Study guides, Class notes & Summaries

An individual who is not eligible for premium-free Medicare Part A coverage may apply for coverage during which of the following enrollment periods? A. All of the above B. Initial enrollment period C. General enrollment period D. Special enrollment period - A. All of the above Medicare makes what payment for services in which another payer may be responsible: A. Conditional payment B. Interim payment C. Transitional payment D. Temporary payment - A. Conditional payment

An insured has 10 years of work experience. She participated in the Social Security program for 10 years. Her medicare Part A premium is most likely to be A. $0 B. $458 per month C. About 5% of monthly income D. $458 per month - $0 EXPLANATION: People do not pay a monthly Part A premium because they or their spouse have 40 or more quarters of Medicare-covered employment.

Medicare - A federal program of health insurance for persons 65 years of age and older Medicare is run by - Centers for Medicare and Medicaid services of the department of health and human services Medicare parts A & B are - Referred to as original Medicare Medicare Part A(Inpatient) is funded - By the hospital insurance portion of the FICA payroll tax collected from workers and employers. Also by the premiums paid by individuals who aren't automatically covered by medicare but wish to pu...

Medicare Supplement and Long Term Care NC Study Set Exam Q & A what facility is long term care NOT provided in - Answer - Hospital an insured receives health care through both Medicare and Medicaid. She Currently has prescription drug coverage through Medicaid. does the insured need to enroll in Medicare part D? - Answer - Yes, she must begin receiving her prescription Drug coverage through Part D To quality for skilled nursing care a patient must - Answer - have a qualifying hospital...

Horace buys a Medicare supplement insurance policy but decides not to keep it. How many days does he have to return it for a full refund of the premium? - ANSWER 30 days Which of the following individuals is an appropriate customer for a Medicare supplement policy? - ANSWER Someone enrolled in both Part A and Part B of Medicare A purchased a long-term care policy on June 15. Two weeks later, she lost her job and decided that she could no longer afford the policy. What are her options? - AN...

An insured has 10 years of work experience. She participated in the Social Security program for 10 years. Her medicare Part A premium is most likely to be A. $0 B. $458 per month C. About 5% of monthly income D. $458 per month - ANSWER $0 EXPLANATION: People do not pay a monthly Part A premium because they or their spouse have 40 or more quarters of Medicare-covered employment. A patient has 20 day stay in Medicare covered SNF. All of these services are covered EXCEPT A. Medica...

Medi-Medi beneficiary - ANSWER An individual who is eligible for both Medicaid and Medicare is a______. Medigap insurance policies - ANSWER Medicare Part B deductibles, coinsurance,and some noncovered services can be covered by buying policies from federally approved private insurance carriers. These policies are known as_____. crossover claims - ANSWER Claims for Medi-Medi beneficiaries are first submitted to Medicare and then sent to Medicaid, making them known as_____. additional pay...

1. Long-Term Care benefits may be triggered by the insured's inability to perform at least ______ Activities of Daily Living (ADL's). A 5 B 3 C 4 D 2 - ANSWER D 2 2. In North Carolina, eligibility for Medicaid is determined by: A The State Treaury B North Carolina's Department of Health and Welfare C The U.S. Treasury D The county Departments of Social Services (DSS) and the Social Security Administration (SSA) for Supplemental Security Income (SSI) beneficiaries - ANSWER I...

A man is planning to retire after age 65. Until then, he will have his employer's health plan. When should he enroll in Medicare Part B? - ANSWER Within the 8 months of the day he is no longer employed or when coverage under the group plan ends In the Original Medicare Plan Part B, the percentage of the approved amount paid by the patient is 20%. This is referred to as - ANSWER Coinsurance What process will the insurance company use to monitor the insured's hospital stay to make sure tha...

Medicare (4 parts) - ANSWER Part A: Hospital insurance (hospital Visit) Part B: Physician Service(doctor visit) Part C: Medicare advantage(Privatized Medicare) Part D: Prescription drugs Which best describes medicare? - ANSWER It is a basic hospital and doctor policy Who receives medicade? - ANSWER Low income, in need of financial aid true name of social security - ANSWER old age survivors insurance Medicare supplements - ANSWER Medi-gap medicare select -off set the cost of m...