Question1 Mr. Buck has several family members who died from different cancers. He wants to know if Medicare coverscancer screening. What should youtell him? a. Medicare coversall screening tests that have been approved by the FDA on a frequency determined by the treating physician. b.Medicare coverstreatments for existing disease, injury, and malformed limbs or body parts. As such, it does not coverany screening tests and these must be paid forby the beneficiary out-ofpocket. c.Medicare coverssome screening tests that must be performed within the first year after enrollment. Beyond that point expenses for screening tests are the responsibility ofthe beneficiary. d.Medicarecoverstheperiodic performanceofarangeofscreeningtests that aremeanttoprovide earlydetectionofdisease. Mr.Buckwillneedtocheckspecific testsbeforeobtaining themtoseeifthey will becovered. Source: Module 1, Slide - Medicare Part B Benefits -PreventiveServices and Screenings Question2 Mr. Schmidt would like to plan for retirement and has asked youwhat is covered under Original Fee-for- Service (FFS) Medicare? What could youtell him? a.Part C, which always coversdental and vision services, is covered under Original Medicare. b.Part A,which covershospital, skillednursingfacility, hospice, andhomehealth servicesandPartB, whichcoversprofessional servicessuchasthose providedbyadoctor arecoveredunderOriginal Medicare. c.PartA, which coverslong-term custodial care services, is covered under Original Medicare. d.Part D, which coversprescription drug services, is covered under Original Medicare. Source: Module 1, Slide -Overview of Medicare Benefits and Coverage -Parts A, B, C, and Slide - Overview of Different Waysto Get Medicare Question3 Juan Perez,who is turning age 65 next month, intends to work for several more years at Smallcap, Incorporated. Smallcap has a workforceof 15employees and offersemployersponsored healthcare coverage. Juanis a naturalized citizen and has contributed to the Medicare system forover 20 years. Juan asks youif he will be entitled to Medicare and if he enrolls how that will impact his employer- sponsored healthcare coverage. How would you respond? a.Juan is likely to be ineligible forMedicare since he was born outside the United States and has only contributed to the Medicare system for20 years. b.JuanislikelytobeeligibleforMedicareonceheturns age65andifheenrollsMedicarewould become theprimary payorofhishealthcare claimsbutSmallcap mustcontinuetoofferhimcoverage underits employer-sponsored grouphealthplanandwould becomeasecondary payor. c.Juan is likely to be eligible forMedicare once he turns age 65 and if he enrolls his employersponsored coverage would continue to be the primary payor while Medicare would be considered a secondary payorof his healthcare claims. Incorrect: Medicare is the primary payor for individuals who have group health coverage due to their continued employment with a small employer. A small group health plan is one offered by a company with fewer than 20 employees. d. Juan is likely to be eligible forMedicare once he turns age 65 and if he enrolls Medicare would become the primary payor of his healthcare claims and Smallcap does not have to continue to offerhim coverage comparable to those under age 65 under its employer-sponsored group health plan. Source: Module 1, Slide - Eligibility forPart A and Part B Benefits and Slide - Medicare for Individuals WhoAre Still Working - Small GHPs and Slide -Medicare Coordination with Employer GroupHealth Plans Question4 Mr. Bauer is 49 years old, but eighteen months ago he was declared disabled by the Social Security Administration and has been receiving disability payments. He is wondering whether he can obtain coverage under Medicare. What should youtell him? a.Afterreceivingsuchdisability paymentsfor24months, hewill beautomatically enrolledinMedicare, regardless ofage. b.Individuals who become eligible for such disability payments only have to wait 12 months before they can apply for coverage under Medicare. c.Individuals receiving such disability payments from the Social Security Administration continue to receive those payments but only become eligible forMedicare upon reaching age 65. d.He became eligible forMedicare when his disability eligibility determination was first made. Source: Module 1, Slide - Medicare Enrollment Part A & B Question5 Ms. Moore plans to retire when she turns 65 in a few months. She is in excellent health and will have considerable income when she retires. She is concerned that her income will make it impossible forher to qualify forMedicare. What could you tell her to address her concern? a.Medicare is a program forpeople who have incomes and assets below specific limits, so youwill have to findout her exact financial situation before telling her whether she can obtain Medicare coverage. b.Eligibility for Medicare is based on whether or not a person has ever been employed by the federal government. If she or her husband were ever employed by the federal government, she can enroll in Medicare.