Ch 4 quiz Questions

which type of care is NOT covered by Medicare? a) long term care b) hospice c) respite d) hospital

a- hospice care, which includes respite care, and hospital care are included in Medicare plan A

which of the following must be present in all Medicare supplement plans? a) plan a b) foreign travel provisions c) outpatient drugs d) plan c coinsurance

a- in order to standardize the coverage provided under Medicare supplement polices the NAIC has developed standard Medicare supplement benefit plans which are identified with the letters A-N. the benefits in part a are considered to be core benefits and must be included in other types.

which of the following statements is INCORRECT concerning Medicare Part B coverage? a) part B coverage is provided free of charge when an individual turns age 65 b) participants under part B are responsible for an annual deductible c) part B will pay 80% of covered expenses, subject to Medicare's standards for reasonable charges d) it is a voluntary program designed to provide supplementary medical insurance to cover physician services, medical services and supplies not covered under Part A

a- those who desire part B coverage must enroll and pay a monthly premium

Which of the following statements is NOT true concerning Medicaid? a) it is intended to provide medical assistance for certain categories of people who are needy b) it is consists of 3 parts : A hospitalization, B doctors services, C disability income c) it is a state program d) it is funded by state and federal taxes

b- Medicaid is a state program funded by state and federal taxes that provide medical care for the needy. Part A-C are part of Medicare

which of the following is NOT covered under part B of Medicare policy? a) physician expenses b) routine dental care c) home health care d) lab services

b- Medicare part B covers dental expense resulting from an accident only.

which one of the following is an eligibility requirement for social security disability income benefits? a) currently employed status b) fully insured status c) experiencing at least one year of disability d) being at least 50 years of age

b- Social Security Disability benefits are available only if worker is fully insured. benefits are provided only after a 5 month waiting period

regarding Medicare SELECT polices, what are the restricted network provisions? a) they help avoid adverse selection b) they condition the payment of benefits c) they determine who can be insured d) the determine premium rates

b- a Medicare SELRCT policy is a Medicare supplement policy that contains restricted network provisions. provisions that condition the payment of benefits, in whole or in part, on the use of network providers

in reference to the standard Medicare supplement benefit plans, what does the term standard mean? a) coverage options and conditions are developed for average individuals b) all providers will have the same coverage options and conditions for each plan c) coverage options and conditions comply with the law, but will vary from provider to provider d) all plans must include basic benefits A-N

b- in reference to the standard Medicare supplement benefit plans, the term standard implies that all providers will have the same coverage options and conditions for each plan

all of the following statements concerning Medicare are correct EXCEPT: a) individual states designed and administer the Medicare program under broad guidelines established by the federal government b) individuals claiming benefits must prove they do not have the ability or means to pay for their own medical care c) persons at least age 65 who are blind, or disabled and financially unable to pay may be qualify for Medicaid nursing home benefits d) Medicaid is a state funded program that provides health care to persons over age 65 only

d- Medicaid is a government funded (both state and federal ) program designed to provide health care to poor people of all ages

which of the following statements is CORRECT about Social Security? a) it is more than income received while employed b) it is very easy to qualify for disability benefits c) it is designed for people over 59.5 d) to be eligible one must meet certain requirements.

d- a person must have been employed in a job that is covered under social security or the spouse of a deceased covered worker.

which statement regarding qualifications for Social Security disability benefits is NOT true? a) the individual must satisfy the waiting period b) the individual must meet the definition of disability c) the individual must have proper insured status d) the individual must be at least 65 years old

d- it is difficult to receive social security disability benefits, prospective recipients must have a particular insured status and satisfy a waiting period. recipients must also meet a strict definition of total disability, making qualifying for benefits difficult.

An applicant is discussing his options for Medicare supplement coverage with his agent. The applicant is 65 years old and has just enrolled in Medicare Part A and Part B. What is the insurance company obligated to do? a) exclude pre-existing conditions from coverage under the supplement policies b) look at the applicants medical history to decide what premium to charge c) send the applicant to a doctor for a physical. Nothing can happen until they get the results d) offer the supplement policy on a guaranteed issue basis

d- once a person becomes eligible for Medicare supplement plans, and during the open enrollment period, coverage must be offered on a guaranteed issue basis.

Prior to purchasing a Medigap policy, a person must be enrolled in which of the following? a) all four parts of Medicare b) any private insurance policy c) only part A of Medicare d) Parts A and B of Medicare

d- to buy a Medigap policy, the applicant must generally have both Medicare Part A and B

An insured becomes disabled at age 22 and can no longer work. She meets the definition of total disability under Social Security. What other requirement must the insured have met to receive Social Security disability benefits? a) have accumulated 20 work credits in the past 10 years b) have accumulated 40 work credits c) have reached the age of 25 d) have accumulated 6 work credits in the past

d- to qualify for disability benefits under social security, the disabled person must have earned a certain amount of work credits. A maximum of 4 work credit can be earned each year. the amount of credits required varies by age. persons disabled before the age of 24 can qualify for Social security benefits with only 6 work credits earned in the 3 years prior to the start of the disability

which of the following statements pertaining to Medicare Part A is correct? a) for the first 90 days of hospitalization Medicare part a pays 100% of all covered services except for the initial deductible b) individuals with ESRD do not qualify for part A c) each individual covered by Medicare part A is allowed one 90-day benefit period per year d) Medicare part A is automatically provided when an individual qualifies for social security benefits at age 65

d- workers who have paid FICA taxes automatically qualify for Medicare part A at 65. Part A has been prepaid through the FICA taxes. Workers who qualify for part A are also eligible for Part B, however, it requires that a monthly premium is withheld from social security benefits.