CRPC Navigating Retirement Healthcare 2 — Questions and Answers
Question 1: A 65-year-old retiree has End-Stage Renal Disease (ESRD). Which Medicare enrollment rule applies?
- She must wait until the next General Enrollment Period
- She qualifies for Medicare immediately regardless of age (Correct answer)
- She must enroll through a state Medicaid office
- She must have 40 quarters of work history first
Correct answer: She qualifies for Medicare immediately regardless of age
ESRD is one of the special qualifying conditions that allows Medicare enrollment at any age, not just 65.
Question 2: Which Medicare Supplement (Medigap) plan is the ONLY one that covers the Medicare Part A deductible after Plan C was discontinued for new enrollees?
- Plan G (Correct answer)
- Plan N
- Plan K
- Plan D
Correct answer: Plan G
Plan G covers the Part A deductible and all other gaps except the Part B deductible, making it the most comprehensive plan available to new enrollees after Plan C was closed.
Question 3: A retiree on Medicare Advantage wants to switch to Original Medicare. Which statement is TRUE regarding Medigap availability?
- She has a guaranteed issue right during a 63-day special enrollment period
- She may be subject to medical underwriting in most states (Correct answer)
- She cannot purchase Medigap once previously enrolled in Medicare Advantage
- She must wait for the Annual Enrollment Period to purchase Medigap
Correct answer: She may be subject to medical underwriting in most states
Most states allow insurers to use medical underwriting when a Medicare Advantage enrollee switches back to Original Medicare outside a guaranteed-issue window.
Question 4: How does the Medicare Income-Related Monthly Adjustment Amount (IRMAA) affect a high-income retiree?
- It reduces their Social Security benefit to offset higher Medicare premiums
- It increases their Part B and Part D premiums based on prior-year income (Correct answer)
- It disqualifies them from Medicare Advantage plans
- It triggers automatic enrollment in a Medigap plan
Correct answer: It increases their Part B and Part D premiums based on prior-year income
IRMAA surcharges are added to standard Part B and Part D premiums for beneficiaries whose modified adjusted gross income exceeds IRS thresholds two years prior.
Question 5: A retiree withdraws $60,000 from a traditional IRA in a year when their income otherwise would have been below the IRMAA threshold. What is the PRIMARY planning concern?
- The withdrawal will permanently disqualify them from Medicare Part D
- The withdrawal may push modified AGI above an IRMAA bracket and increase Medicare premiums (Correct answer)
- The withdrawal triggers a 6% Medicare surtax
- The withdrawal reduces their Medicare cost-sharing subsidies automatically
Correct answer: The withdrawal may push modified AGI above an IRMAA bracket and increase Medicare premiums
Large IRA distributions increase MAGI, which Medicare measures two years later for IRMAA surcharge determination, potentially causing a significant premium spike.
Question 6: Which of the following is NOT covered by Medicare Part B?
- Outpatient physical therapy
- Annual wellness visit
- Routine dental care (Correct answer)
- Durable medical equipment
Correct answer: Routine dental care
Routine dental care, including cleanings, fillings, and extractions, is explicitly excluded from Medicare Part B coverage.
Question 7: A client turns 65 while still covered by her employer's group health plan (employer has 25 employees). What is her best Medicare strategy?
- Enroll in Part A and Part B immediately because employer coverage is secondary (Correct answer)
- Delay Part B enrollment since employer coverage is primary, avoiding the late-enrollment penalty
- Enroll only in Part D immediately to avoid its late-enrollment penalty
- Decline Medicare entirely since employer coverage exempts her permanently
Correct answer: Enroll in Part A and Part B immediately because employer coverage is secondary
When an employer has fewer than 20 employees, Medicare is primary, so delaying Part B would result in coverage gaps; she should enroll in both parts immediately.
CRPC Navigating Retirement Healthcare 2
A 65-year-old retiree has End-Stage Renal Disease (ESRD).
Which Medicare enrollment rule applies?