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Juan Perez, who is turning age 65 next month, intends to work for several
more years at Small cap, Incorporated. Small cap has a workforce of15
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?
Correct answers 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 Small cap does not have to continue to offer him
coverage comparable to those under age 65 under its employer-sponsored
group health plan.
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Mr. Moy's wife has a Medicare Advantage plan, but 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?
Correct answers Medicare Supplemental Insurance would help cover his
Part A and Part B deductibles or coinsurance in Original Fee-for-Service
(FFS) Medicare as well as possibly some services that Medicare does not
cover.
Mr. Davis is 52 years old and has recently been diagnosed with end-stage
renal disease (ESRD) and will soon begin dialysis. He is wondering if he
can obtain coverage under Medicare. What should you tell him? Correct
answers He may sign-up for Medicare at any time however coverage
usually begins on the fourth month after dialysis treatments start.
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Mrs. Peňa is 66 years old, has coverage under an employer plan, and will
retire next year. She heard she must enroll in Part B at the beginning of
the year to ensure no gap in coverage. What can you tell her?correct
answersShe 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
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general enrollment period, during which she may enroll in Medicare Part B.
Mrs. Chen will be 65 soon, has been a citizen for twelve years, has been
employed full time, and paid taxes during that entire period. She is
concerned that she will not qualify for coverage under part A because she
was not born in the United States. What should you tell her?correct
answersMost individuals who are citizens and age 65 or over are covered
under Part A by virtue of having paid Medicare taxes while working, though
some may be covered as a result of paying monthly premiums.
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