Medicare Unit 20 Quiz
Medicare Plans K and L are characterized by which of the following features? A) No annual limit on annual out-of-pocket expenditures B) No annual deductible C) Higher coinsurance contributions D) Lower co-payments
Higher coinsurance contributions Explanation Medicare Plans K and L require higher co-payments and coinsurance contributions from Medicare beneficiaries. They also have a limit on annual out-of-pocket expenditures incurred by the policyholders. However, once the out-of-pocket limit on annual expenditures is reached, the policy covers 100% of all cost sharing under Medicare Parts A and B for the balance of the calendar year.
What is the maximum number of days of skilled nursing facility care for which Medicare will pay benefits? A) 75 days B) 25 days C) 60 days D) 100 days
100 days Explanation Part A covers the costs of care in a skilled nursing facility as long as the patient was first hospitalized for 3 consecutive days. Medicare will cover treatment in a skilled nursing facility in full for the first 20 days. From the 21st to the 100th day, the patient must pay a daily co-payment. There are no Medicare benefits provided for treatment in a skilled nursing facility beyond 100 days.
Lynn is insured under Medicare Part A and enters the hospital for surgery. Assuming that Lynn has not yet tapped into her lifetime reserve, what is the maximum number of days that Medicare will pay for her hospital bills? A) 90 days B) 120 days C) 150 days D) 60 days
150 days Explanation After an initial deductible is met, Medicare pays for all covered hospital charges for the first 60 days of hospitalization. The next 30 days are also covered, but the patient will be required to contribute a certain daily co-payment amount. If, after these first 90 days, the patient is still hospitalized, he can tap into a 60-day lifetime reserve and pay a higher level of daily co-payments. Consequently, a patient who has not yet tapped into the lifetime reserve days could have up to 150 days of Medicare coverage for a single hospital stay.
Under Medicare Part B, the participant must pay A) have a physician certify that skilled care is required B) a per benefit deductible C) 20% of covered charges above the deductible D) 80% of covered charges above the deductible
20% of covered charges above the deductible Explanation Part B participants must pay a monthly premium and are responsible for an annual deductible. After the deductible, Part B will pay 80% of covered expenses, subject to Medicare's standards for reasonable charges.
To be eligible for Medicare, you must be fully insured according to Social Security. This involves accumulating a minimum of how many credits? A) 40 credits B) 80 credits C) 100 credits D) 60 credits
40 credits Explanation Social Security fully insured status requires the accumulation of 40 credits, which are earned by generating a minimum amount of work-related income over at least the last 10 years and paying Social Security (FICA) taxes.
Charles signs up for Medicare Part B on March 21, during the open enrollment period. His coverage will become effective A) 43556 B) 43545 C) 43647 D) 43646
43647 Explanation Medicare Part B coverage for those who sign on during the open enrollment period always becomes effective the following July 1.
Medicare supplement insurance is designed for persons who have reached the age of A) 65 or older B) 70 to 80 C) 60 or older D) 50 to 65
65 or older Explanation Medicare supplement insurance fills the gaps in coverage left by Medicare, which provides hospital and medical expense benefits for persons aged 65 and older.
Medicare Part A covers A) 80% of the cost of durable medical equipment B) custodial care C) private duty nursing D) the first three pints of blood
80% of the cost of durable medical equipment Explanation Medicare Part A covers 80% of the cost of durable medical equipment such as wheelchairs and hospital beds. The following are specifically excluded: private duty nursing, non-medical services, intermediate care, custodial care, and the first three pints of blood.
Tom is covered under Medicare Part A. He spends 1 week in the hospital for some minor surgery and returns home on July 10. It was his first hospital stay in years. Which of the following statements regarding his Medicare coverage is CORRECT? A) After Tom pays the deductible, Medicare Part A will pay 100% of all covered charges. B) Medicare Part A will not cover Tom's hospital expenses because he was not hospitalized for 10 consecutive days. C) After Tom pays the deductible, Medicare Part A will pay 80% of all covered charges. D) Medicare Part A will pay benefits, but Tom must make a daily co-payment.
