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 (D)</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 (B)</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 (A)</p> Signup and view all the answers

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

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

Which part of Medicare pays for outpatient hospital services?

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

How is Medicare Part B funded?

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

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

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

Who is automatically enrolled in Medicare Part B?

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

What is a characteristic of Social Insurance Programs?

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

Who administers the Medicare program centrally?

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

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

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

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