Latest (2025/2026) Complete Questions and Correct
Answers Complete GRADED A+
•
Contains 250+ Questions & Answers
,/ ,/ ,/ ,/
1. Mrs.Burtonisaretireewithsubstantialincome.SheisenrolledinanMA-PD plan
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
and was disappointed with the service she received from her primary care
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
physicianbecauseshewastoldshewouldhavetowaitfiveweekstoget an
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
appointmentwhenshewasfeelingill.Shecalledyoutoaskwhatshecould dososhe
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
wouldnothavetoputupwithsuchpooraccesstocare.Whatcould youtellher?
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
Ans>> :Shecouldfileagrievancewithherplantocomplainaboutthelackof timeliness in
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
getting an appointment.
,/ ,/ ,/
2. Edward IP suffered from serious kidney disease. As a result. Edward be- came
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
eligible for Medicare coverage due to end-stage renal disease (ESRD). A close
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
relative donated their kidney and Edward successfully underwent transplant
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
surgery 12 months ago.Edward is now age 50 and asks you if his Medicare
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
coverage will continue,what should you say?
,/ ,/ ,/ ,/ ,/ ,/ ,/
Ans>>:Individuals eligible for Medicare based on ESRD generally lose eligibility 36
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
months after the month in whichtheindividualreceivesakidneytransplantunlesstheyare
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
,/ ,/
,eligibleforMedicare onanotherbasissuchasageordisability.Edwardmay,however,
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
remainenrolledin PartBbutsolelyforcoverageofimmunosuppressivedrugsifhehasno
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
otherhealth care coverage that would cover the drugs.
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
3. Mildred Savage enrolled in Allcare Medicare Advantage plan several years ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
ago.Mildredrecentlylearnedthatsheissufferingfrominoperablecancerand has
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
just a few months to live. She would like to spend these final months in hospice
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
care.Mildred's familyasksyouwhetherhospicebenefitswillbepaid forunderthe
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
AllcareMedicareAdvantageplan.Whatshouldyousay?
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
Ans>>: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.
,/ ,/ ,/ ,/ ,/
4. Mr. Diaz continued working with his company and was insured under his
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
employer's group plan until he reached age 68. He has heard that there is a
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
premiumpenaltyforthosewhodidnotsignupforPartBwhenfirsteligibleand wants
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
to know how much he will have to pay.What should you tell him?
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
Ans>>:Mr. Diaz will not pay any penalty because he had continuous coverage under
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
his employer's plan.
,/ ,/ ,/
5. Mr. Moy's wife has a Medicare Advantage plan, but he wants to under- stand
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
what coverage Medicare Supplemental Insurance provides since his health
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
care needs are different from his wife's needs.What could you tell Mr. Moy?
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
Ans>>: Medicare Supplemental Insurance would help cover his Part A and Part B
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
deductibles or coinsurance in Original Fee-for-Service (FFS) Medicare as well as
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
possibly some services that Medicare does not cover.
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
6. Mrs. Chen will be 65 soon, has been a citizen for twelve years, has been
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
employedfulltime,andpaidtaxesduringthatentireperiod.Sheisconcerned
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
,/ ,/
,thatshewillnotqualifyforcoverageunderpartAbecauseshewasnotbornin the
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
United States.What should you tell her?
,/ ,/ ,/ ,/ ,/ ,/ ,/
Ans>>: 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.
,/ ,/ ,/ ,/ ,/ ,/
7. Mr. Bauer is 49 years old, but eighteen months ago he was declared dis- abled
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
by the Social Security Administration andhas been receiving disability
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
payments.He is wondering whether he can obtain coverage under Medicare.
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
Whatshouldyoutellhim?
,/ ,/ ,/ ,/ ,/
Ans>>:Afterreceivingsuchdisabilitypaymentsfor24months, he will be automatically ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
enrolled in Medicare, regardless of age.
,/ ,/ ,/ ,/ ,/ ,/
8. Mr. Xi will soon turn age 65 and has come to you for advice as to what services
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
areprovidedunderOriginalMedicare.WhatshouldyoutellMr.Xithat best
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
describesthehealthcoverageprovidedtoMedicarebeneficiaries?:Ben- eficiaries
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
underOriginalMedicarehavenocost-sharingformostpreventiveservices which include
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
immunizations such as annual flu shots.
,/ ,/ ,/ ,/ ,/ ,/
9. Mrs.PeaH is 66yearsold,hascoverageunderanemployerplan,andwillretire next
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
year.She heard she must enroll in Part B at the beginning of the year to ensure no
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
gap in coverage.What can you tell her?
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
Ans>>:She may enroll at any time whilesheiscoveredunderheremployerplan,butshe ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
willhaveaspecialeight-month enrollment period after the last month on her employer
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
plan that differs from the standard general enrollment period, during which she may
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
enroll in Medicare Part B.
,/ ,/ ,/ ,/ ,/
10. 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?
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
Ans>>: He may sign-up forMedicareatanytimehowevercoverageusuallybeginsonthe ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
fourthmonthafter dialysis treatments start.
,/ ,/ ,/ ,/ ,/ ,/
11. Madeline Martinez was widowed several years ago. Her husband worked for ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
many years and contributed into the Medicare system. He also left a substantial
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
estatewhichprovidesMadelinewithanannualincomeofapprox- imately
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
,/ ,/
, ,/ $130,000. Madeline, who has only worked part-time for the last three years, will
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
,/ soon turn age 65 and hopes to enroll in Original Medicare. She comes to you for
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
,/ advice.What should you tell her? ,/ ,/ ,/ ,/ ,/
Ans>>: You should tell Madeline that she will be able to enroll in Medicare Part A
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
without paying monthly premiums due to her husband's long work record and
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
participation in the Medicare system. You should also tell Madeline that she will pay
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
Part B premiums at more than the standard lowest rate but less than the highest rate
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
due her substantial income.
,/ ,/ ,/ ,/
12. Ms.Henderson believes that she will qualify for Medicare Coverage when she
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
turns 65, without paying any premiums, because she has been working
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
,/ ,/