MEDICARE SUPPLEMENT AND LONG
TERM CARE INSURANCE LICENSING EXAM
PREP QUESTIONS AND ANSWERS
COMPREHENSIVE STUDY GUIDE
●● The Omnibus Budget Reconcilliation Act of 1990 (OBRA) requires
that large group health plans must provide primary coverage for disabled
individuals under
- age 65 who are retired
- age 59 1/2 who are retired
- age 65 who are not retired
- age 59 1/2 who are not retired
Answer: age 65 who are not retired
●● OBRA requires which disease to be covered by an employer for 30
months before Medicare becomes the primary mode of coverage?
- end-stage heart failure
- end-stage renal failure
- black lung
- leukemia
Answer: end-stage renal failure
,●● The primary eligibility requirement for Medicaid benefits is based
upon
- number of dependents
- need
- whether the claimant is insurable on the private market
- age
Answer: need
●● Which of the following types of LTC is NOT provided in an
institutional setting?
- home health care
- custodial care
- skilled nursing care
- intermediate care
Answer: home health care
●● Which of the following is correct about Medicare?
- the program is divided into four parts (a-d)
- part b is available to the insured at no cost
- it is a federal program for welfare recipients
- the program provides complete medical care at no cost
Answer: the program is divided into four parts (a-d)
,●● All of the following statements concerning Medicaid are correct
EXCEPT
- individuals claiming benefits must prove they do not have the ability or
means to pay for their own medical care
- persons, at least 65 years of age, who are blind or disabled and
financially unable to pay, may qualify for Medicaid Nursing Home
Benefits
- Medicaid is a state funded program that provides health care to persons
over age 65, only
- individual states design and administer the Medicaid program under
broad guidelines established by the federal government
Answer: medicaid is a state funded program that provides health care to
persons over age 65, only
●● All of the following would fall under the definition of Durable
Medical Equipment except
- wheel chairs
- hospital bed
- hospital blankets
- oxygen equipment
Answer: hospital blankets
●● Medicaid provides all of the following benefits EXCEPT
- eyeglasses
, - family planning services
- income assistance for work-related injury
- home health care services
Answer: income assistance for work-related injury
●● What is the difference between the Medicare approved amount for a
service or supply and the actual charge?
- actual charge
- limiting charge
- coinsurance
- excess charge
Answer: excess charge
●● Which of the following statements is CORRECT concerning the
relationship between Medicare and HMOs?
- HMOs do not pay for services covered by Medicare
- Medicare advantage is Medicare provided by an approved HMO only
- all HMOs and PPOs charge premiums beyond what is paid by
Medicare
- HMOs may pay for services not covered by Medicare
Answer: HMOs may pay for services not covered by Medicare
TERM CARE INSURANCE LICENSING EXAM
PREP QUESTIONS AND ANSWERS
COMPREHENSIVE STUDY GUIDE
●● The Omnibus Budget Reconcilliation Act of 1990 (OBRA) requires
that large group health plans must provide primary coverage for disabled
individuals under
- age 65 who are retired
- age 59 1/2 who are retired
- age 65 who are not retired
- age 59 1/2 who are not retired
Answer: age 65 who are not retired
●● OBRA requires which disease to be covered by an employer for 30
months before Medicare becomes the primary mode of coverage?
- end-stage heart failure
- end-stage renal failure
- black lung
- leukemia
Answer: end-stage renal failure
,●● The primary eligibility requirement for Medicaid benefits is based
upon
- number of dependents
- need
- whether the claimant is insurable on the private market
- age
Answer: need
●● Which of the following types of LTC is NOT provided in an
institutional setting?
- home health care
- custodial care
- skilled nursing care
- intermediate care
Answer: home health care
●● Which of the following is correct about Medicare?
- the program is divided into four parts (a-d)
- part b is available to the insured at no cost
- it is a federal program for welfare recipients
- the program provides complete medical care at no cost
Answer: the program is divided into four parts (a-d)
,●● All of the following statements concerning Medicaid are correct
EXCEPT
- individuals claiming benefits must prove they do not have the ability or
means to pay for their own medical care
- persons, at least 65 years of age, who are blind or disabled and
financially unable to pay, may qualify for Medicaid Nursing Home
Benefits
- Medicaid is a state funded program that provides health care to persons
over age 65, only
- individual states design and administer the Medicaid program under
broad guidelines established by the federal government
Answer: medicaid is a state funded program that provides health care to
persons over age 65, only
●● All of the following would fall under the definition of Durable
Medical Equipment except
- wheel chairs
- hospital bed
- hospital blankets
- oxygen equipment
Answer: hospital blankets
●● Medicaid provides all of the following benefits EXCEPT
- eyeglasses
, - family planning services
- income assistance for work-related injury
- home health care services
Answer: income assistance for work-related injury
●● What is the difference between the Medicare approved amount for a
service or supply and the actual charge?
- actual charge
- limiting charge
- coinsurance
- excess charge
Answer: excess charge
●● Which of the following statements is CORRECT concerning the
relationship between Medicare and HMOs?
- HMOs do not pay for services covered by Medicare
- Medicare advantage is Medicare provided by an approved HMO only
- all HMOs and PPOs charge premiums beyond what is paid by
Medicare
- HMOs may pay for services not covered by Medicare
Answer: HMOs may pay for services not covered by Medicare
