MEDICARE, MEDICAIDE, LTC NC
INSURANCE EXAM QUESTIONS AND
CORRECT ANSWERS (VERIFIED)
Federal |Program
Correct |Answer: | Medicare |is |a |federal |health |insurance |program. |Part |of |the |Social
| Security |program, |Medicare |is |run |by |the |Centers |for |Medicare |& |Medicaid |Services |of
| the |Department |of |Health |and |Human |Services. |Private |firms |contract |with |the |federal
| government |to |handle |the |paperwork, |review |claims, |and |disburse |claim |payments.
Medicare |Part |A
Correct |Answer: | Designed |primarily |to |provide |hospital |insurance |and |to |pay |for
| certain |other |types |of |institutional |care.
Medicare |Part |B
Correct |Answer: | Designed |primarily |to |provide |medical |insurance |for |physician |visits
| and |other |out-patient |care.
Medicare |Part |C
,Correct |Answer: | Provides |expanded |coverage |through |managed |care |plans |such |as
| Health |Maintenance |Organizations |(HMOs) |and |Preferred |Provider |Organizations
| (PPOs).
Medicare |Part |D
Correct |Answer: | Provides |coverage |for |prescription |drugs.
What |is |the |"original |medicare"?
Correct |Answer: | Parts |A |and |B |because |those |two |parts |were |enacted |together |in |the
| original |amendment |to |Social |Security |that |created |the |Medicare |program |in |1965. |Parts |C
| and |D |were |added |later |(in |1997 |and |2003, |respectively) |to |keep |the |Medicare |program
| up |to |date |with |changes |in |the |health |care |delivery |system.
If |someone |has |Original |Medicare, |in |which |part |or |parts |of |Medicare |is |he |or |she
| enrolled?
A |Parts |A, |B, |and |C
B |Parts |A, |B, |C, |and |D
C |Part |C
D |Parts |A |and |B
Correct |Answer: | D |Parts |A |and |B
*Parts |A |and |B |are |referred |to |as |Original |Medicare |because |they |were |enacted |together
when |the |So-cial |Security |law |was |originally |amended |to |create |Medicare. |Parts |C |and |D
|
| were |added |later.
,Qualified |Medicare |Beneficiary |(QMB)
Correct |Answer: | Program |is |for |persons |whose |monthly |income |is |no |more |than |the
| Federal |Poverty |Level |(FPL) |plus |$20. |Some |states |disregard |more |than |an |additional
$20 |of |monthly |income. |In |addition |to |helping |pay |the |Part |B |premium, |the |QMB |program
may |also |help |pay |a |beneficiary's |Part |A |premium |(if |any) |and |Medicare |cost- |sharing
|
| amounts |such |as |deductibles, |coinsurance, |and |copayments.
Specified |Low-Income |Medicare |Beneficiary |(SLMB)
Correct |Answer: | For |persons |whose |monthly |income |is |no |more |than |120% |of |the |FPL
| plus |$20. |As |with |the |QMB |program, |some |states |disregard |more |than |an |additional |$20
| of |monthly |income. |The |SLMB |program |helps |pay |for |only |the |Part |B |premium, |not |other
| Medicare |costs.
Qualifying |Individual |(QI)
Correct |Answer: | For |persons |whose |monthly |income |is |no |more |than |135% |of |the |FPL
plus |$20. |Some |states |disregard |more |than |an |additional |$20 |of |monthly |income. |The |QI
|
| program |helps |pay |for |only |the |Part |B |premium.
An |individual |has |been |working |for |8 |years |while |the |Hospital |Insurance |tax |has |been
| getting |deducted |from |her |paycheck. |How |many |more |years |must |she |work |before |she
| can |get |Medicare |Part |A |coverage |premium-free?
A |12
, B |4
C |7
D |2
Correct |Answer: | D |2
*Part |A |coverage |is |premium-free |for |workers |who |have |paid |the |Hospital |Tax |for |10
| years. |The |individual |has |paid |for |8 |years, |so |she |has |2 |more |years |to |go.
Suppose |a |worker's |income |is |between |120% |and |135% |of |the |federal |poverty |level. |What
| is |the |name |of |the |Medicare |Savings |Program |for |which |she |is |eligible?
A |Specified |Low-Income |Medicare |Beneficiary
B |Medicare |Advantage
C |Qualified |Medicare |Beneficiary
D |Qualifying |Individual
Correct |Answer: | D |Qualifying |Individual
*The |Qualifying |Individual |program |pays |the |Part |B |premium |for |persons |whose |income |is
less |than |135% |of |the |federal |poverty |level |but |higher |than |the |requirements |for |other
|
| Medicare |savings |pro-grams.
Medicare |Advantage |is |another |name |for |what |part |of |Medicare?
