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Medicaid provides all of the following benefits EXCEPT
Medicaid provides all of the following benefits EXCEPT
Following an injury, a policyowner covered under Medicare Parts A & B was treated by her physician on an outpatient basis. How much of her doctor's bill will she be required to pay out-of-pocket?
Following an injury, a policyowner covered under Medicare Parts A & B was treated by her physician on an outpatient basis. How much of her doctor's bill will she be required to pay out-of-pocket?
20% of covered charges above the deductible
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. The insurance company is obligated to offer the supplement policy on a guaranteed issue basis.
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. The insurance company is obligated to offer the supplement policy on a guaranteed issue basis.
True
In which of the following situations would Social Security Disability benefits NOT cease?
In which of the following situations would Social Security Disability benefits NOT cease?
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Social Security disability definition includes all of the following EXCEPT
Social Security disability definition includes all of the following EXCEPT
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If a person is disabled at age 27 and meets Social Security's definition of total disability, how many work credits must he/she have earned to receive benefits?
If a person is disabled at age 27 and meets Social Security's definition of total disability, how many work credits must he/she have earned to receive benefits?
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Which of the following is NOT an enrollment period for Medicare Part A applicants?
Which of the following is NOT an enrollment period for Medicare Part A applicants?
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Regarding Medicare SELECT policies, what are restricted network provisions?
Regarding Medicare SELECT policies, what are restricted network provisions?
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Which statement regarding qualifications for Social Security disability benefits is NOT true?
Which statement regarding qualifications for Social Security disability benefits is NOT true?
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An insured has Medicare Part D coverage. Upon reaching the initial benefit limit, what percentage of the prescription drug cost is the insured responsible for paying?
An insured has Medicare Part D coverage. Upon reaching the initial benefit limit, what percentage of the prescription drug cost is the insured responsible for paying?
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The primary eligibility requirement for Medicaid benefits is based upon
The primary eligibility requirement for Medicaid benefits is based upon
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How long is an open enrollment period for Medicare supplement policies?
How long is an open enrollment period for Medicare supplement policies?
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In order for an insured under Medicare Part A to receive benefits for care in a skilled nursing facility, the insured must have first been hospitalized for 3 consecutive days.
In order for an insured under Medicare Part A to receive benefits for care in a skilled nursing facility, the insured must have first been hospitalized for 3 consecutive days.
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To sign up for a Medicare prescription drug plan, individuals must first be enrolled in
To sign up for a Medicare prescription drug plan, individuals must first be enrolled in
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Which of the following statements is NOT true concerning Medicaid?
Which of the following statements is NOT true concerning Medicaid?
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Which type of care is NOT covered by Medicare?
Which type of care is NOT covered by Medicare?
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Which of the following is NOT covered by Medicare?
Which of the following is NOT covered by Medicare?
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Which of the following is NOT a factor in determining qualifications for Social Security disability benefits?
Which of the following is NOT a factor in determining qualifications for Social Security disability benefits?
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Which of the following is NOT covered under Plan A in Medigap insurance?
Which of the following is NOT covered under Plan A in Medigap insurance?
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Concerning Medicare Part B, it is fully funded by Social Security taxes (FICA).
Concerning Medicare Part B, it is fully funded by Social Security taxes (FICA).
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All of the following individuals may qualify for Medicare health insurance benefits EXCEPT
All of the following individuals may qualify for Medicare health insurance benefits EXCEPT
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For how many days of skilled nursing facility care will Medicare pay benefits?
For how many days of skilled nursing facility care will Medicare pay benefits?
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In which Medicare supplemental policies are the core benefits found?
In which Medicare supplemental policies are the core benefits found?
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Prior to purchasing a Medigap policy, a person must be enrolled in which of the following?
Prior to purchasing a Medigap policy, a person must be enrolled in which of the following?
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The part of Medicare that helps pay for inpatient hospital care, inpatient care in a skilled nursing facility, home health care and hospice care, is known as
The part of Medicare that helps pay for inpatient hospital care, inpatient care in a skilled nursing facility, home health care and hospice care, is known as
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Which of the following programs expands individual public assistance programs for people with insufficient income and resources?
