Medicare
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Questions and Answers

What percentage of the Medicare eligible population enrolled in Part B in 2020?

  • 85%
  • 75%
  • 65%
  • 95% (correct)
  • How is Medicare Part B funded?

  • By premiums from recipients (correct)
  • By government taxes
  • Through donations
  • By private insurance companies
  • What is the premium for Medicare Part B in 2024?

  • $150/month
  • $250/month
  • $200/month
  • $174.70/month (correct)
  • For incomes over $500,000 (single) or $750,000 (married), what is the premium for Medicare Part B?

    <p>$594/month</p> Signup and view all the answers

    Which Medicare service is designed to help recovery in a less expensive environment than the hospital?

    <p>Home health</p> Signup and view all the answers

    What kind of services does Medicare pay for that are lower cost substitutes for hospital care?

    <p>Skilled nursing and home health services</p> Signup and view all the answers

    What percentage of the Medicare population has fair/poor health?

    <p>23%</p> Signup and view all the answers

    Which part of Medicare pays for outpatient hospital services?

    <p>Part B</p> Signup and view all the answers

    Who automatically receives Medicare Part A benefits without paying a premium?

    <p>Persons aged 65 and older</p> Signup and view all the answers

    How is Medicare Part B funded?

    <p>By payroll taxes</p> Signup and view all the answers

    What is the deductible amount for Hospital Deductible under Medicare Part A in 2024?

    <p>$1,632</p> Signup and view all the answers

    Who is automatically enrolled in Medicare Part B?

    <p>Persons who are Medicare eligible</p> Signup and view all the answers

    What is a characteristic of Social Insurance Programs?

    <p>Benefits are earned</p> Signup and view all the answers

    Who administers the Medicare program centrally?

    <p>Social Security Administration (SSA)</p> Signup and view all the answers

    Which department is responsible for investigating fraud in the Medicare system?

    <p>Centers for Medicare and Medicaid Services (CMS)</p> Signup and view all the answers

    What is the eligibility requirement for individuals to receive Medicare benefits?

    <p>Having worked at eligible jobs during their career</p> Signup and view all the answers

    Which agency is responsible for making policy and paying healthcare providers in the Medicare system?

    <p>Centers for Medicare and Medicaid Services (CMS)</p> Signup and view all the answers

    What does it mean when it is said that benefits in Medicare are earned?

    <p>Individuals work at eligible jobs and pay into the system</p> Signup and view all the answers

    What is the purpose of the low-income subsidy mentioned in the text?

    <p>To waive or reduce Medicare premiums and deductibles for eligible individuals</p> Signup and view all the answers

    Which group of beneficiaries is highlighted as potentially having significant savings through Part D enrollment?

    <p>Beneficiaries with higher incomes and assets who don’t have adequate coverage</p> Signup and view all the answers

    What does TrOOP stand for in the context of Medicare Part D?

    <p>True Out-of-Pocket Costs</p> Signup and view all the answers

    What is the late penalty fee incurred by individuals not enrolled in Part D or a creditable plan after 12/31/23?

    <p>1% of premium per month</p> Signup and view all the answers

    What significant change occurred regarding insulin products in 2023 in relation to Medicare Part D coverage?

    <p>Insulin products were limited to $35/month for all beneficiaries</p> Signup and view all the answers

    What key feature is introduced for Medicare coverage in 2025 according to the text?

    <p>Out-of-pocket spending capped at $2,000</p> Signup and view all the answers

    What does a 5-star plan in Part D have that other plans do not?

    <p>Special enrollment period</p> Signup and view all the answers

    Why was there a dramatic decline in pharmacy reimbursement, especially in rural areas?

    <p>Lack of minimum or maximum reimbursement rates set by Congress</p> Signup and view all the answers

    Which of the following medications are NOT covered under Part D?

    <p>Antigens (allergy shots)</p> Signup and view all the answers

    What is an example of a drug covered by Nebraska Medicaid but not covered under Part D?

    <p>Rx cough &amp; cold medications</p> Signup and view all the answers

    What requirement must be met by the retail pharmacy network in urban areas according to Tricare standards?

    <p>90% of beneficiaries must live within 2 miles of a retail pharmacy</p> Signup and view all the answers

    What is the primary goal of a Medication Therapy Management (MTM) program?

    <p>Ensure appropriate use of Part D drugs and optimize therapeutic outcomes</p> Signup and view all the answers

    Why did Congress avoid setting minimum or maximum reimbursement rates for pharmacies?

    <p>To allow the marketplace to determine fair rates</p> Signup and view all the answers

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