After Tom pays the deductible, Medicare Part A will pay 100% of all covered charges. Explanation Medicare Part A pays 100% of covered services for the first 60 days of hospitalization after the deductible is paid.
Paul, age 66, works for American Accounting, Inc., a firm with 500 employees. He is covered by its health insurance plan. He is also covered by Medicare. Which of the following statements is CORRECT? A) Medicare is the primary payor, and American Accounting's plan is the secondary payor. B) American Accounting's plan is the primary payor, and Medicare is the secondary payor. C) Medicare is not required to provide coverage for Paul. D) Medicare will pay only the deductibles that are not covered by American Accounting's plan.
American Accounting's plan is the primary payor, and Medicare is the secondary payor. Explanation Because Paul is over age 65, he is eligible for Medicare. He is also entitled to the same health insurance benefits that American Accounting offers to its younger employees. In this case, the employer-sponsored plan is considered the primary payor and Medicare is the secondary payor. This means that Medicare pays only those charges that the employer-sponsored plan does not cover.
Which of the following is NOT covered by Medicare Part A? A) Hospice care B) An outpatient medical facility C) A skilled nursing facility D) Home health care
An outpatient medical facility Explanation An outpatient medical facility is covered by Medicare Part B. Skilled nursing facilities, home health care and hospice are covered under Medicare Part A.
Which of the following coverages must be included in all Medicare supplement policies? A) Cost of the first 3 pints of blood B) At-home recovery services C) Daily coinsurance amount for skilled nursing facility care D) Emergency care in a foreign country
Cost of the first 3 pints of blood Explanation Coverage for the reasonable cost of the first 3 pints of blood is part of the minimum benefits required for Medicare supplements.
Which of the following is a mandatory minimum benefit for Medicare supplement policies? A) Supplemental coverage for 80% of all eligible hospital expenses not covered by Medicare B) Coverage of the 30% coinsurance amount under Medicare Part B, subject to a calendar year deductible of $100 C) A $1,000 death benefit D) Coverage of Medicare Part A-eligible hospital expenses to the extent not covered by Medicare from the 61st through the 90th day in any Medicare benefit period
Coverage of Medicare Part A-eligible hospital expenses to the extent not covered by Medicare from the 61st through the 90th day in any Medicare benefit period Explanation The benefits in Plan A, which is known as the core plan, must be contained in all other plans sold. Among the core benefits is coverage of Medicare Part A-eligible expenses for hospitalization, to the extent not covered by Medicare, from the 61st day through the 90th day in any Medicare benefit period.
Which of the following statements about Medicare supplement policies is CORRECT? A) Medicare Plan A provides coverage for skilled nursing facility care. B) Medicare Plan B provides coverage for skilled nursing facility care and at-home recovery care. C) Each standardized Medicare supplement policy must cover the basic benefits. D) There are 3 basic supplement policies that are considered core plans.
Each standardized Medicare supplement policy must cover the basic benefits. Explanation Each standardized Medicare supplement policy must cover the basic benefits. Medicare Plan A is the basic core plan. Medicare Plan B covers the basic benefits plus the Part A deductible for hospitalization. Neither Plan A nor Plan B covers skilled nursing facility care or at-home recovery care.
A 65-year-old employee of a company with 90 employees suffers a heart attack and, as a result, becomes totally disabled. Which of the following statements describes how his health benefits will be paid? A) As an active employee, his employer-sponsored health insurance will pay all benefits. B) Because he is over age 65, Medicare is responsible for paying all benefits. C) Medicare pays most of the benefits. After that, his employer-sponsored health insurance pays the remainder. D) His employer is the primary payer and Medicare pays the remaining eligible expenses.
His employer is the primary payer and Medicare pays the remaining eligible expenses. Explanation The employer has more than 20 employees and the individual is still an employee. Therefore, the employer-sponsored health insurance will be primary and Medicare will cover the remaining eligible expenses.
Which of the following statements about Medicare Part D is CORRECT? A) It is available to anyone enrolled in Medicare Part A or B) Some plans offer basic drug coverage. C) It helps cover the costs of hospitalization. D) Benefits are available only through Medicare Advantage plans.
