Started on Monday, August 25, 2025, 9:09 AM

State Finished
Completed on Monday, August 25, 2025, 9:10 AM
Time taken 1 min 2 secs
Points 5.00/20.00
Grade 25.00 out of 100.00
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Question 1 Mr. Bauer is 49 years old, but eighteen months ago he was declared disabled by the Social Security Administration and
Incorrect has been receiving disability payments. He is wondering whether he can obtain coverage under Medicare. What should
you tell him?

a. He became eligible for Medicare when his disability eligibility determination was first made.

b. After receiving such disability payments for 24 months, he will be automatically enrolled in Medicare,
regardless of age.

c. Individuals who become eligible for  Incorrect: Individuals with disabilities who are under age 65 are
such disability payments only have to automatically enrolled in Medicare Parts A and B the month after
wait 12 months before they can apply they have received Social Security or Railroad Retirement
for coverage under Medicare. disability benefits for 24 months.

d. Individuals receiving such disability payments from the Social Security Administration continue to receive
those payments but only become eligible for Medicare upon reaching age 65.

Source: Module 1, Slide - Medicare Enrollment Part A & B

Question 2 Mrs. Cook is an elderly retiree. Mrs. Cook has a low fixed income. What could you tell Mrs. Cook that might be of
Correct assistance?

a. She should only seek help from private organizations to cover her Medicare costs.

b. She should contact her state Medicaid 

Correct: Mrs. Cook can apply for programs through her
agency to see if she qualifies for one of
State Medicaid office that could assist with her Medicare
several programs that can help with
costs, such as Medicare Savings Programs, Part D low-
Medicare costs for which she is
income subsidies, and Medicaid.
responsible.

c. She should not sign up for a Medicare Advantage plan.

d. She can apply to the Medicare agency for lower premiums and cost-sharing.

Source: Module 1, Slide - Help for Individuals with Limited Income/Resources

Question 3 Mr. Moy will soon turn age 65. He is slightly younger than his wife. Mr. Moy's wife has a Medicare Advantage plan, but
Incorrect he wants to understand what coverage Medicare Supplemental Insurance provides since his health care needs are
different from his wife’s needs. What could you tell Mr. Moy?

a. Medicare Supplemental Insurance would cover his dental, vision and hearing services only.

b. Medicare Supplemental Insurance would cover all of his IRS approved health care expenditures not
covered under Original Fee-for-Service (FFS) Medicare.

c. Medicare Supplemental 
Incorrect: Medicare Supplement Insurance (Medigap) does not cover long-term
Insurance would cover
care services. Such services are covered under private long-term care insurance
his long-term care
and under Medigap for some impoverished individuals.
services.

d. Medicare Supplemental Insurance would help cover his Part A deductible and Part B coinsurance or
copayments in Original Fee-for-Service (FFS) Medicare as well as possibly some services that Medicare does
not cover.

Source: Module 1, Slide - Medigap (Medicare Supplement Insurance), Slide – Medigap Plans
Question 4 Mr. Vasquez is in good health and is preparing a budget in anticipation of his retirement when he turns 66. He wants to
Incorrect understand the health care costs he might be exposed to under Medicare if he were to require hospitalization because
of an illness. In general terms, what could you tell him about his costs for inpatient hospital services under Original
Medicare?

a. Under Original Medicare, there is a single deductible amount due for the first 60 days of any inpatient
hospital stay, after which it converts into a per-day coinsurance amount through day 90. After day 90, he
would pay a daily amount up to 60 days over his lifetime, after which he would be responsible for all costs.

b. Under Original 
Medicare, the
Incorrect: The amount that a beneficiary owes for inpatient hospital care is
inpatient hospital co-
not based on a percentage of allowed charges. Beneficiaries are responsible
payment is a
for a single deductible amount for each benefit period, followed by a per day
percentage of allowed
coinsurance amount through day 90. For day 91 and beyond, there is a
charges. The
charge for each “lifetime reserve day” up to 60 days over a beneficiary’s
percentage increases
lifetime. After this, he would be responsible for all costs.
after 60 days and
again after 90 days.

c. Under Original Medicare, if the inpatient hospital service is provided by a participating Medicare provider,
the co-payment is waived. Co-payments are only charged when a beneficiary opts to receive care from a
non-participating provider.

d. Under Original Medicare, the inpatient hospital co-payment is a flat per-day amount that remains the
same throughout the first 60 days of a beneficiary’s stay. After day 60 the amount gradually increases until
day 90. After 90 days he would pay the full amount of all costs.

