XCEL Chapter 15 Flashcards
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Questions and Answers

Continuous 24-hour care provided by licensed medical professionals under the direct supervision of a physician is called which of the following?

  • Home health care
  • Adult day care
  • Custodial care
  • Skilled nursing care (correct)
  • Long-Term Care policies may provide coverage for claims arising from which of the following?

  • Senile dementia (correct)
  • Acute care in hospital
  • Drug addiction
  • Alcoholism
  • Which of the following statements is TRUE about Medicaid?

  • It is health insurance for the elderly
  • It is administered by the Federal government
  • Coverage includes compulsory hospital and voluntary supplementary medical insurance
  • It is funded by federal, state, and local taxes (correct)
  • Tom has a home health care benefit and is confined to his home. Which of these benefits is NOT typically covered?

    <p>Full-time nursing care</p> Signup and view all the answers

    Generally speaking, which three levels of care are Long-Term Care policies provided with?

    <p>Skilled nursing, intermediate, and custodial care</p> Signup and view all the answers

    Joe is a Medicare participant who receives his benefits through a Managed Health Care Plan. Which Medicare plan does he have?

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

    A Medicare Supplement basic benefit is what?

    <p>The first 3 pints of blood per year</p> Signup and view all the answers

    Which type of plan would be most appropriate for an individual on Medicare and concerned that Medicare will NOT pay for charges exceeding the approved amount?

    <p>Medicare supplement Plan F</p> Signup and view all the answers

    Benefits provided by a Medicare Supplement policy must NOT do what?

    <p>Duplicate Medicare benefits</p> Signup and view all the answers

    A Medicare Supplement Policy is designed to do what?

    <p>Designed to fill in the gaps of Part A and Part B Medicare</p> Signup and view all the answers

    Which of these gaps in Medicare coverage is addressed with Medicare Supplemental Insurance?

    <p>Medicare in-hospital deductible</p> Signup and view all the answers

    Bill requires some nursing care and supervision but NOT full-time care. Which of these nursing home options would best serve him?

    <p>Assisted living</p> Signup and view all the answers

    Which type of long-term care benefit would be most appropriate for a stroke victim who requires speech therapy administered at her home?

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

    Which of the following nursing home options would BEST suit an individual who needs some nursing care and supervision but NOT full-time care?

    <p>Assisted living facilities</p> Signup and view all the answers

    The purpose of Medicare Supplement Insurance is to address gaps in Medicare coverage, which can include what?

    <p>Medicare in-hospital deductible</p> Signup and view all the answers

    Study Notes

    Skilled Nursing Care

    • Continuous 24-hour care overseen by licensed medical professionals under a physician's supervision is termed skilled nursing care.

    Long-Term Care Policies

    • Long-Term Care policies often cover conditions like senile dementia but may not include acute care in hospitals or substance abuse.

    Medicaid

    • Medicaid, unlike Medicare, is funded through federal, state, and local taxes, ensuring coverage for low-income individuals, including the elderly.

    Home Health Care Benefits

    • Home health care typically covers part-time nursing care, physical therapy, and home health aides; however, full-time nursing care is generally excluded from coverage.

    Levels of Long-Term Care

    • Long-Term Care policies generally offer three care tiers: skilled nursing, intermediate, and custodial care, addressing different patient needs.

    Medicare Plans

    • Medicare Part C refers to managed health care plans that deliver Medicare benefits through private insurance companies.

    Medicare Supplement Benefits

    • A fundamental benefit of Medicare Supplement policies includes covering the first three pints of blood required per year for beneficiaries.

    Coverage Concerns with Medicare

    • Individuals worried that Medicare may not cover charges exceeding approved amounts may consider Medicare supplement Plan F for comprehensive coverage.

    Medicare Supplement Policy Restrictions

    • Benefits from a Medicare Supplement policy cannot duplicate existing Medicare benefits, ensuring that these are supplemental rather than redundant.

    Gaps Addressed by Medicare Supplement

    • The primary purpose of Medicare Supplement Insurance is to fill coverage gaps found in Part A and Part B Medicare plans, such as the Medicare in-hospital deductible.

    Nursing Care Options

    • Assisted living facilities are suited for individuals needing nursing care and supervision without requiring full-time assistance.

    Home Health Care for Rehabilitation

    • Home health care services are ideal for patients, like stroke victims, who need specialized therapies administered at home.

    Nursing Home Choices

    • Assisted living facilities also best serve individuals who require some nursing care without necessitating full-time residential nursing home care.

    Medicare Gaps Coverage

    • Gaps in Medicare coverage, particularly the Medicare in-hospital deductible, are often addressed through Medicare Supplement Insurance.

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    Description

    Test your knowledge on key concepts from XCEL Chapter 15. This quiz covers important terms related to long-term care and skilled nursing services. Answer questions about care types and related policies to see how well you understand the material.

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