It is available to anyone enrolled in Medicare Part A or Explanation Medicare Part D helps cover the cost of prescription drugs. It is available to anyone enrolled in Medicare Part A or Benefits are available through private prescription drugs plans or Medicare Advantage plans. All plans must offer basic drug coverage.
Which of the following statements regarding Medicare Part B is NOT true? A) It pays for skilled care provided in the home like speech, physical, or occupational therapy. B) It provides glaucoma testing once every 12 months. C) It covers a routine physical exam within 6 months of enrollment. D) It provides for annual mammograms for those over 40, pap tests, pelvic exams, and clinical breast exams.
It pays for skilled care provided in the home like speech, physical, or occupational therapy. Explanation Medicare Part A pays for skilled nursing after a hospital stay lasting at least 3 days. The other routine preventive items are covered by Part B.
Monica is covered under Medicare Part A. She spends 9 days in the hospital for back surgery and is released on August 22nd. It was the first time she ever had to stay overnight in the hospital. When the bill arrives, she pays her deductible, and Medicare pays the balance. She is admitted to the hospital again on November 14th of that same year for additional surgery. Which of the following statements is CORRECT? A) She need not pay the Part A deductible, but she must make a daily co-payment. B) It will be considered the start of a new benefit period. C) She will have to pay the Part A deductible again only if the second surgery is unrelated to the first surgery. D) She will not have to pay the Part A deductible again.
It will be considered the start of a new benefit period. Explanation The second hospitalization is part of a new benefit period, since it begins more than 60 days after the first hospitalization started. The new benefit period will require payment of the deductible again, but another hospitalization period of 60 days with 100% coverage of benefits is available.
Which of the following individuals would be eligible for Medicare? A) Marta, who is 59 and has received Social Security disability benefits for the last 36 months B) Nick, a single person who is 45 and has never worked C) Bernadette, who retired at 55 and is now 60 and living on her company pension D) Simon, who is 62 and just started receiving his Social Security monthly retirement checks
Marta, who is 59 and has received Social Security disability benefits for the last 36 months Explanation Marta is the only one who would be eligible for Medicare coverage. Eligibility is based on being 65 years of age or older; receiving Social Security disability benefits for at least the previous 24 months; or having end-stage renal disease (kidney failure).
Which of the following is a federal and state program designed to help provide needy persons, regardless of age, with medical coverage? A) Medigap B) Workers' compensation C) Medicaid D) Medicare
Medicaid Explanation Medicaid is a federal and state program designed to help provide needy persons, regardless of age, with medical coverage.
Which of the following statements pertaining to Medicare is CORRECT? A) Each individual covered by Medicare Part A is allowed one 90-day benefit period per year. B) For the first 90 days of hospitalization, Medicare Part A pays 100% of all covered services, except for an initial deductible. C) Medicare Part A is automatically provided when a qualified individual applies for Social Security benefits. D) Elena is covered under Medicare Part She submitted a total of $1,100 of approved medical charges to Medicare after paying the required deductible. Of that total, Elena must pay $880.
Medicare Part A is automatically provided when a qualified individual applies for Social Security benefits. Explanation Medicare Part A is available when an individual turns 65 and is automatically provided when he applies for Social Security benefits. Medicare Part B pays 80% of medical expenses after the insured pays the deductible.
Which of the following statements regarding Medicare is CORRECT? A) Under Medicare Part B, payments for physicians' services are unlimited. B) Medicare Part A carries no deductible. C) Medicare recipients are billed for their Medicare Part A premiums on a semiannual basis. D) Medicare Part B is voluntary.
Medicare Part B is voluntary. Explanation Medicare coverage has 2 distinct parts: Hospital Insurance (Part A) and Medical Insurance (Part B). Medicare Part A is automatically available to persons who have turned 65 and have applied for Social Security benefits. Part B is voluntary and may be elected or rejected as the recipient wishes.
Which of the following required provisions is INCORRECT? A) Medigap policies must be at least guaranteed renewable. B) Pre-existing conditions limitations may not last longer than six months from the date of issue. C) Medigap policies may not duplicate benefits provided by Medicare. D) Medicare supplement policies must have a 10-day free look period.