Source: Module 1, Slide – Medicare Part A – Original Medicare Cost-Sharing for Inpatient Hospital Care

Question 5 Mr. Singh would like drug coverage but does not want to be enrolled in a Medicare Advantage plan. What should you
Incorrect tell him?

a. Mr. Singh can enroll in a stand-alone prescription drug plan and continue to be covered for Part A and Part
B services through Original Fee-for-Service Medicare.

b. Part D prescription drug coverage can only be obtained by enrollment into a Medicare Advantage plan that
also covers Part A and Part B services.

c. Mr. Singh will have to enroll in Medicaid if  Incorrect: Medicaid is a program designed for
he wishes to obtain prescription drug individuals with limited means for which individuals
coverage through some means other than must qualify. Prescription drug coverage is available
a Medicare Advantage plan. through Medicare Part D.

d. Mr. Singh must leave Original Medicare to receive drug coverage.

Source: Module 1, Slide - Original Medicare and Part D Prescription Drug Coverage
Question 6 Juan Perez, who is turning age 65 next month, intends to work for several more years at Smallcap, Incorporated.
Incorrect Smallcap has a workforce of 15 employees and offers employer-sponsored healthcare coverage. Juan is a naturalized
citizen and has contributed to the Medicare system for over 20 years. Juan asks you if 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 eligible for Medicare once he 

Incorrect: Small GHPs do not have to continue to
turns age 65 and if he enrolls, Medicare would
offer their age 65 and over employees and their
become the primary payor of his healthcare
spouses the same benefits under the GHP as
claims but Smallcap must continue to offer him
individuals under age 65. Nor do they have to offer
coverage under its employer-sponsored group
such coverage under the same conditions as for
health plan and would become a secondary
individuals under age 65.
payor.

b. Juan is likely to be ineligible for Medicare since he was born outside the United States and has only
contributed to the Medicare system for 20 years.

c. Juan is likely to be eligible for Medicare once he turns age 65 and if he enrolls his employer-sponsored
coverage would continue to be the primary payor while Medicare would be considered a secondary payor
of his healthcare claims.

d. Juan is likely to be eligible for Medicare 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 offer him coverage
comparable to those under age 65 under its employer-sponsored group health plan and would become a
secondary payor.

Source: Module 1, Slide - Eligibility for Part A and Part B and Slide – Medicare for Individuals Who Are Still Working –
Small GHPs and Slide – Medicare Coordination with Employer Group Health Plans

Question 7 Ms. Lewis has aggressive cancer and would like to know if Medicare will cover hospice services in case she needs them.
Incorrect What should you tell her?

a. Medicare covers hospice services, and they will be available for her.

b. Medicare does not cover hospice services. Hospice services are only available through state Medicaid
programs if the state offers such coverage.

c. The Federal government facilitates competition between hospice programs to lower the price of their
services for Medicare beneficiaries but does not offer coverage for hospice services through the Medicare
program.

d. Hospice services are currently only offered under a limited  Incorrect: Hospice
demonstration project. Whether they will eventually become available services are offered
nationally depends on the outcome of the demonstration. under Medicare Part A.

