Edward IP suffered from serious kidney disease. As a result. Edward became eligible for Medicare
coverage due to end-stage renal disease (ESRD). A close
... [Show More] 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? - ans 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.
Mildred Savage enrolled in Allcare Medicare Advantage plan several years ago. Mildred recently learned
that she is 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? - ans 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.
Mr. Diaz continued working with his company and was insured under his employer's group plan until he
reached age 68. He has heard that there is a premium penalty for those who did not sign up for Part B
when first eligible and wants to know how much he will have to pay. What should you tell him? - ans
Mr. Diaz will not pay any penalty because he had continuous coverage under his employer's plan.
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? - ans 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.
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? - ans Most 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.
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 obtai [Show Less]