Which of the following programs expands individual public assistance programs for people with insufficient income and resources?
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Which of the following is NOT covered under Part B of a Medicare policy?
Which of the following is NOT covered under Part B of a Medicare policy?
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A Medicare supplement plan must have at least which of the following renewal provisions?
A Medicare supplement plan must have at least which of the following renewal provisions?
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A 63 year old man is planning to be employed until age 68. He will be eligible for Medicare at age 65, regardless of employment status.
A 63 year old man is planning to be employed until age 68. He will be eligible for Medicare at age 65, regardless of employment status.
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The CORRECT statement concerning the relationship between Medicare and HMOs is: HMOs may pay for services not covered by Medicare.
The CORRECT statement concerning the relationship between Medicare and HMOs is: HMOs may pay for services not covered by Medicare.
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Once the person meets the stringent requirements for disability benefits under Social Security, how long is the waiting period before any benefits will be paid?
Once the person meets the stringent requirements for disability benefits under Social Security, how long is the waiting period before any benefits will be paid?
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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?
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?
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A Medicare SELECT policy does all of the following EXCEPT
A Medicare SELECT policy does all of the following EXCEPT
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Which type of Medicare policy requires insureds to use specific healthcare providers and hospitals (network providers), EXCEPT in emergency situations?
Which type of Medicare policy requires insureds to use specific healthcare providers and hospitals (network providers), EXCEPT in emergency situations?
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All of the following are covered by Part A of Medicare EXCEPT
All of the following are covered by Part A of Medicare EXCEPT
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Part B coverage is provided free of charge when an individual turns age 65.
Part B coverage is provided free of charge when an individual turns age 65.
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Medicare Advantage must be provided through HMOs.
Medicare Advantage must be provided through HMOs.
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Medicare Part A provides
Medicare Part A provides
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Medicare Advantage (previously Medicare + Choice)
Medicare Advantage (previously Medicare + Choice)
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How many pints of blood will be paid for by Medicare Supplement core benefits?
How many pints of blood will be paid for by Medicare Supplement core benefits?
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Medicare supplement insurance policies cover the cost of extended nursing home care.
Medicare supplement insurance policies cover the cost of extended nursing home care.
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All of the following qualify for Medicare Part A EXCEPT
All of the following qualify for Medicare Part A EXCEPT
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Following hospitalization because of an accident, Bill was confined in a skilled nursing facility. Medicare will pay full benefits in this facility for how many days?
Following hospitalization because of an accident, Bill was confined in a skilled nursing facility. Medicare will pay full benefits in this facility for how many days?
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Medicare Part A services do NOT include which of the following
Medicare Part A services do NOT include which of the following
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Hospice care is intended for
Hospice care is intended for
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The correct statement concerning Medicare Part B is: It pays for physicians services, diagnostic tests, and physical therapy.
The correct statement concerning Medicare Part B is: It pays for physicians services, diagnostic tests, and physical therapy.
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Medicaid is solely a federally administered program.
Medicaid is solely a federally administered program.
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Medicaid is
Medicaid is
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To be eligible for Social Security, one must meet certain requirements.
To be eligible for Social Security, one must meet certain requirements.
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Plan A must be present in all Medicare supplement plans.
Plan A must be present in all Medicare supplement plans.
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All of the following are advantages of an HMO or PPO for a Medicare recipient EXCEPT
All of the following are advantages of an HMO or PPO for a Medicare recipient EXCEPT
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Medicare Part B is a compulsory program.
Medicare Part B is a compulsory program.
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Medicare Part B is
Medicare Part B is
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Study Notes
Medicaid
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Medicaid provides income assistance for work-related injury.
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Medicaid eligibility is based on need.
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It is a joint federal and state-funded assistance program for those with insufficient income or resources for healthcare.
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It is not primarily about hospitalization, doctors, services, and disability income; rather, it focuses on assistance for those with insufficient income and/or resources.
Medicare Parts A & B
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Outpatient medical care: 20% of covered costs above deductible.
