Chapter 31 Medicare & Medicaid

Which of the following policies is meant to cover only gaps for medical costs not covered by another policy?

Medicare Supplement Insurance

New point not in the text - be sure to read the explanation! If a physician has agreed to accept assignment of Medicare benefits, that means that the physician:

Medicare assignment means that the doctor or other provider will accept the Medicare-approved payment amount as full payment for the service. The care provider can only charge the patient the Medicare deductible and coinsurance amount. The provider is required to submit the claim directly to Medicare rather than having the patient submit the claim. This is a new point not in the text. The correct answer is: agreed to accept the Medicare-approved rate as full payment although the patient will have to pay the deductible and coinsurance amount.

Each of the following is true regarding Skilled Nursing Facility care under a Medicare policy EXCEPT:

Physician prescription, yes. Daily prescription, no. The correct answer is: The Insured must have a daily prescription from a physician.

New point not in the text - be sure to read the explanation! Under Medicare Part B, the Insured will be expected to pay what portion of a physician's bill?

20%

Which of the following statements regarding Medicare is CORRECT?

It is funded by payroll taxes.

Which is a state/federal program to provide health coverage for the destitute?

Medicaid

New point not in the text - be sure to read the explanation! Each of the following can provide a Medicare Advantage Plan EXCEPT:

Medicare Advantage plans aren't sold by the government. So, Social Security (a government agency) doesn't provide Medicare Advantage Plans, but HMOs and PPOs do. A Private Fee-for-Service) provider is simply a private insurance company (other than an HMO or PPO) that offers a Medicare Advantage plan. The correct answer is: Social Security Disability Insurance (SSDI)

Jane will not need a Medicare Supplement Policy if she has:

Medicare Part C

A Basic Hospital Plan is comparable to Medicare's:

Part A

The Social Security Administration is the sole source of funding for which Medicare coverage section?

Part A

Under a Medicare policy:

Part A pays for hospital, Part B pays for physician care.

Which of the following is NOT covered under Medicare Supplement Insurance?

The correct answer is: Long-Term Care.

Which of the following statements regarding Medicare Supplement policies is CORRECT?

The correct answer is: They may pay for extra days of hospital stay when Medicare benefits are exhausted.

What is the main purpose of Medicare Supplement Insurance?

To cover expenses not fully covered by Medicare.