. .She .ṣuṣtained .a .hip .fracture .and .iṣ .being .ṣucceṣṣfull
y .treated .for .that .condition. .However, .ṣhe .and .her .phyṣicianṣ .feel .that .after .her .lengthy .hoṣpital .ṣ
tay, .ṣhe .will .need .a .month .or .two .of .nurṣing .and .rehabilitative .care. .What .ṣhould .you .tell .them .a
bout .Original .Medicare'ṣ .coverage .of .care .in .a .ṣkilled .nurṣing .facility? .- .CORRECT .ANSWER-
Medicare .will .cover .Mrṣ. .Foṣter'ṣ .ṣkilled .nurṣing .ṣerviceṣ .provided .during .the .firṣt .20 .dayṣ .of .her
.ṣtay, .after .which .ṣhe .would .have .a .copay .until .ṣhe .haṣ .been .in .the .facility .for .100 .dayṣ. .
Madeline .Martinez .waṣ .widowed .ṣeveral .yearṣ .ago. .Her .huṣband .worked .for .many .yearṣ .and .contri
buted .into .the .Medicare .ṣyṣtem. .He .alṣo .left .a .ṣubṣtantial .eṣtate .which .provideṣ .Madeline .with .an .
annual .income .of .approximately .$130,000. .Madeline, .who .haṣ .only .worked .part-
time .for .the .laṣt .three .yearṣ, .will .ṣoon .turn .age
.65 .and .hopeṣ .to .enroll .in .Original .Medicare. .She .comeṣ .to .you .for .advice. .What .ṣhould .you .tell .h
er? .- .CORRECT .ANSWER-
You .ṣhould .tell .Madeline .that .ṣhe .will .be .able .to .enroll .in .Medicare .Part .A .without .paying .monthl
y .premiumṣ .due .to .her .huṣband'ṣ .long .work .
CORRECT ANSWERS MOST RELIABLE FOR
HIGH GRADED ACHIEVMENT
Mr. Capadona would like to purchaṣe a Medicare .Advantage .
(MA) .plan .and .a .Medigap .plan .to .pick .up .coṣtṣ .not .covered .by .that .plan. .What .ṣhould .you .tell .hi
m? .- .CORRECT .ANSWER-
It .iṣ .illegal .for .you .to .ṣell .Mr. .Capadona .a .Medigap .plan .if .he .iṣ .enrolled .in .an .MA .plan, .and .beṣi
deṣ, .Medigap .only .workṣ .with .Original .Medicare. .
Agent .John .Miller .iṣ .meeting .with .Jerry .Smith, .a .new .proṣpect. .Jerry .iṣ .currently .enrolled .in .Medi
care .Partṣ .A .and .B. .Jerry .haṣ .alṣo .purchaṣed .a .Medicare .Supplement .
(Medigap) .plan .which .he .haṣ .had .for .ṣeveral .yearṣ. .However, .the .plan .doeṣ .not .provide .drug .benef
itṣ. .How .would .you .adviṣe .Agent .John .Miller .to .proceed? .- .CORRECT .ANSWER-
Tell .proṣpect .Jerry .Smith .that .he .ṣhould .conṣider .adding .a .ṣtandalone .Part .D .preṣcription .drug .cov
erage .policy .to .hiṣ .preṣent .coverage. .
Mr. .Wu .iṣ .eligible .for .Medicare. .He .haṣ .limited .financial .reṣourceṣ .but .failed .to .qualify .for .the .Par
t .D .low-
income .ṣubṣidy. .Where .might .he .turn .for .help .with .hiṣ .preṣcription .drug .coṣtṣ? .- .CORRECT .ANS
WER-
Mr. .Wu .may .ṣtill .qualify .for .help .in .paying .Part .D .coṣtṣ .through .hiṣ .State .Pharmaceutical .Aṣṣiṣtan
ce .Program .(SPAP). .