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Medicare Part A: Covers hospital care, skilled nursing facility care, home health care, and hospice care. It's not all-encompassing as Part B is also needed.
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Medicare Part B: Covers physician services, diagnostic tests, and physical therapy. it covers medical services, but not all of them.
Medicare Supplement Coverage
- Guaranteed issue for applicants age 65 newly enrolled in Part A and Part B.
- Open enrollment period: 6 months.
- Required enrollment in Medicare Parts A and B before purchasing a supplemental policy.
Social Security Disability Benefits
- Disability benefits do not stop if the disabled person's child gets a part-time job.
- Disability is continuous, not temporary. Expected duration must exceed 6 months
- Disability is not necessarily a condition that is expected to last for 6 months.
- 12 work credits are needed for benefits.
- There isn't an age minimum for eligibility, so not 65 years old automatically.
- A person must meet a specific definition of disability in addition to accumulating work credits.
Medicare Part D
- 25% of prescription drug costs are the insured's responsibility once the initial benefit limit has been reached.
- Part D is specifically for prescription drugs and doesn't cover other medical expenses.
Medicare Enrollment
- No automatic enrollment option exists for Part A.
- Enrollment periods do not include automatic enrollment options for Part A or Part B
Medicare SELECT Policies
- Benefit payment conditions are set and restricted to network care providers.
Medicare Care Types
- Medicare does not cover long-term care or routine dental services.
- Cosmetic surgery is not a covered service.
Medicare Part A
- For inpatient hospital care, inpatient care in a skilled nursing facility, home health care, and hospice care. Covers 20 days in a skilled nursing facility after hospitalization
- 100 days of skilled nursing facility care; a specific timeframe.
Medicare Part B
- Part B is not fully funded by Social Security taxes; there are premiums involved.
- It does cover physicians' services and diagnostic tests.
Medicare Eligibility
- Age 65 is not the only requirement for eligibility.
- Not for those who are 50 years old.
Social Security Disability Requirements
- The insured's occupation isn't a qualification factor.
Medicare Supplement (Medigap)
- Medigap does not cover the Medicare Part A deductible; separate policies are needed to cover.
- First 3 pints of blood are covered.
- Medigap does not cover extended nursing home care.
Medicare and HMOs
- HMOs or PPOs may cover some services not covered by Original Medicare. Medicare Advantage plans can be structured through various provider types.
Social Security Disability Waiting Period
- Eligibility standards necessitate a waiting period of 5 months.
Social Security Disability Work Credits
- 6 credits within the prior 3 years is a requirement for benefit eligibility.
- This is a time constraint. Six credits are not sufficient on their own.
Medicare SELECT
- Medicare SELECT does not typically prohibit payment for services if a non-network provider is used if applicable.
Medicare Part A Eligibility
- Requirements vary.
Medicare Skilled Nursing Facility Benefits
- Medicare pays for only a set period.
Medicare Part A Services Exclusions
- Outpatient hospital treatment is excluded from Medicare Part A coverage.
- It is covered under Part B.
Hospice Care
- Intended for the terminally ill individuals. Hospice care is for those nearing the end of their life.
Medicare Part B Services
- Covers physician services, diagnostic tests, and physical therapy; but not all healthcare services is part of this plan.
Medicaid Administration
- Medicaid is not a solely federally-administered program.
Social Security Eligibility
- Social Security eligibility depends on meeting requirements.
- Social security eligibility is dependent on meeting specific requirements.
Medicare Supplement Core Benefits
- Medicare supplement plans include a core set of benefits, but those benefits are not universally applicable across all policies.
HMO and PPO Advantages
- Elective cosmetic procedures are not typically covered by Medicare Advantage or related plans, whether in an HMO or PPO.
Medicare Part B
- Part B is not compulsory; it is optional coverage.
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Description
This quiz covers the essential differences and coverage details of Medicaid, Medicare Parts A and B, and Medicare Supplement Coverage. Understand the financial assistance provided for healthcare under these programs, including eligibility criteria and the services covered. Test your knowledge on the important aspects of these vital healthcare options.