Medicare supplement policies must have a 10-day free look period. Explanation Medicare supplement policies must have a 30-day (not 10-day) free look period.
The abbreviation PDP refers to which part of Medicare? A) Part A B) Part D C) Part C D) Part B
Part D Explanation PDP stands for prescription drug plan. Medicare Part D makes prescription drug coverage available to people covered by Medicare Part A and Part B.
Victoria currently as a Medicare Advantage plan. Should her agent sell her a Medicare supplement policy? A) Yes, if her agent does not offer to sell her a Medicare supplement policy, the agent could be sued under her Errors and Omissions policy. B) Yes, it is her agent's responsibility to make sure she has the coverages she needs. C) No, it is illegal for anyone to sell a Medicare supplement policy to someone who is already in a Medicare Advantage plan (Medicare Part C). D) No, her agent already provides her with all the insurance she requires.
No, it is illegal for anyone to sell a Medicare supplement policy to someone who is already in a Medicare Advantage plan (Medicare Part C). Explanation When a person is already in a Medicare Advantage plan, it is illegal for anyone to sell that person a Medicare supplement policy.
An individual who requires 24-hour-a-day supervision by skilled medical professionals in a nursing home receives what kind of care? A) Skilled nursing care B) Respite care C) Intermediate nursing care D) Custodial care
Skilled nursing care Explanation Skilled nursing care is daily nursing care performed by, or under the supervision of, skilled medical professionals and is available 24 hours a day. It is typically administered in nursing homes.
Skilled nursing care differs from intermediate care in which of the following ways? A) Skilled nursing care must be available 24 hours a day, whereas intermediate care is daily, but not 24-hour, care. B) Skilled nursing care is typically given in a nursing home, whereas intermediate care is usually given at home. C) Skilled nursing care encompasses rehabilitation, whereas intermediate care is for meeting daily personal needs, such as bathing and dressing. D) Skilled nursing care must be performed by skilled medical professionals, whereas intermediate care does not require medical training.
Skilled nursing care must be available 24 hours a day, whereas intermediate care is daily, but not 24-hour, care. Explanation Unlike intermediate care, skilled nursing care is continuous, around-the-clock care provided by licensed medical professionals under the direct supervision of a physician. It is usually administered in nursing homes. Intermediate care is provided under the supervision of a physician by registered nurses, licensed practical nurses, and nurse's aides. Intermediate care is provided in nursing homes for stable medical conditions that require daily, but not 24-hour, supervision.
Which of the following statements regarding Medicare supplement insurance is INCORRECT? A) All standard Medigap plans must include 100% of the Part A hospital coinsurance. B) Medicare supplement policies cover co-payments, coinsurance and deductibles. C) It is illegal to sell a Medicare supplement policy to a person who is in a Medicare Advantage plan. D) The number of standard Medigap plans changes every year.
The number of standard Medigap plans changes every year. Explanation Medicare supplement insurance (Medigap) is standardized by the National Association of Insurance Commissioners (NAIC). There are 10 standard plans which offer different combinations of benefits and premiums.
In addition to the Buyer's Guide, what must be delivered to an applicant or insured either with or before the delivery of a life insurance policy? A) A copy of the company annual report B) The outline of coverage C) A statement regarding dividends D) A copy of the signed application
The outline of coverage Explanation The outline of coverage must be delivered with the policy or before the policy is delivered, whether by a producer or a direct response insurer.
Which of the following statements regarding the lifetime reserve of hospital coverage for Medicare patients is CORRECT? A) Tapping into the reserve results in a lower daily co-payment. B) If a patient exhausts the reserve, she must pay a higher co-payment. C) The reserve does not renew with a new benefit period. D) The reserve may be replenished if the patient reenters a hospital after a benefit period ends and pays a new deductible.
The reserve does not renew with a new benefit period. Explanation The lifetime reserve is an additional 60 days of coverage on top of the 90-day benefit period Medicare provides for hospitalization. A patient who is hospitalized for longer than 90 days can tap into the 60-day reserve. This reserve is a onetime benefit; it is not replenished with a new benefit period. Tapping into the reserve will require a higher co-payment from the patient. If a patient is hospitalized beyond the 60th lifetime reserve day, thus exhausting the reserve, she will be responsible for all hospital charges.
