CMS Medicare Specialist Enrollment & Eligibility Guidelines 3

Question 1

What penalty applies to a Medicare beneficiary who goes 15 full months without creditable prescription drug coverage after their Part D Initial Enrollment Period ends?

Accepted Answer

15 x 1% = 15% added to the national base beneficiary premium, paid for as long as enrolled

Answer

The Part D late enrollment penalty is 1% of the national base beneficiary premium for each uncovered month, added permanently to the Part D premium.

Question 2

Which of the following is NOT a qualifying condition for Medicare eligibility based on disability before age 65?

Accepted Answer

Permanent blindness with no SSDI entitlement

Answer

Blindness alone without SSDI entitlement or ESRD/ALS diagnosis does not qualify someone for Medicare before age 65.

Question 3

A beneficiary with ESRD has a 3-month waiting period before Medicare begins. In which month does Medicare coverage start if their dialysis began in April?

Accepted Answer

July

Answer

For ESRD patients on dialysis, Medicare begins the 4th month of dialysis treatment, meaning if dialysis starts in April, coverage begins in July.

Question 4

A Medicare beneficiary is hospitalized on November 30. Their Medicare Advantage Annual Enrollment Period change takes effect January 1. Which plan covers the hospitalization?

Accepted Answer

Their current plan in effect on November 30

Answer

AEP changes take effect January 1, so the plan in force on the date of service (November 30) covers the hospitalization.

Question 5

Which statement accurately describes Medicare Savings Programs (MSPs) in relation to Medicare enrollment?

Accepted Answer

MSPs are state Medicaid programs that help pay Medicare premiums, deductibles, and/or cost-sharing

Answer

Medicare Savings Programs are state Medicaid programs designed to assist low-income Medicare beneficiaries with their Medicare cost-sharing obligations.

(CMS) Certified Medicare Specialist Practice Test

(CMS) Certified Medicare Specialist Practice Test

CMS Medicare Specialist Enrollment & Eligibility Guidelines 3