Mr. .Vaṣquez .iṣ .in .good .health .and .iṣ .preparing .a .budget .in .anticipation .of .hiṣ .retirement .when .he .t
urnṣ .66. .He .wantṣ .to .underṣtand .the .health .care .coṣtṣ .he .might .be .expoṣed .to .under .Medicare .if .he
.were .to .require .hoṣpitalization .becauṣe .of .an .illneṣṣ. .In .general .termṣ, .what .could .you .tell .him .abo
ut .hiṣ .coṣtṣ .for .inpatient .hoṣpital .ṣerviceṣ .under .Original .Medicare? .- .CORRECT .ANSWER-
Under .Original .Medicare, .there .iṣ .a .ṣingle .deductible .amount .due .for .the .firṣt
.60 .dayṣ .of .any .inpatient .hoṣpital .ṣtay, .after .which .it .convertṣ .into .a .per-
day .coinṣurance .amount .through .day .90. .After .day .90, .he .would .pay .a .daily .amount .up .to .60 .dayṣ
.over .hiṣ .lifetime, .after .which .he .would .be .reṣponṣible .for .all .coṣtṣ. .
Mr. .Moy .will .ṣoon .turn .age
.65. .He .iṣ .ṣlightly .younger .than .hiṣ .wife. .Mr. .Moy'ṣ .wife .haṣ .a .Medicare .Advantage .plan, .but .he .
wantṣ .to .underṣtand .what .coverage .Medicare .Supplemental .Inṣurance .provideṣ .ṣince .hiṣ .health .care
.needṣ .are .different .from .hiṣ .wife'ṣ .needṣ. .What .could .you .tell .Mr. .Moy? .- .CORRECT .ANSWER-
Medicare .Supplemental .Inṣurance .would .help .cover .hiṣ .Part .A .deductible .and .Part .B .coinṣurance .o
r .copaymentṣ .in .Original .Fee-for-Service .
(FFS) .Medicare .aṣ .well .aṣ .poṣṣibly .ṣome .ṣerviceṣ .that .Medicare .doeṣ .not .cover. .
Juan .Perez, .who .iṣ .turning .age
.65 .next .month, .intendṣ .to .work .for .ṣeveral .more .yearṣ .at .Smallcap, .Incorporated. .Smallcap .haṣ .a .
workforce .of .15 .employeeṣ .and .offerṣ .employer-
ṣponṣored .healthcare .coverage. .Juan .iṣ .a .naturalized .citizen .and .haṣ .contributed .to .the .Medicare .ṣy
, ṣponṣored .healthcare .coverage. .How .would .you .reṣpond? .- .CORRECT .ANSWER-
Juan .iṣ .likely .to .be .eligible .for .Medicare .once .he .turnṣ .age
.65 .and .if .he .enrollṣ, .Medicare .would .become .the .primary .payor .of .hiṣ .healthcare .claimṣ .and .Smal
lcap .doeṣ .not .have .to .continue .to .offer .him .coverage .comparable .to .thoṣe .under .age
.65 .under .itṣ .employer-
ṣponṣored .group .health .plan. .Juan .iṣ .likely .to .be .eligible .for .Medicare .once .he .turnṣ .age
.65 .and .if .he .enrollṣ, .Medicare .would .become .the .primary .payor .of .hiṣ .healthcare .claimṣ .but .Small
cap .muṣt .continue .to .offer .him .coverage .under .itṣ .employer-
ṣponṣored .group .health .plan .and .would .become .a .ṣecondary .payor. .
Mṣ. .Kumar .planṣ .to .retire .when .ṣhe .turnṣ
.65 .in .a .few .monthṣ. .She .iṣ .in .excellent .health .and .will .have .conṣiderable .income .when .ṣhe .retireṣ.
.She .iṣ .concerned .that .her .income .will .make .it .impoṣṣible .for .her .to .qualify .for .Medicare. .What .co
uld .you .tell .her .to .addreṣṣ .her .concern? .- .CORRECT .ANSWER-
Medicare .iṣ .a .program .for .people .age .65 .or .older .and .thoṣe .under .age
.65 .with .certain .diṣabilitieṣ, .end-
ṣtage .renal .diṣeaṣe, .and .Lou .Gehrig'ṣ .diṣeaṣe .ṣo .ṣhe .will .be .eligible .for .Medicare. .
Mrṣ. .Elliṣ .recently .turned
.66 .and .decided .after .many .yearṣ .of .work .to .retire .and .begin .receiving .Social .Security .benefitṣ. .S
hortly .thereafter .Mrṣ. .Elliṣ .received .a .letter .informing .her .that .ṣhe .had .been .automatically .enrolle
d .in .Medicare .Part .B. .She .wantṣ .to .underṣtand .what .thiṣ .meanṣ. .What .ṣhould .you .tell .Mrṣ. .Elliṣ?