A Medicare supplement policy that contains restricted network provisions is known as A) a Medicare SELECT policy B) a long-term care policy C) an HMO D) an individual health policy
a Medicare SELECT policy Explanation A Medicare select policy or Medicare select certificate mean, respectively, a Medicare supplement policy or certificate that contains restricted network provisions.
A contract designed primarily to supplement reimbursement under Medicare for hospital, medical or surgical expenses is known as A) an alternative benefits plan B) a home health care plan C) a Medicare supplement plan D) an alternative health care plan
a Medicare supplement plan Explanation Because of the significant gaps in coverage provided by Medicare, many insurers offer Medicare supplement policies that supplement Medicare, paying much of what Medicare does not. To protect consumers, the law narrowly defines what must be included in a Medicare supplement policy. These minimum standards apply to both individual and group policies.
A contract that is designed primarily to augment reimbursement under Medicare for hospital, medical, or surgical expenses is known as A) an alternative benefits plan B) a home health care plan C) a Medicare supplement plan D) an alternative health care plan
a Medicare supplement plan Explanation Medicare supplement policies cover significant gaps in Medicare health insurance coverage.
Medicare is designed to pay for A) old-age benefits B) death benefits C) disability benefits D) a large portion of the health care bill for eligible persons
a large portion of the health care bill for eligible persons Explanation Medicare is designed to pay for a large portion of the health care bill for those eligible. To be covered, a person must be fully insured according to Social Security. The qualifications include accumulating 40 credits, which are earned by generating a minimum amount of work-related income over at least 10 years and paying Social Security taxes.
Medicare supplement (or Medigap) policies pay A) all or most of Medicare's deductibles B) benefits to those who cannot afford Medicare Part B coverage C) medical costs arising from extended custodial (nursing home) care D) benefits provided under Medicare Part A
all or most of Medicare's deductibles Explanation Medicare supplement, or Medigap, policies pick up coverage where Medicare leaves off. These policies supplement Medicare's benefits by paying most, if not all, coinsurance amounts and deductibles and paying for some health care services not covered by Medicare, such as outpatient prescription drugs. They do not cover the cost of extended nursing home care.
People age 65 or older who enroll in Medicare Part B may also select Medigap coverage during A) a grace period B) a free-look period C) an open enrollment period D) a free-enrollment period
an open enrollment period Explanation People age 65 or older who enroll in Medicare Part B are afforded a 6-month open enrollment period for purchasing Medigap insurance coverage. The coverage becomes effective the following July 1.
The purpose of Medicare supplement insurance is to provide A) coverage for certain medical expenses before the insured becomes eligible for Medicare B) coverage for certain expenses not fully covered by Medicare C) coverage to elderly people who are not covered under a corporate plan for retired employees D) an alternative insurance plan for people who do not want to use Medicare
coverage for certain expenses not fully covered by Medicare Explanation The primary purpose of Medicare supplement insurance is to augment Medicare by paying hospital, medical, or surgical expenses that Medicare does not cover because of the deductibles, coinsurance amounts, or other limitations. Medicare supplement policies cannot contain benefits that duplicate those provided by Medicare.
The purpose of Medicare supplement insurance is to provide A) coverage for certain expenses not fully covered by Medicare B) coverage for certain medical expenses before the insured becomes eligible for Medicare C) coverage to elderly people who are not covered under a corporate plan for retired employees D) an alternative insurance plan for people who do not want to use Medicare
coverage for certain expenses not fully covered by Medicare Explanation The primary purpose of a Medicare supplement insurance policy is to augment Medicare with payment of hospital, medical, or surgical expenses that Medicare does not cover.
The core policy (Plan A) developed by NAIC as a standard Medicare supplement policy includes all of the following EXCEPT A) coverage for the 20% Part B coinsurance amounts for Medicare-approved services B) coverage for the Part A coinsurance amounts C) coverage for the first 3 pints of blood each year D) coverage for the Medicare Part A deductible
coverage for the Medicare Part A deductible Explanation The Medicare Plan A supplement policy does not provide coverage for the Medicare Part A deductible. All the other answer choices are included in the core benefits that all Medicare supplement policies must provide, including Medicare Plan A supplement policies.
