Module 1 - Overview of Medicare Program Basics: Choices,
Eligibility, and Benefits
Question 1
Ms. Henderson believes that she will qualify for Medicare Coverage when she turns 65, without
paying any premiums, because she has been working for 40 years and paying Medicare taxes.
What should you tell her?
To obtain Part B coverage, she must pay a standard monthly premium, though it is higher for
individuals with higher incomes.
Question 2
Mr. Xi will soon turn age 65 and has come to you for advice as to what services are provided
under Original Medicare. What should you tell Mr. Xi that best describes the health coverage
provided to Medicare beneficiaries?
d.
Beneficiaries under Original Medicare have no cost-sharing for most preventive services which
include immunizations such as annual flu shots.
Question 3
,Shirly Thomas was enrolled in Medicaid during the Public Health Emergency (PHE). This
coverage has recently been terminated due to the end of the PHE. While Shirley was enrolled in
Medicaid, she missed an opportunity to enroll in Medicare and now wants Part B. Which of the
following statements best describes Shirley’s ability to now enroll in Medicare Part B?
b.
Shirley is eligible for a Special Enrollment Period (SEP) for up to six months after the termination
of her Medicaid coverage. Under this SEP, Shirley can choose retroactive coverage back to the
date of termination from Medicaid or coverage beginning the month after the month of
enrollment.
Question 4
Mr. Davis is 52 years old and has recently been diagnosed with end-stage renal disease (ESRD)
and will soon begin dialysis. He is wondering if he can obtain coverage under Medicare. What
should you tell him?
b.
He may sign-up for Medicare at any time however coverage usually begins on the fourth month
after dialysis treatments start.
Question 5
Mr. Schmidt would like to plan for retirement and has asked you what is covered under Original
Fee-for-Service (FFS) Medicare. What could you tell him?
b.
,Part A, which covers hospital, skilled nursing facility, hospice, and home health services and
Part B, which covers professional services such as those provided by a doctor are covered
under Original Medicare.
Question 6
Mrs. Chen will be 65 soon, has been a citizen for twelve years, has been employed full time, and
paid taxes during that entire period. She is concerned that she will not qualify for coverage
under part A because she was not born in the United States. What should you tell her?
d.
Most individuals who are citizens and age 65 or over are covered under Part A by virtue of
having paid Medicare taxes while working, though some may be covered as a result of paying
monthly premiums.
Question 7
Mrs. Gonzalez is enrolled in Original Medicare and has a Medigap policy as well, but it provides
no drug coverage. She would like to keep the coverage she has but replace her existing
Medigap plan with one that provides drug coverage. What should you tell her?
d.
Mrs. Gonzalez cannot purchase a Medigap plan that covers drugs, but she could keep her
Medigap policy and enroll in a Part D prescription drug plan.
Question 8
, Mr. Bauer is 49 years old, but eighteen months ago he was declared disabled by the Social
Security Administration and has been receiving disability payments. He is wondering whether
he can obtain coverage under Medicare. What should you tell him?
a.
After receiving such disability payments for 24 months, he will be automatically enrolled in
Medicare, regardless of age.
Question 9
Mildred Savage enrolled in Allcare Medicare Advantage plan several years ago. Mildred recently
learned that she is suffering from inoperable cancer and has just a few months to live. She
would like to spend these final months in hospice care. Mildred’s family asks you whether
hospice benefits will be paid for under the Allcare Medicare Advantage plan. What should you
say?
a.
Mildred may remain enrolled in Allcare and make a hospice election. Hospice benefits will be
paid for by Original Medicare under Part A and Allcare will continue to pay for any non-hospice
services.
Question 10
Madeline Martinez was widowed several years ago. Her husband worked for many years and
contributed into the Medicare system. He also left a substantial estate which provides Madeline
with an annual income of approximately $130,000. Madeline, who has only worked part-time
Eligibility, and Benefits
Question 1
Ms. Henderson believes that she will qualify for Medicare Coverage when she turns 65, without
paying any premiums, because she has been working for 40 years and paying Medicare taxes.
What should you tell her?
To obtain Part B coverage, she must pay a standard monthly premium, though it is higher for
individuals with higher incomes.
Question 2
Mr. Xi will soon turn age 65 and has come to you for advice as to what services are provided
under Original Medicare. What should you tell Mr. Xi that best describes the health coverage
provided to Medicare beneficiaries?
d.
Beneficiaries under Original Medicare have no cost-sharing for most preventive services which
include immunizations such as annual flu shots.
Question 3
,Shirly Thomas was enrolled in Medicaid during the Public Health Emergency (PHE). This
coverage has recently been terminated due to the end of the PHE. While Shirley was enrolled in
Medicaid, she missed an opportunity to enroll in Medicare and now wants Part B. Which of the
following statements best describes Shirley’s ability to now enroll in Medicare Part B?
b.
Shirley is eligible for a Special Enrollment Period (SEP) for up to six months after the termination
of her Medicaid coverage. Under this SEP, Shirley can choose retroactive coverage back to the
date of termination from Medicaid or coverage beginning the month after the month of
enrollment.
Question 4
Mr. Davis is 52 years old and has recently been diagnosed with end-stage renal disease (ESRD)
and will soon begin dialysis. He is wondering if he can obtain coverage under Medicare. What
should you tell him?
b.
He may sign-up for Medicare at any time however coverage usually begins on the fourth month
after dialysis treatments start.
Question 5
Mr. Schmidt would like to plan for retirement and has asked you what is covered under Original
Fee-for-Service (FFS) Medicare. What could you tell him?
b.
,Part A, which covers hospital, skilled nursing facility, hospice, and home health services and
Part B, which covers professional services such as those provided by a doctor are covered
under Original Medicare.
Question 6
Mrs. Chen will be 65 soon, has been a citizen for twelve years, has been employed full time, and
paid taxes during that entire period. She is concerned that she will not qualify for coverage
under part A because she was not born in the United States. What should you tell her?
d.
Most individuals who are citizens and age 65 or over are covered under Part A by virtue of
having paid Medicare taxes while working, though some may be covered as a result of paying
monthly premiums.
Question 7
Mrs. Gonzalez is enrolled in Original Medicare and has a Medigap policy as well, but it provides
no drug coverage. She would like to keep the coverage she has but replace her existing
Medigap plan with one that provides drug coverage. What should you tell her?
d.
Mrs. Gonzalez cannot purchase a Medigap plan that covers drugs, but she could keep her
Medigap policy and enroll in a Part D prescription drug plan.
Question 8
, Mr. Bauer is 49 years old, but eighteen months ago he was declared disabled by the Social
Security Administration and has been receiving disability payments. He is wondering whether
he can obtain coverage under Medicare. What should you tell him?
a.
After receiving such disability payments for 24 months, he will be automatically enrolled in
Medicare, regardless of age.
Question 9
Mildred Savage enrolled in Allcare Medicare Advantage plan several years ago. Mildred recently
learned that she is suffering from inoperable cancer and has just a few months to live. She
would like to spend these final months in hospice care. Mildred’s family asks you whether
hospice benefits will be paid for under the Allcare Medicare Advantage plan. What should you
say?
a.
Mildred may remain enrolled in Allcare and make a hospice election. Hospice benefits will be
paid for by Original Medicare under Part A and Allcare will continue to pay for any non-hospice
services.
Question 10
Madeline Martinez was widowed several years ago. Her husband worked for many years and
contributed into the Medicare system. He also left a substantial estate which provides Madeline
with an annual income of approximately $130,000. Madeline, who has only worked part-time
