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Questions and Answers
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 Medicare Part A.
To sign up for a Medicare prescription drug plan, individuals must first be enrolled in Medicare Part A.
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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, which statement is INCORRECT?
Concerning Medicare Part B, which statement is INCORRECT?
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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. When will he be eligible for Medicare?
A 63 year old man is planning to be employed until age 68. When will he be eligible for Medicare?
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Which of the following statements is CORRECT concerning the relationship between Medicare and HMOs?
Which of the following statements is CORRECT concerning the relationship between Medicare and HMOs?
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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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Which of the following statements is INCORRECT concerning Medicare Part B coverage?
Which of the following statements is INCORRECT concerning Medicare Part B coverage?
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Which of the following statements is NOT correct regarding Medicare?
Which of the following statements is NOT correct regarding Medicare?
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Medicare Part A
Medicare Part A
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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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All of the following statements about Medicare supplement insurance policies are correct EXCEPT
All of the following statements about Medicare supplement insurance policies are correct EXCEPT
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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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Which of the following statements concerning Medicare Part B is correct?
Which of the following statements concerning Medicare Part B is correct?
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Which of the following is INCORRECT concerning Medicaid?
Which of the following is INCORRECT concerning Medicaid?
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Medicaid
Medicaid
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Which of the following statements is CORRECT about Social Security?
Which of the following statements is CORRECT about Social Security?
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Which of the following must be present in all Medicare supplement plans?
Which of the following 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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All of the following statements about Medicare Part B are correct EXCEPT
All of the following statements about Medicare Part B are correct EXCEPT
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Study Notes
Medicaid
- Medicaid provides assistance for healthcare to individuals with limited income and resources.
- While income assistance for work-related injuries is a benefit, this is not the complete list of Medicaid benefits.
Medicare Parts A & B
- Outpatient treatment subject to 20% copay for covered charges above the deductible.
Medicare Supplement Coverage
- Insurance companies must offer Medicare supplement policies on a guaranteed issue basis for those newly eligible for Part A & B (age 65).
Social Security Disability Benefits
- Disability benefits do not stop if the recipient's child finds a part-time job.
- Disability is not determined by expected duration; it's about the present inability to work.
- 12 work credits are required for those under 65 to receive benefits.
- Factors to qualify include work history, inability to work due to disability, and meeting eligibility criteria (not age-specific unless over 65).
- A waiting period of 5 months exists before receiving disability benefits. The applicant must have earned at least 6 credits in the three years immediately before applying for the benefits.
Medicare Enrollment Periods
- Medicare Part A applicants do not have an automatic enrollment period.
Medicare SELECT Policies
- Payment for benefits may be conditioned due to participating in a restricted provider network.
Medicare Prescription Drug Plans (Part D)
- The insured is responsible for 25% of the prescription drug cost once the initial benefit limit is reached.
Medicare Part A
- Covers inpatient hospital care, skilled nursing facility care, home health care, and hospice care.
- A three-day hospital stay requirement precedes skilled nursing facility care coverage.
- It does not cover outpatient hospital treatment, which is covered under Part B.
Medicare Part B
- Covers physicians' services, diagnostic tests, and physical therapy, but not routine dental care. It is not funded by Social Security taxes alone; premiums are paid. It is elective.
Medicare and HMOs
- HMOs and PPOs may offer services beyond Medicare coverage.
Medicare Eligibility
- Medicare eligibility is dependent on age 65 or other qualifying criteria. A retired person of age 50 does not qualify for Medicare benefits.
Medicare Payment for Skilled Nursing Facility Care
- Medicare pays for up to 100 days of skilled nursing facility care following hospitalization for 3 days.
- Requires prior hospitalization for 3 consecutive days.
Medicare Supplement Policies
- All Medicare supplement plans cover the core benefits.
- Medicare supplement plans must be guaranteed renewable.
- These plans do not cover long-term care costs.
- Before you can purchase a Medigap policy, you must be enrolled in Part A and Part B of Medicare.
- The first 3 pints of blood are covered in a Medicare Supplement plan
Medicare Part A and Part B Enrollment
- A person must be enrolled in Part A to enroll in Part D (Prescription Drug Coverage)
Medicare and Cosmetic Surgery
- Cosmetic surgery is not covered under Medicare.
Social Security Disability Requirements
- Employment occupation is not a factor in determining eligibility.
Medicare Part A Deductible
- Medicare Part A deductible is not covered by Medigap plans.
Medicare and Blood Transfusions
- First 3 pints of blood are covered in a Medicare Supplement plan.
Medicare and Benefit Limits
- Initial benefit limit, 25% coverage after is reached.
Hospice Care for Terminally Ill
- Hospice care is intended for those with a projected short lifespan as determined by certain medical criteria.
Medicare and Physician Services
- Medicare Part B covers the costs of physician and surgeon's services.
Medicaid Administration
- Multiple stakeholders are involved in Medicaid program administration (federal and state).
Medicare Advantage
- Offers expanded benefits (compared to standard Medicare) within private insurance frameworks via HMOs or PPOs, for a premium.
Social Security Eligibility
- Eligibility is dependent on meeting specific requirements.
Medicare and HMO or PPO Advantages
- Cosmetic elective procedures are not covered by Medicare Advantage plans.
Medicare Part B Requirements
- Part B is not compulsory. Individuals may elect to enroll and pay a premium.
Medicare Part A Hospital Care
- Medicare Part A provides coverage for hospital care, hospice, and skilled nursing facilities
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Description
This quiz provides an overview of Medicaid and Medicare benefits, focusing on the assistance available for healthcare. It covers key aspects of eligibility for Medicare Supplement Coverage and Social Security Disability Benefits. Test your knowledge on these crucial healthcare programs!