All of the following benefits are available under Medicare EXCEPT A) home health care visits for a speech therapist B) skilled nursing care following a hospital stay of at least 3 days C) custodial care D) hospital expenses
custodial care Explanation Medicare provides benefits for hospital stays, skilled nursing, and home health care visits under Part A.
An individual who chooses not to enroll in Part B when first applying for Medicare may do so A) at any time after enrolling in Part A B) between July and September of each year C) on the anniversary of his Part A enrollment date D) during an annual open enrollment period
during an annual open enrollment period Explanation Applicants can choose to enroll in Part B of Medicare during the open enrollment period each year, from January 1 through March 31. Coverage then begins the following July 1.
A Medicare supplement policy must offer coverage of Medicare Part A-eligible expenses for hospitalization A) from days 1 through 90 B) for the first year C) for the length of the illness D) from days 61 through 90
from days 61 through 90 Explanation Medicare supplement policies must offer certain minimum benefits. For example, they must offer coverage of Medicare Part A-eligible expenses for hospitalization not covered by Medicare from days 61 through 90 in any Medicare benefit period.
Sally, age 66, has accumulated 50 credits from working during the past 15 years. For Social Security purposes, this means that Sally is A) ineligible for full retirement and survivor benefits B) partially insured C) fully insured D) ineligible for Medicare
fully insured Explanation Sally is fully insured if she has accumulated the required number of credits, which in most cases is 40 (representing approximately 10 years of work). Because she is fully insured, Sally is eligible for full retirement, survivor, and disability benefits.
With regard to medical benefits available through the federal government, Medicaid provides A) medical benefits for the disabled, regardless of income B) funds to states to assist their medical public assistance programs C) medical benefits exclusively for the aged D) medical benefits to all who have contributed to its funding through payroll taxes
funds to states to assist their medical public assistance programs Explanation Medicaid provides funds to states to assist their medical public assistance programs. Medicare provides health benefits for the aged and disabled.
Medicaid provides A) funds to charitable organizations for providing medical benefits to poor people B) funds to states for the provision of medical care to the aged C) medical benefits to those who have contributed to its funding through payroll taxes D) funds to states to assist their medical public assistance programs
funds to states to assist their medical public assistance programs Explanation Medicaid provides matching federal funds to states for their medical public assistance programs to help needy persons, regardless of age.
The core policy (Plan A) developed by the NAIC as a standard Medicare supplement policy includes all of the following EXCEPT A) long-term care insurance deductibles B) coverage for Part A co-payment amounts C) the first 3 pints of blood each year D) the 20% Part B coinsurance amounts for Medicare-approved services
long-term care insurance deductibles Explanation This plan includes coverage for Part A co-payment amounts; 365 additional (lifetime) days of Medicare-eligible expenses once the Medicare lifetime reserve days are exhausted; the 20% Part B co-payment amounts (for Medicare-approved services); and the first 3 pints of blood each year. At a minimum, all Medicare supplement policies must contain these core benefits.
To be eligible for Medicare's skilled nursing facility care benefit, the claimant must do all of the following EXCEPT A) spend at least 3 days in a hospital B) meet acceptable income limits C) have a physician certify that skilled care is required D) enter a Medicare-certified skilled nursing care facility
meet acceptable income limits Explanation Medicare nursing facility care benefits are available only if the following conditions are met: the patient must have been hospitalized for at least 3 days before entering the skilled nursing care facility and admittance to the facility must be within 30 days of discharge from the hospital; a doctor must certify that skilled nursing is required; and the services must be provided by a Medicare-certified skilled nursing care facility.
Individuals claiming a need for Medicaid must prove that they cannot pay for their own nursing home care. In addition, the potential recipient must A) be at least 70 years old B) need the type of care that is provided only in a nursing home C) be a long-term care insurance policyowner D) be receiving Social Security
need the type of care that is provided only in a nursing home Explanation To qualify for Medicaid nursing home benefits, an individual must be at least 65 years old, blind, or disabled; be a U.S. citizen or permanent resident alien; need the type of care that is provided only in a nursing home; and meet certain asset and income tests.