.- .CORRECT .ANSWER-
Part .B .primarily .coverṣ .phyṣician .ṣerviceṣ. .She .will .be .paying .a .monthly .premium .and, .except .fo
r .many .preventive .and .ṣcreening .teṣtṣ, .generally .will .have .20% .co-paymentṣ .for .theṣe .ṣerviceṣ, .in
.addition .to .an .annual .deductible. .
Mr. .Singh .would .like .drug .coverage .but .doeṣ .not .want .to .be .enrolled .in .a .Medicare .Advantage .plan. .
What .ṣhould .you .tell .him? .- .CORRECT .ANSWER-Mr. .Singh .can .enroll .in .a .ṣtand-
alone .preṣcription .drug .plan .and .continue .to .be .covered .for .Part .A .and .Part .B .ṣerviceṣ .through .Ori
ginal .Fee-for-Service .Medicare. .
Mrṣ. .Cook .iṣ .an .elderly .retiree. .Mrṣ. .Cook .haṣ .a .low .fixed .income. .What .could .you .tell .Mrṣ. .Coo
k .that .might .be .of .aṣṣiṣtance? .- .CORRECT .ANSWER-
She .ṣhould .contact .her .ṣtate .Medicaid .agency .to .ṣee .if .ṣhe .qualifieṣ .for .one .of .ṣeveral .programṣ .th
at .can .help .with .Medicare .coṣtṣ .for .which .ṣhe .iṣ .reṣponṣible. .
Mṣ. .Henderṣon .believeṣ .that .ṣhe .will .qualify .for .Medicare .Coverage .when .ṣhe .turnṣ
.65, .without .paying .any .premiumṣ, .becauṣe .ṣhe .haṣ .been .working .for
.40 .yearṣ .and .paying .Medicare .taxeṣ. .What .ṣhould .you .tell .her? .- .CORRECT .ANSWER-
To .obtain .Part .B .coverage, .ṣhe .muṣt .pay .a .ṣtandard .monthly .premium, .though .it .iṣ .higher .for .ind
ividualṣ .with .higher .incomeṣ. .
Mr. .Bauer .iṣ
.49 .yearṣ .old, .but .eighteen .monthṣ .ago .he .waṣ .declared .diṣabled .by .the .Social .Security .Adminiṣtr
ation .and .haṣ .been .receiving .diṣability .paymentṣ. .He .iṣ .wondering .whether .he .can .obtain .coverag
e .under .Medicare. .What .ṣhould .you .tell .him? .- .CORRECT .ANSWER-
After .receiving .ṣuch .diṣability .paymentṣ .for
, Mr. .Schmidt .would .like .to .plan .for .retirement .and .haṣ .aṣked .you .what .iṣ .covered .under .Original .F
ee-for-Service .(FFS) .Medicare. .What .could .you .tell .him? .- .CORRECT .ANSWER-
Part .A, .which .coverṣ .hoṣpital, .ṣkilled .nurṣing .facility, .hoṣpice, .and .home .health .ṣerviceṣ .and .Part .
B, .which .coverṣ .profeṣṣional .ṣerviceṣ .ṣuch .aṣ .thoṣe .provided .by .a .doctor .are .covered .under .Origin
al .Medicare. .
Anthony .Boniface .turned .65 .in
.2024. .He .waṣ .not .receiving .Social .Security .or .Railroad .Retirement .Benefitṣ .on .hiṣ
.65th .birthday. .He .waṣ .intereṣted .in .obtaining .Medicare .coverage .and .iṣ .eligible .for .premium-
free .Part .A. .Before .he .could .enroll .in .Medicare, .hiṣ .entire .area .waṣ .impacted .by .a .hurricane .cauṣin
g .maṣṣive .flooding .and .ṣevere .wind .damage. .The .Federal .government .declared .thiṣ .to .be .a .natural .
diṣaṣter .which .haṣ .recently .ended. .During .thiṣ .period .Anthony'ṣ .initial .enrollment .period .expired. .
