CSA Certified Senior Advisor Medicare and Medicaid for Seniors Questions and Answers 3

Question 1

What is the 'donut hole' (coverage gap) in Medicare Part D?

Accepted Answer

A temporary period of higher cost-sharing after total drug costs reach a threshold, before catastrophic coverage begins

Answer

The donut hole is a coverage gap in Part D where beneficiaries historically paid more out-of-pocket; the Inflation Reduction Act capped out-of-pocket drug costs starting in 2025.

Question 2

Under Medicaid, 'spousal impoverishment protections' are designed to:

Accepted Answer

Allow a community spouse to retain a minimum level of income and assets when the other spouse enters a nursing home

Answer

Federal spousal impoverishment rules ensure the community spouse can keep a protected income allowance (MMMNA) and a minimum asset amount (CSRA).

Question 3

Medicare's Skilled Nursing Facility (SNF) benefit requires a qualifying hospital stay of at least:

Accepted Answer

3 consecutive inpatient days

Answer

To qualify for Medicare-covered SNF care, a beneficiary must have a prior inpatient hospital stay of at least 3 consecutive days (not counting the discharge day).

Question 4

What is Medicaid estate recovery?

Accepted Answer

A process by which states seek reimbursement from a deceased Medicaid recipient's estate for costs paid on their behalf

Answer

After a Medicaid recipient dies, states are required to attempt recovery of long-term care costs from the recipient's probate estate.

Question 5

A senior enrolled in both Medicare and Medicaid is referred to as:

Accepted Answer

A dual-eligible beneficiary

Answer

Dual-eligible individuals qualify for both Medicare and Medicaid, with Medicare paying first and Medicaid covering remaining cost-sharing expenses.

Certified Senior Advisor Exam Practice Test

Certified Senior Advisor Exam Practice Test

CSA Certified Senior Advisor Medicare and Medicaid for Seniors Questions and Answers 3