Under Medicare Part A, the participant must pay his deductible A) twice per benefit period B) monthly C) once per benefit period D) annually
once per benefit period Explanation For Medicare Part A, the participant must pay his deductible once per benefit period. A benefit period starts when a patient enters the hospital and ends when the patient has been out of the hospital for 60 consecutive days. Once 60 days have passed, any new hospital admission is considered to be the start of a new benefit period. Thus, if a patient reenters a hospital after a benefit period ends, a new deductible is required and the 90-day hospital coverage period is renewed.
Medicare supplement (Medigap) policies do NOT A) pay for extended nursing home care B) pay for most or all Medicare deductibles and co-payments C) pay for some health care services not covered by Medicare D) supplement Medicare benefits
pay for extended nursing home care Explanation Medicare supplement, or Medigap, policies supplement Medicare's benefits by paying most deductibles and co-payments as well as some health care services that Medicare does not cover. They do not cover the cost of extended nursing home care.
In the standardized Medicare supplement policy, Plan A is characterized by A) availability only to Medicare recipients younger than age 75 B) duplicating Medicare benefits for maximum security C) offering the widest coverage D) providing the least comprehensive coverage
providing the least comprehensive coverage Explanation In the 12 standardized Medicare supplement plans, Plan A provides the least coverage and is referred to as the core plan. Plan J has the most comprehensive coverage. Plans K and L provide basic benefits similar to plans A through J, but cost sharing is at different levels.
Medicare is an example of A) casualty insurance B) social insurance C) commercial insurance D) debt insurance
social insurance Explanation Medicare is an example of a social insurance program, as it is instituted by the federal government.
All Medicare supplement policies must cover 100% of the Part A hospital coinsurance amount for each day used from A) the 30th through the 90th day in any Medicare benefit period B) the 61st through the 90th day in any Medicare benefit period C) the 45th through the 90th day in any Medicare benefit period D) the 1st through the 60th day in any Medicare benefit period
the 61st through the 90th day in any Medicare benefit period Explanation All Medicare supplement policies must cover the core basic benefits that Plan A covers. This includes covering 100% of the Part A hospital coinsurance amount for each day used from the 61st through the 90th day in any Medicare benefit period and 100% of the Part A hospital coinsurance amount for each Medicare lifetime inpatient reserve day used from the 91st through the 150th day in any Medicare benefit period.
According to the National Association of Insurance Commissioners' standardized model Medicare supplement policy, insurers must offer coverage for all of the following core benefits EXCEPT A) coverage under Medicare Parts A and B for the first 3 pints of blood or equivalent (unless replaced according to federal regulations) B) Medicare Part A-eligible hospital expenses not covered by Medicare from the 61st day through the 90th day in any Medicare benefit period C) the coinsurance amount of Medicare Part B-eligible expenses, regardless of hospital confinement, subject to the Medicare Part B deductible D) the Medicare Part A deductible
the Medicare Part A deductible Explanation All Medicare supplement policies must provide certain core benefits, including coverage for Medicare Part A-eligible hospital expenses not covered by Medicare from the 61st day through the 90th day in any Medicare benefit period, the coinsurance amount of Medicare Part B-eligible expenses, and coverage under Medicare Parts A and B for the first 3 pints of blood. Although Plan A does not provide coverage for the Medicare Part A deductible, other Medicare supplement policies (Plans B through J) cover this deductible.
The first page of a Medicare supplement policy must contain all of the following EXCEPT A) the producer's commission and the policy's premium B) highly visible notice of the 30-day free look period C) the policy's renewal provision, including a description of any premium increases that may be involved D) the Notice to Buyer -this policy may not cover all of your medical expenses
the producer's commission and the policy's premium Explanation The disclosure regulations require the first page of the policy to contain the Notice to Buyer, 30-day free look period notice and the renewal provision with descriptions of premium increases. Applicants must be also provided with a buyer's guide "A Guide to Health Insurance for People with Medicare", and an Outline of Coverage.