Source: Module 1, Slide - Overview of Medicare Benefits and Coverage

Question 8 Edward suffered from serious kidney disease. As a result, Edward became eligible for Medicare coverage due to end-
Incorrect stage renal disease (ESRD). A close relative donated their kidney and Edward successfully underwent transplant surgery
12 months ago. Edward is now age 50 and asks you if his Medicare coverage will continue, what should you say?

a. Individuals eligible for Medicare based on ESRD generally lose eligibility 48 months after the month in
which the individual receives a kidney transplant unless they are eligible for Medicare on another basis
such as age or disability. Edward may, however, remain enrolled in Part E (Medigap) but solely for coverage
of immunosuppressive drugs if he has no other health care coverage that would cover the drugs.

b. Individuals eligible for Medicare based on ESRD generally lose eligibility 36 months after the month in
which the individual receives a kidney transplant unless they are eligible for Medicare on another basis
such as age or disability. Edward should apply for Medicaid if he has no other health care coverage that
would cover the drugs regardless of his income level or assets.

c. Individuals eligible for Medicare based on 

Incorrect: Individuals eligible for Medicare based on
ESRD generally lose eligibility 24 months
ESRD generally lose eligibility 36 months (not 24
after the month in which the individual
months) after the month in which the individual
receives a kidney transplant unless they are
receives a kidney transplant unless they are eligible for
eligible for Medicare on another basis such
Medicare on another basis such as age or disability.
as age or disability. Edward may, however,
Edward may, however, remain enrolled in Part B (not
remain enrolled in Part A but solely for
Part A) but solely for coverage of immunosuppressive
coverage of immunosuppressive drugs if he
drugs if he has no other health care coverage that
has no other health care coverage that
would cover the drugs.
would cover the drugs.

d. Individuals eligible for Medicare based on ESRD generally lose eligibility 36 months after the month in
which the individual receives a kidney transplant unless they are eligible for Medicare on another basis
such as age or disability. Edward may, however, remain enrolled in Part B but solely for coverage of
immunosuppressive drugs if he has no other health care coverage that would cover the drugs.

Source: Module 1, Slide - Eligibility – Individuals with ESRD

Question 9 Agent John Miller is meeting with Jerry Smith, a new prospect. Jerry is currently enrolled in Medicare Parts A and B. Jerry
Incorrect has also purchased a Medicare Supplement (Medigap) plan which he has had for several years. However, the plan does
not provide drug benefits. How would you advise Agent John Miller to proceed?

a. Tell prospect Jerry Smith that Medigap is simply a variation of a Medicare Advantage plan and the
companies John represents offer more comprehensive coverage for a lower price.

b. Tell prospect Jerry Smith that he should keep his Medigap plan but he should supplement his healthcare
coverage by purchasing a Medicare Advantage plan that offers prescription drug coverage (MA-PD).

c. Tell prospect Jerry Smith that he should 

Incorrect: Jerry may not always be able to reactivate his
drop his Medigap coverage and put those
Medigap plan on a guaranteed issue basis. Turning age 65
premium dollars toward the purchase of
and signing up for Part B triggers a six-month Medigap open
a standalone Part D prescription drug
enrollment period when plans must be issued, regardless of
plan because he can always reactivate his
any pre-existing conditions. Furthermore, several years have
Medigap policy on a guaranteed issue
likely elapsed since Jerry first became eligible for Part D. This
basis. Furthermore, because he has had
is also likely to mean that Jerry would be subject to a late
Medigap Jerry will not incur a Part D late
enrollment penalty.
enrollment penalty.

d. Tell prospect Jerry Smith that he should consider adding a standalone Part D prescription drug coverage
policy to his present coverage.

Source: Module 1, Slide - Medigap (Medicare Supplement Insurance); Slide – Further Information on Medigap and Slide
– Beneficiaries with Medigap Plans with/without Drug Coverage

Question 10 Mrs. Ellis recently turned 66 and decided after many years of work to retire and begin receiving Social Security benefits.
Incorrect Shortly thereafter Mrs. Ellis received a letter informing her that she had been automatically enrolled in Medicare Part B.
She wants to understand what this means. What should you tell Mrs. Ellis?

a. Part B primarily covers physician services. She will be paying a monthly premium and, except for many
preventive and screening tests, generally will have 20% co-payments for these services, in addition to an
annual deductible.

b. She will need to pay no premiums for Part B as she qualifies for premium-free coverage due to the
number of quarters she has worked.

c. Part B will cover her routine dental and  Incorrect: Medicare does not cover routine dental and
vision needs. vision needs.

d. She should disenroll if she does not want to pay the monthly premiums. There is no disadvantage in doing
so.

