Practice Test Geeks(CMS) Certified Medicare Specialist Practice Test
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Medicare Specialist Coverage Planning Options Flashcards

7 cards from real CMS practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

Read the first 7 Medicare Specialist Coverage Planning Options flashcards as text

  1. A client with Medicare Parts A and B wants to add drug coverage. They choose a standalone Part D plan. Which Medicare Supplement plan covers the Part B excess charges that Original Medicare may not fully cover?

    Answer: Plan G

    Medicare Supplement Plan G covers Part B excess charges, protecting beneficiaries who see providers that do not accept Medicare assignment.

  2. What is the Medicare Advantage Open Enrollment Period (OEP) and when does it occur?

    Answer: January 1–March 31; allows MA enrollees to switch MA plans or return to Original Medicare once

    The MA OEP runs January 1 through March 31 and allows current MA enrollees to make one plan change or switch back to Original Medicare.

  3. Which of the following best describes a Medicare Medical Savings Account (MSA) plan?

    Answer: A high-deductible Medicare Advantage plan paired with a tax-advantaged savings account funded by Medicare

    MSA plans combine a high-deductible Medicare Advantage plan with a special savings account that Medicare deposits money into to help pay medical costs.

  4. A client has both Medicare and Medicaid (dual eligible). Which statement about their coverage coordination is correct?

    Answer: Medicare is the primary payer and Medicaid is the payer of last resort

    For dual-eligible beneficiaries, Medicare always pays first as the primary payer, and Medicaid may cover remaining cost-sharing as the payer of last resort.

  5. What is a Medicare Advantage Special Needs Plan (SNP) and who qualifies?

    Answer: A plan specifically designed for individuals with certain diseases, dual eligibles, or institutionalized individuals

    SNPs are Medicare Advantage plans tailored to specific populations: chronic condition SNPs (C-SNPs), dual-eligible SNPs (D-SNPs), or institutional SNPs (I-SNPs).

  6. Under the Part D standard benefit structure, what is the significance of the True Out-of-Pocket (TrOOP) threshold?

    Answer: It is the point at which Medicare pays 100% of drug costs with no further cost-sharing

    Once a beneficiary's TrOOP costs reach the catastrophic threshold, Medicare pays the vast majority of remaining drug costs with minimal cost-sharing for the rest of the year.

  7. A beneficiary enrolled in a Medicare Cost plan moves to a new county still served by the same plan. What enrollment action is typically required?

    Answer: No action is needed as Cost plans typically adjust service areas automatically

    Medicare Cost plans generally allow beneficiaries to continue coverage if they remain within the plan's service area without requiring re-enrollment.