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Medicare Certification Exam Questions and Answers 100% Pass
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Medicare Certification Exam Questions and Answers 100% Pass In order to qualify for Medicare, an individual must be 65 years old, lawfully present in the United States, and meet one more CMS enrollment criteria. What is that? - Be eligible to recieve Social Security A plan is not required to d...

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  • December 23, 2024
  • 30
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers

Subjects

  • medicare certification exam questions and answers

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  • Medicare certifications
  • Medicare certifications

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KatelynWhitman

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Medicare Certification Exam Questions and
Answers 100% Pass


In order to qualify for Medicare, an individual must be 65 years old, lawfully present in the United

States, and meet one more CMS enrollment criteria. What is that? - ✔✔Be eligible to recieve Social

Security


A plan is not required to disenroll a member under CMS guidelines if the member..... - ✔✔Fails to pay

plan premium. In fact an MAO is never required to terminate a member on their own.


Mrs. Smith submits an enrollment request on November 11 and has no special election period. What

regular election period may she use and what will her coverage effective date be? - ✔✔Annual Election

Period, Jan 1


Are there open enrollment risks when a beneficiary has a Employer Group Plan? - ✔✔Yes, members

should check with their benefits administrator at work to avoid possibly losing coverage. Beneficiaries

may still be able to use employer coverage with the plan that they join


What is the first step in finding appropriate Medicare coverage? - ✔✔The first step is to determine if the

individual is elegible to be covered under employer group coverage.


What is the second step in finding appropriate Medicare coverage? - ✔✔Decide whether to select original

Medicare A & B or Medicare part C


If an individual chooses Medicare Part C, what is the next important choice? - ✔✔To decide if they want

medical benefits only or Part C with drug coverage.




Created by Katelyn Whitman © 2025, All Rights Reserved. 100% PASS GUARANTEE

,2|Page


If an individual wants Parts A and B original Medicare, what are the next two choices to be made? -

✔✔Decide if they want Part D perscription Drug coverage, and decide if they want supplemental

coverage.


Can a Part D PDP be added to Original Medicare without cancelling Original Medicare? - ✔✔Yes, these

work together


Can a Part D PDP be added to another Part D PDP without cancelling the original Part D PDP? - ✔✔No,

only one plan is allowed


Can a Part D PDP be added to a Med Sup plan without cancelling the Med Sup plan? - ✔✔Yes, a stand

alone works with Medigap


Can a Part D PDP be added to a Medical only part C plan without cancelling the Medical only part C

plan? - ✔✔Not unless the Medical only part C plan is a PFFS plan, an MSA plan or a 1876 cost plan


Can a Part D PDP be added to a part C plan with prescription drug coverage without cancelling the part

C plan with prescription drug coverage? - ✔✔No, this enrollment will result in the beneficiary being on

original Medicare with a stand-alone PDP


Can a Part D PDP be added to a part C PFFS plan without cancelling the part C PFFS plan? - ✔✔Yes,

PFFS works with Stand-alone


Can a Part D PDP be added to a part C PFFS MA-PD plan without cancelling the part C PFFS MA-PD

plan? - ✔✔No, since the plan already has drug coverage, this would duplicate the coverage


Can a Part D PDP be added to a part C MSA plan without cancelling the part C MSA plan? - ✔✔Yes, an

MSA plan will work with a stand alone PDP.


Can a Part D PDP be added to a 1876 cost plan without cancelling the 1876 cost plan? - ✔✔Yes, because

these plans are not Advantage plans




Created by Katelyn Whitman © 2025, All Rights Reserved. 100% PASS GUARANTEE

, 3|Page


What are the three main questions that you must clarify completely about a clients situation before you

can make an appropriate reccomendation for them? - ✔✔What is their financial situation, What is their

current coverage, What are their coverage needs?


What are the three requirements a client must meet in order to enroll in a MA-only or an MA-PD plan? -

✔✔Must have Medicare A and B, Must be a permanent resident in the plans coverage area, Must not

have end stage renal disease


If a client has end stage renal disease, is there any way that they can they still have a part C plan? -

✔✔Yes, if the client has had a kidney transplant which has ended the need for regular dialysis, Yes, if

they had a plan with a Medicare Provider Organization that lost or failed to renew their contract with

CMS, Yes. if they "age in" to Medicare while a member of a plan with the same Medicare Provider

Organization


What is "Medicare Advantage Lock-In?" - ✔✔After the effective date of enrollment, the member will

remain in the plan and will not be permitted to disenroll or change plans. The member is "locked in" until

an applicable election period arises, either the annual election period or a special election period.


As regards Medicare Advantage, the term Election means what? - ✔✔Either enrollment in, or

disenrollment from, a Medicare Advantage plan


As regards Medicare Advantage, the term Election Period means what? - ✔✔The specific dates between

which an individual can elect to enroll in, or disenroll from a Medicare Advantage Plan


AEP stands for what? - ✔✔Annual Election Period


AEP applies to what Medicare Advantage family of plans? - ✔✔MA Only, MA-PD, and PDP Stand-Alone

plans


ICEP stands for what? - ✔✔Initial Coverage Election Period




Created by Katelyn Whitman © 2025, All Rights Reserved. 100% PASS GUARANTEE

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