Chapter Ten: Other Medicare Health Plans

A Medicare supplement policy must provide coverage Medicare Part A-eligible expenses for hospitalization:

From days 61 through 90 Among the minimum benefits Medicare supplements must cover is coverage for Medicare-eligible expenses for hospitalization not covered by Medicare from days 61 to 90 in any benefit period.

A contract designed primarily to augment reimbursement under Medicare for hospital, medical, or surgical expenses is:

A Medicare supplement plan Medical supplement policies cover gaps in Medicare health insurance coverage. They supply coverage of these gaps.

To be eligible for PACE, an individual must be:

Age 55 or above, live in a PACE service area, and state-certified as requiring nursing home care Individuals who meet all of the following are eligible for PACE: age 55 and above; resides in a PACE organization's service area; and state-certified as requiring nursing home care.

Medicaid will pay for all of the following, EXCEPT:

Cosmetic procedures Medicaid pays for medical care that certain financially needy individuals cannot afford, such as physicians' fees, hospitalization, pregnancy and maternity care.

All the following statements about Medicare supplement policies are false, EXCEPT:

Each standardized Medicare supplement policy must cover the basic benefits. Each standardized Medicare supplement must cover the basic defined benefits in Medicare Supplement Plan A, the core plan. Medicare Supplement Plan B covers basic benefits plus Medicare Part A deductible for hospitalization. Neither Medicare Supplement Plan A nor Plan B covers skilled nursing facility care or at-home recovery care.

How is Medicaid funded?

Federal and state taxes Medicaid is funded through state and federal taxes.

Which of the following is a Medicare supplement additional benefit?

Medicare Part B deductible The core benefits include: Medicare Part A copayments for approved hospital charges during the 61st through 90th day of hospitalization; Medicare Part A copayments for approved hospital charges for the 60 lifetime reserve days; approved hospitalization costs for 365 extra days after all Medicare benefits have been exhausted; coverage for the blood deductible (first three pints); and the 20% Medicare Part B coinsurance.

When is open enrollment for Medicare supplement policies?

Open enrollment for Medigap policies spans a six-month period beginning on the first day of the month in which the individual is age 65 or above and enrolls in Medicare Part B. Open enrollment for Medigap policies spans a six-month period beginning on the first day of the month in which the individual is age 65 or above and enrolls in Medicare Part B.

Medicaid is operated on the:

State level Each state operates its own Medicaid program through its Department of Public Welfare. However, states must comply with federal regulations and guidelines.

Which of the following pays monthly income for food, shelter and clothing needs to individuals with limited incomes, are disabled or blind, or are age 65 and older?

Supplemental Security Income Benefits Supplemental Security Income (SSI) benefits are monthly income paid by Social Security to individuals with limited incomes, are disabled or blind, or are age 65 and older. SSI is different from Social Security benefits, and pays for an individual's food, shelter and clothing needs.