Source: Module 1, Slide – Overview of Medicare Benefits and Coverage – Part B, Slide – Medicare Premiums for Part B,
Slide – Medicare Part B – Original Medicare Cost Sharing and Slide – Medigap (Medicare Supplement Insurance).
Question 11 Mr. Wu is eligible for Medicare. He has limited financial resources but failed to qualify for the Part D low-income
Correct subsidy. Where might he turn for help with his prescription drug costs?

a. Mr. Wu may still qualify for help in paying for Part D costs through the Federal Pharmaceutical Assistance
Program.

b. Mr. Wu has no alternative but to liquidate his remaining assets and apply for coverage through his state’s
Medicaid program.

c. Mr. Wu may still qualify for help  Correct: A State Pharmaceutical Assistance Program may be able
in paying Part D costs through to provide assistance with prescription drug costs for those who
his State Pharmaceutical are of limited means but do not qualify for the Part D low-income
Assistance Program (SPAP). subsidy.

d. Mr. Wu may still qualify for help in paying for Part D costs through the local Office of the Aging.

Source: Module 1, Slide - Help for Individuals with Limited Income/Resources.

Question 12 Mrs. Thomas is 66 years old, has coverage under an employer plan, and will retire next year. She heard she must enroll
Incorrect in Part B at the beginning of the year to ensure no gap in coverage. What can you tell her?

a. She may not enroll in Part B while covered under an employer group health plan and must wait until the
standard general enrollment period after she retires.

b. She may enroll at any time while she is covered under her employer plan, but she will have a special eight-
month enrollment period after the last month on her employer plan that differs from the standard general
enrollment period, during which she may enroll in Medicare Part B.

c. She must wait at least 30 days 

Incorrect: Upon retirement, Mrs. Thomas will be able to enroll in
after her employment terminates
Part B during a special enrollment period that lasts 8 months
before she may enroll in Medicare
following the last month of her employer coverage.
Part B.

d. She may only enroll in Part B during the general enrollment period whether she is retired or not.

Source: Module 1, Slide - Enrollment in Parts A & B After the Part A/Part B Initial Enrollment Period
Question 13 Mildred Savage enrolled in Allcare Medicare Advantage plan several years ago. Mildred recently learned that she is
Incorrect suffering from inoperable cancer and has just a few months to live. She would like to spend these final months in
hospice care. Mildred’s family asks you whether hospice benefits will be paid for under the Allcare Medicare Advantage
plan. What should you say?

a. Mildred may remain enrolled in Allcare and make a hospice election. Hospice benefits will be paid for by
Original Medicare under Part A and Allcare will continue to pay for any non-hospice services.

b. Hospice benefits are not covered under Medicare and  Incorrect: Original Medicare Part A provides
must be paid for using private funds. coverage for hospice care.

c. Hospice benefits will be available to Mildred but they will be paid for by Original Medicare under Part B.

d. Hospice benefits will be paid for under Mildred’s Allcare Medicare Advantage plan which must cover all
Medicare Part A and Part B benefits.

Source: Module 1, Slide – Overview of Medicare Benefits and Coverage, Slide - Overview of Medicare Benefits and
Coverage – Part B, and Slide – Other Part B Items and Services

Question 14 Anthony Boniface turned 65 in 2024. He was not receiving Social Security or Railroad Retirement Benefits on his 65th
Incorrect birthday. He was interested in obtaining Medicare coverage and is eligible for premium-free Part A. Before he could
enroll in Medicare, his entire area was impacted by a hurricane causing massive flooding and severe wind damage. The
Federal government declared this to be a natural disaster which has recently ended. During this period Anthony’s initial
enrollment period expired. Anthony asks you how he can now obtain Medicare coverage. What should you say?

