CRPC Navigating Retirement Healthcare 5 — Questions and Answers
Question 1: What is the Medicaid look-back period for nursing home eligibility, and what is the consequence of violating it?
- 24 months; applicant is permanently disqualified from Medicaid
- 36 months; applicant receives a reduced benefit period
- 60 months; applicant faces a penalty period of ineligibility proportional to transferred assets (Correct answer)
- 48 months; applicant must repay all transferred amounts with interest
Correct answer: 60 months; applicant faces a penalty period of ineligibility proportional to transferred assets
Medicaid reviews asset transfers made within 60 months of application; improper transfers create a penalty period during which Medicaid will not pay for nursing home care.
Question 2: Which healthcare inflation rate assumption is most commonly recommended when projecting retirement healthcare costs over a 20-year horizon?
- Equal to general CPI (approximately 2–3%)
- Higher than general CPI, typically 5–7% annually (Correct answer)
- Equal to Social Security COLA adjustments
- Lower than general CPI due to Medicare price controls
Correct answer: Higher than general CPI, typically 5–7% annually
Healthcare costs historically inflate faster than general inflation, typically 5–7% annually, so projections must use a higher rate to avoid underestimating lifetime healthcare needs.
Question 3: A recently widowed 64-year-old lost health coverage under her deceased husband's employer plan. What is her best Medicare-related option to bridge coverage to age 65?
- She must purchase a Medicare Supplement plan immediately
- She may elect COBRA continuation coverage from the employer plan for up to 36 months (Correct answer)
- She qualifies for early Medicare enrollment due to loss of spousal coverage
- She must enroll in Medicaid until reaching Medicare eligibility
Correct answer: She may elect COBRA continuation coverage from the employer plan for up to 36 months
Loss of coverage due to a spouse's death qualifies a surviving dependent for up to 36 months of COBRA continuation, bridging the gap until Medicare eligibility at 65.
Question 4: What is the primary advantage of a Medicare SELECT plan compared to a standard Medigap plan?
- Medicare SELECT plans eliminate the Part B deductible entirely
- Medicare SELECT plans typically have lower premiums in exchange for using a restricted network of providers (Correct answer)
- Medicare SELECT plans provide dental and vision coverage
- Medicare SELECT plans are available without medical underwriting in all states
Correct answer: Medicare SELECT plans typically have lower premiums in exchange for using a restricted network of providers
Medicare SELECT is a type of Medigap policy that offers lower premiums in exchange for a network restriction, requiring enrollees to use specific hospitals and providers for full benefits.
Question 5: Under the ACA, how does the pre-existing condition exclusion affect retirees between ages 62 and 64 purchasing individual health insurance?
- Insurers can charge higher premiums based on pre-existing conditions but cannot deny coverage
- Insurers cannot deny coverage or charge higher premiums based on pre-existing health conditions (Correct answer)
- Insurers may impose up to a 12-month waiting period for pre-existing conditions
- Insurers may deny coverage for pre-existing conditions only if the applicant had a gap in coverage
Correct answer: Insurers cannot deny coverage or charge higher premiums based on pre-existing health conditions
The ACA prohibits insurers in the individual and small group markets from denying coverage or charging higher premiums based on pre-existing conditions.
Question 6: A CRPC practitioner advises a 63-year-old client with a high-deductible health plan (HDHP) to maximize HSA contributions for two years before Medicare enrollment. What is the PRIMARY reason this is beneficial?
- HSA balances can be rolled over to an IRA penalty-free at Medicare enrollment
- Accumulated HSA funds can be used tax-free for Medicare premiums, out-of-pocket costs, and LTC premiums in retirement (Correct answer)
- HSA contributions continue to grow tax-free even after Medicare enrollment begins
- HDHP participants receive a Medicare premium discount proportional to HSA balance
Correct answer: Accumulated HSA funds can be used tax-free for Medicare premiums, out-of-pocket costs, and LTC premiums in retirement
HSA balances can be used tax-free in retirement to pay Medicare premiums (except Medigap), deductibles, copays, coinsurance, and qualified LTC insurance premiums.
Question 7: Which of the following correctly describes the relationship between Veterans Administration (VA) healthcare benefits and Medicare?
- VA benefits count as creditable coverage, eliminating the need for Medicare Part B
- VA benefits and Medicare are separate programs; Medicare does not pay for care received at VA facilities (Correct answer)
- Enrolling in VA benefits automatically enrolls veterans in Medicare Part A
- VA benefits supplement Medicare in the same way Medigap plans do
Correct answer: VA benefits and Medicare are separate programs; Medicare does not pay for care received at VA facilities
VA healthcare and Medicare operate independently; Medicare does not cover care at VA facilities, and veterans must enroll in Medicare separately to have coverage outside the VA system.
CRPC Navigating Retirement Healthcare 5
What is the Medicaid look-back period for nursing home eligibility, and what is the consequence of violating it?