CMS Medicare Specialist Enrollment & Eligibility Guidelines 2

Question 1

A 64-year-old individual with ALS (Lou Gehrig's disease) is diagnosed in March. When does Medicare eligibility begin?

Accepted Answer

Immediately upon ALS diagnosis

Answer

Individuals diagnosed with ALS are automatically enrolled in Medicare the month their Social Security disability benefits begin, with no waiting period.

Question 2

Which of the following individuals qualifies for a Special Enrollment Period (SEP) to enroll in Medicare Part B without a late enrollment penalty?

Accepted Answer

An employee who had employer group health plan coverage and retired at age 67

Answer

Employees who delayed Part B while covered under an employer Group Health Plan (GHP) qualify for an SEP without penalty when that coverage ends.

Question 3

What is the General Enrollment Period (GEP) for Medicare Part B, and when does coverage become effective?

Accepted Answer

January 1–March 31; coverage begins July 1 of that year

Answer

The GEP runs January 1–March 31 each year, and Part B coverage obtained during this period begins July 1.

Question 4

A beneficiary is enrolled in Medicare Part A and Part B. They want to join a Medicare Advantage plan. Which enrollment period allows them to switch from one MA plan to another MA plan between January 1 and March 31?

Accepted Answer

Medicare Advantage Open Enrollment Period (MA OEP)

Answer

The Medicare Advantage Open Enrollment Period (MA OEP), January 1–March 31, allows MA enrollees to switch to a different MA plan or return to Original Medicare once.

Question 5

How long does a newly Medicare-eligible individual have to enroll in a Medicare Advantage plan for the first time through their Initial Coverage Election Period (ICEP)?

Accepted Answer

3 months before through the end of the month they become entitled to Part A and Part B

Answer

The ICEP runs from 3 months before through the last day of the month an individual first becomes entitled to both Part A and Part B.

(CMS) Certified Medicare Specialist Practice Test

(CMS) Certified Medicare Specialist Practice Test

CMS Medicare Specialist Enrollment & Eligibility Guidelines 2