a. Anthony must wait until 

Incorrect: Anthony does not have to wait until the next General Enrollment
the next General
Period. He may sign up for premium-free Part A at any time and he is eligible
Enrollment Period (GEP)
for a Special Enrollment Period (SEP) to enroll in Part B due to the impact of the
which runs from January
Federally declared disaster causing him to miss an enrollment period.
1 through March 31.

b. Anthony will have a special enrollment period (SEP) beginning after the end of the emergency declaration,
but he will be subject to a late enrollment penalty if he chooses Part B coverage.

c. Anthony is eligible for a special enrollment period (SEP) because he missed an enrollment period due to
the impact of the Federally declared disaster. This SEP will allow Anthony to enroll in Part B up to six
months after the end of the emergency declaration. Anthony may enroll in premium-free Part A at any
time and his Part A coverage will be retroactive for up to 6 months.

d. Anthony will be automatically enrolled in Medicare Part A within one month from the date the Federal
government declared the disaster ended. If he wishes Part B coverage he must wait until the next General
Enrollment Period.

Source: Module 1, Slide – Medicare Enrollment – Parts A and B and Slide – Parts A and B After the Part A/Part B Initial
Enrollment Period
Question 15
Mr. Capadona would like to purchase a Medicare Advantage (MA) plan and a Medigap plan to pick up costs not covered
Incorrect
by that plan. What should you tell him?

a. Medigap policies designed to cover 

Incorrect: The purpose of Medigap plans is to supplement
costs not paid for by an MA plan can be
Original Medicare benefits. Medigap plans do not work with
purchased, but only if the MA plan’s
Medicare Advantage plans. It is illegal to sell a Medigap plan to
design is considered to be the “defined
someone already in a Medicare Advantage health plan.
standard benefit.”

b. You will help Mr. Capadona to select a Medigap plan that is designed to cover gaps in Medicare Advantage.

c. It is illegal for you to sell Mr. Capadona a Medigap plan if he is enrolled in an MA plan, and besides,
Medigap only works with Original Medicare.

d. Medigap plans that cover costs not paid for by an MA plan are available only in Massachusetts, Minnesota,
and Wisconsin.

Source: Module 1, Slide - Medigap (Medicare Supplement Insurance)

Question 16 Ms. Henderson believes that she will qualify for Medicare Coverage when she turns 65, without paying any premiums,
Incorrect because she has been working for 40 years and paying Medicare taxes. What should you tell her?

a. She is correct that she will not have to pay a premium because State programs cover the cost of Part B
premiums for all Medicare beneficiaries.

b. To obtain Part B coverage, she must pay a standard monthly premium, though it is higher for individuals
with higher incomes.

c. Medicare beneficiaries only pay a Part B premium if they are enrolled in a Medicare Advantage plan.

d. She is correct because she will 

Incorrect: Current employment and/or work history does not
be covered under Part A,
entitle a person to Part B coverage without paying a monthly
without paying premiums and
premium. Typically, people eligible for Medicare pay the standard
she has worked for 40 years so
monthly premium rate for Part B. However, this amount can vary
she will not have to pay Part B
based on an individual's income.
premiums.

Source: Module 1, Slide - Medicare Premiums for Part B

Question 17 Mr. Schmidt would like to plan for retirement and has asked you what is covered under Original Fee-for-Service (FFS)
Correct Medicare. What could you tell him?

a. Part A, which covers hospital, skilled nursing facility, hospice, and home  Correct: Original
health services and Part B, which covers professional services such as those Medicare consists of
provided by a doctor are covered under Original Medicare. Part A and Part B.

b. Part A, which covers long-term custodial care services, is covered under Original Medicare.

c. Part D, which covers prescription drug services, is covered under Original Medicare.

d. Part C, which always covers dental and vision services, is covered under Original Medicare.

