CSA Certified Senior Advisor Medicare and Medicaid for Seniors Questions and Answers 2 — Questions and Answers
Question 1: What is a Medigap (Medicare Supplement) policy designed to do?
- Cover out-of-pocket costs not paid by Original Medicare, such as copayments and deductibles (Correct answer)
- Replace Original Medicare with an all-in-one plan
- Provide prescription drug coverage
- Pay for long-term custodial care
Correct answer: Cover out-of-pocket costs not paid by Original Medicare, such as copayments and deductibles
Medigap policies fill the 'gaps' in Original Medicare by covering cost-sharing expenses like copayments, coinsurance, and deductibles.
Question 2: The Medicare Savings Programs (MSPs) help low-income Medicare beneficiaries by:
- Paying Medicare premiums, deductibles, and copays on their behalf (Correct answer)
- Providing free prescription drugs
- Offering dental and vision coverage
- Automatically enrolling them in Medicaid
Correct answer: Paying Medicare premiums, deductibles, and copays on their behalf
MSPs are state programs that help pay Medicare cost-sharing expenses for eligible low-income beneficiaries, easing their out-of-pocket burden.
Question 3: The Extra Help program (Low Income Subsidy) assists Medicare beneficiaries with:
- Part D prescription drug costs, including premiums, deductibles, and copays (Correct answer)
- Part A hospital deductibles
- Medicare Advantage plan premiums
- Home health aide costs
Correct answer: Part D prescription drug costs, including premiums, deductibles, and copays
Extra Help (also called the Low Income Subsidy or LIS) reduces or eliminates Part D costs for eligible low-income Medicare beneficiaries.
Question 4: What does the Medicare Annual Wellness Visit (AWV) include?
- A personalized prevention plan and health risk assessment, with no physical exam required (Correct answer)
- A complete physical examination with lab work
- Prescription refills and specialist referrals
- A dental and vision screening
Correct answer: A personalized prevention plan and health risk assessment, with no physical exam required
The AWV creates or updates a personalized prevention plan based on a health risk assessment but does not include a traditional physical exam.
Question 5: Which of the following is NOT a countable asset for Medicaid long-term care eligibility purposes?
- The primary residence (if spouse or dependent resides there) (Correct answer)
- Bank savings accounts
- Stocks and bonds
- Non-exempt annuities
Correct answer: The primary residence (if spouse or dependent resides there)
The primary home is generally exempt from Medicaid asset calculations if a spouse, minor child, or disabled dependent continues to live there.
Question 6: A CSA advising a client on Medicare enrollment should know that the standard enrollment window for Part B is:
- A 7-month Initial Enrollment Period around the beneficiary's 65th birthday (Correct answer)
- Anytime throughout the year without penalty
- Only during the annual Open Enrollment Period (Oct 15–Dec 7)
- Only when leaving employer coverage
Correct answer: A 7-month Initial Enrollment Period around the beneficiary's 65th birthday
The Initial Enrollment Period (IEP) for Part B spans 3 months before, the month of, and 3 months after the beneficiary's 65th birthday — 7 months total.
CSA Certified Senior Advisor Medicare and Medicaid for Seniors Questions and Answers 2
What is a Medigap (Medicare Supplement) policy designed to do?