A |Parts |A |and |B
B |Part |C
C |Part |D
D |Part |A
INSURANCE EXAM QUESTIONS AND
CORRECT ANSWERS (VERIFIED)
Federal |Program
Correct |Answer: | Medicare |is |a |federal |health |insurance |program. |Part |of |the |Social
| Security |program, |Medicare |is |run |by |the |Centers |for |Medicare |& |Medicaid |Services |of
| the |Department |of |Health |and |Human |Services. |Private |firms |contract |with |the |federal
| government |to |handle |the |paperwork, |review |claims, |and |disburse |claim |payments.
Medicare |Part |A
Correct |Answer: | Designed |primarily |to |provide |hospital |insurance |and |to |pay |for
| certain |other |types |of |institutional |care.
Medicare |Part |B
Correct |Answer: | Designed |primarily |to |provide |medical |insurance |for |physician |visits
| and |other |out-patient |care.
Medicare |Part |C
,Correct |Answer: | Provides |expanded |coverage |through |managed |care |plans |such |as
| Health |Maintenance |Organizations |(HMOs) |and |Preferred |Provider |Organizations
| (PPOs).
Medicare |Part |D
Correct |Answer: | Provides |coverage |for |prescription |drugs.
What |is |the |"original |medicare"?
Correct |Answer: | Parts |A |and |B |because |those |two |parts |were |enacted |together |in |the
| original |amendment |to |Social |Security |that |created |the |Medicare |program |in |1965. |Parts |C
| and |D |were |added |later |(in |1997 |and |2003, |respectively) |to |keep |the |Medicare |program
| up |to |date |with |changes |in |the |health |care |delivery |system.
If |someone |has |Original |Medicare, |in |which |part |or |parts |of |Medicare |is |he |or |she
| enrolled?
A |Parts |A, |B, |and |C
B |Parts |A, |B, |C, |and |D
C |Part |C
D |Parts |A |and |B
Correct |Answer: | D |Parts |A |and |B
*Parts |A |and |B |are |referred |to |as |Original |Medicare |because |they |were |enacted |together
when |the |So-cial |Security |law |was |originally |amended |to |create |Medicare. |Parts |C |and |D
|
| were |added |later.
,Qualified |Medicare |Beneficiary |(QMB)
Correct |Answer: | Program |is |for |persons |whose |monthly |income |is |no |more |than |the
| Federal |Poverty |Level |(FPL) |plus |$20. |Some |states |disregard |more |than |an |additional
$20 |of |monthly |income. |In |addition |to |helping |pay |the |Part |B |premium, |the |QMB |program
may |also |help |pay |a |beneficiary's |Part |A |premium |(if |any) |and |Medicare |cost- |sharing
|
| amounts |such |as |deductibles, |coinsurance, |and |copayments.
Specified |Low-Income |Medicare |Beneficiary |(SLMB)
Correct |Answer: | For |persons |whose |monthly |income |is |no |more |than |120% |of |the |FPL
| plus |$20. |As |with |the |QMB |program, |some |states |disregard |more |than |an |additional |$20
| of |monthly |income. |The |SLMB |program |helps |pay |for |only |the |Part |B |premium, |not |other
| Medicare |costs.
Qualifying |Individual |(QI)
Correct |Answer: | For |persons |whose |monthly |income |is |no |more |than |135% |of |the |FPL
plus |$20. |Some |states |disregard |more |than |an |additional |$20 |of |monthly |income. |The |QI
|
| program |helps |pay |for |only |the |Part |B |premium.
An |individual |has |been |working |for |8 |years |while |the |Hospital |Insurance |tax |has |been
| getting |deducted |from |her |paycheck. |How |many |more |years |must |she |work |before |she
| can |get |Medicare |Part |A |coverage |premium-free?
A |12
, B |4
C |7
D |2
Correct |Answer: | D |2
*Part |A |coverage |is |premium-free |for |workers |who |have |paid |the |Hospital |Tax |for |10
| years. |The |individual |has |paid |for |8 |years, |so |she |has |2 |more |years |to |go.
Suppose |a |worker's |income |is |between |120% |and |135% |of |the |federal |poverty |level. |What
| is |the |name |of |the |Medicare |Savings |Program |for |which |she |is |eligible?
A |Specified |Low-Income |Medicare |Beneficiary
B |Medicare |Advantage
C |Qualified |Medicare |Beneficiary
D |Qualifying |Individual
Correct |Answer: | D |Qualifying |Individual
*The |Qualifying |Individual |program |pays |the |Part |B |premium |for |persons |whose |income |is
less |than |135% |of |the |federal |poverty |level |but |higher |than |the |requirements |for |other
|
| Medicare |savings |pro-grams.
Medicare |Advantage |is |another |name |for |what |part |of |Medicare?
A |Parts |A |and |B
B |Part |C
C |Part |D
D |Part |A