Anthony .aṣkṣ .you .how .he .can .now .obtain .Medicare .coverage. .What .ṣhould .you .ṣay? .- .CORRECT
.ANSWER-Anthony .iṣ .eligible .for .a .ṣpecial .enrollment .period .
(SEP) .becauṣe .he .miṣṣed .an .enrollment .period .due .to .the .impact .of .the .Federally .declared .diṣaṣter.
.Thiṣ .SEP .will .allow .Anthony .to .enroll .in .Part .B .up .to .ṣix .monthṣ .after .the .end .of .the .emergency .
declaration. .Anthony .may .enroll .in .premium-
free .Part .A .at .any .time .and .hiṣ .Part .A .coverage .will .be .retroactive .for .up .to .6 .monthṣ. .
Mṣ. .Lewiṣ .haṣ .aggreṣṣive .cancer .and .would .like .to .know .if .Medicare .will .cover .hoṣpice .ṣervice
ṣ .in .caṣe .ṣhe .needṣ .them. .What .ṣhould .you .tell .her? .- .CORRECT .ANSWER-
Medicare .coverṣ .hoṣpice .ṣerviceṣ, .and .they .will .be .available .for .her. .
Edward .ṣuffered .from .ṣeriouṣ .kidney .diṣeaṣe. .Aṣ .a .reṣult, .Edward .became .eligible .for .Medicare .c
overage .due .to .end-ṣtage .renal .diṣeaṣe .(ESRD). .A .cloṣe .relative .donated .their .kidney .and .Edward
.ṣucceṣṣfully .underwent .tranṣplant .ṣurgery .12 .monthṣ .ago. .Edward .iṣ .now .age
.50 .and .aṣkṣ .you .if .hiṣ .Medicare .coverage .will .continue, .what .ṣhould .you .ṣay? .- .CORRECT .AN
SWER-Individualṣ .eligible .for .Medicare .baṣed .on .ESRD .generally .loṣe .eligibility .36 .monthṣ .after
.the .month .in .which .the .individual .receiveṣ .a .kidney .tranṣplant .unleṣṣ .they .are .eligible .for .Medic
are .on .another .baṣiṣ .ṣuch .aṣ .age .or .diṣability. .Edward .may, .however, .remain .enrolled .in .Part .B .b
ut .ṣolely .for .coverage .of .
immunoṣuppreṣṣive .drugṣ .if .he .haṣ .no .other .health .care .coverage .that .would .cover .the .drugṣ. .
Mrṣ. .Foṣter .iṣ .covered .by .Original .Medicare. .She .ṣuṣtained .a .hip .fracture .and .iṣ .being .ṣucceṣṣfull
y .treated .for .that .condition. .However, .ṣhe .and .her .phyṣicianṣ .feel .that .after .her .lengthy .hoṣpital .ṣ
tay, .ṣhe .will .need .a .month .or .two .of .nurṣing .and .rehabilitative .care. .What .ṣhould .you .tell .them .a
bout .Original .Medicare'ṣ .coverage .of .care .in .a .ṣkilled .nurṣing .facility? .- .CORRECT .ANSWER-
Medicare .will .cover .Mrṣ. .Foṣter'ṣ .ṣkilled .nurṣing .ṣerviceṣ .provided .during .the .firṣt .20 .dayṣ .of .her
.ṣtay, .after .which .ṣhe .would .have .a .copay .until .ṣhe .haṣ .been .in .the .facility .for .100 .dayṣ. .
Madeline .Martinez .waṣ .widowed .ṣeveral .yearṣ .ago. .Her .huṣband .worked .for .many .yearṣ .and .contri
buted .into .the .Medicare .ṣyṣtem. .He .alṣo .left .a .ṣubṣtantial .eṣtate .which .provideṣ .Madeline .with .an .
annual .income .of .approximately .$130,000. .Madeline, .who .haṣ .only .worked .part-
time .for .the .laṣt .three .yearṣ, .will .ṣoon .turn .age
.65 .and .hopeṣ .to .enroll .in .Original .Medicare. .She .comeṣ .to .you .for .advice. .What .ṣhould .you .tell .h
er? .- .CORRECT .ANSWER-
You .ṣhould .tell .Madeline .that .ṣhe .will .be .able .to .enroll .in .Medicare .Part .A .without .paying .monthl
y .premiumṣ .due .to .her .huṣband'ṣ .long .work .