Source: Module 1, Slide – Different Ways to Get Medicare, Slide – Overview of Medicare Benefits and Coverage, Slide –
Overview of Benefits and Coverage – Part B, Slide – Overview of Benefits and Coverage – Part C, and Slide – Overview
of Benefits and Coverage – Part D

Question 18 Madeline Martinez was widowed several years ago. Her husband worked for many years and contributed into the
Correct Medicare system. He also left a substantial estate which provides Madeline with an annual income of approximately
$130,000. Madeline, who has only worked part-time for the last three years, will soon turn age 65 and hopes to enroll in
Original Medicare. She comes to you for advice. What should you tell her?

a. You should tell Madeline that she will 

Correct: Madeline will be able to enroll in premium-free
be able to enroll in Medicare Part A
Part A due to her husband’s work record. She will pay a
without paying monthly premiums due
premium for Part B coverage based on her income level
to her husband’s long work record and
(her income-related monthly adjustment amount [IRMMA]).
participation in the Medicare system.
An income level of $130,000 would mean Mrs. Martinez
You should also tell Madeline that she
would pay a premium more than the standard (lowest)
will pay Part B premiums at more than
amount but not at the highest level which looks at incomes
the standard lowest rate but less than
above $500,000 for those filing individual income tax
the highest rate due her substantial
returns.
income.

b. You should tell Madeline that she will be able to enroll in both Medicare Part A and Part B without paying
monthly premiums due to her husband’s long work record and participation in the Medicare system.

c. You should tell Madeline that she will be able to enroll in Medicare Part A without paying monthly
premiums due to her husband’s long work record and participation in the Medicare system. You should
also tell Madeline that she will pay Part B premiums at the highest rate because her income over the last
several years has exceeded $100,000.

d. You should tell Madeline that she will need to pay premiums for Part A because of her short work history.
You should also tell Madeline that she will pay Part B premiums at the highest rate because her income
over the last several years has exceeded $100,000.

Source: Slide – Medicare Premium - Part A and Slide – Medicare Premiums for Part B and the IRMAA
Question 19 Ms. Kumar plans to retire when she turns 65 in a few months. She is in excellent health and will have considerable
Incorrect income when she retires. She is concerned that her income will make it impossible for her to qualify for Medicare.
What could you tell her to address her concern?

a. Medicare is a program for people of all ages with specific mental health disabilities. Since she is in
excellent health, she would not qualify, but should instead look into her state’s Medicaid program if she
wants further coverage.

b. Medicare is a program for people age 65 or older and those under age 65 with certain disabilities, end-
stage renal disease, and Lou Gehrig’s disease so she will be eligible for Medicare.

c. Eligibility for Medicare is based on whether or not the federal  Incorrect: Employment by the
government has ever employed a person. If the federal federal government is not a
government ever employed her or her husband, she can enroll in requirement for Medicare
Medicare. eligibility.

d. Medicare is a program for people who have incomes and assets below specific limits, so you will have to
find out her exact financial situation before telling her whether she can obtain Medicare coverage.

Source: Module 1, Slide - Eligibility for Part A and B and Medicare Basics

Question 20 Mrs. Foster is covered by Original Medicare. She sustained a hip fracture and is being successfully treated for that
Correct condition. However, she and her physicians feel that after her lengthy hospital stay, she will need a month or two of
nursing and rehabilitative care. What should you tell them about Original Medicare’s coverage of care in a skilled
nursing facility?

a. Mrs. Foster will have to apply for Medicaid to have her skilled nursing services covered because Medicare
does not provide such a benefit.

b. Medicare will cover Mrs. Foster’s skilled nursing  Correct: Mrs. Foster has experienced a long
services provided during the first 20 days of her hospital stay, over the 3 days to qualify for
stay, after which she would have a copay until she skilled nursing and rehabilitative care benefits
has been in the facility for 100 days. under Medicare.

c. Once she has expended her liquid assets, Medicare will cover 80% of Mrs. Foster’s long-term care costs.

d. Medicare will cover an unlimited number of days in a skilled nursing facility, as long as a physician certifies
that such care is needed.

Source: Module 1, Slide - Medicare Part A – Original Medicare Cost-Sharing for Skilled Nursing and Rehabilitative Care
and Slide – Overview of Medicare Benefits and Coverage