UHC Medicare Practice Test 2023/2024

UHC Medicare Practice Test 2023/2024 A man is planning to retire after age 65. Until then, he will have his employer's health plan. When should he enroll in Medicare Part B? Answer Within the 8 months of the day he is no longer employed or when coverage under the group plan ends In the Original Medicare Plan Part B, the percentage of the approved amount paid by the patient is 20%. This is referred to as Answer Coinsurance What process will the insurance company use to monitor the insured's hospital stay to make sure that everything is proceeding according to schedule? Answer Concurrent review Medicare Part B will pay for which of the following? Answer Anesthesia received as an outpatient service Prior to obtaining coverage through Medicare Part D, individuals must have which of the following coverage(s)? Answer Medicare Part A or B The assignment payment method only works with which of the following? Answer The Original Medicare Plan All of the following individuals may join a private fee-for-service plan except those who Answer Live outside of the service area If a patient is admitted to a hospital for special care, inpatient dialysis treatments are covered under Answer Medicare Part A A patient has a 110-day stay in a skilled nursing facility. All Medicare requirements have been satisfied. For how many days will Medicare participate in the cost of the patient's care? Answer 100 days First -dollar coverage applies to Answer Home health care Claims for Medicare Part A services are filed by Answer The provider with the Medicare intermediary Hospice benefits are available for a Medicare beneficiary who has met all of these requirements except Answer Having more than 6 months to live The minimum age to purchase long-term care insurance is Answer 18 A man has a Medigap policy. The premium increases each year because he is a year older. In addition, the premium is also adjusted for inflation. The method used to calculate his premium is known as Answer Attained age In North Carolina, the expected loss ratio for individual long-term care insurance is at least Answer 60% A long-term care policy that offers a guarantee that certain policy benefits will remain available even if the insured stops paying premiums is known as a Answer Nonforfeiture feature What are the disclosure requirements for Medicare Supplement policies issued at attained age? Answer The rates structure must be fully disclosed at the time of application Which of the following best describes Medicaid? Answer Eligibility standards are established by each state within national guidelines Medicare will pay all costs of care in a skilled nursing facility for the first Answer 20 days Care for eating, dressing, bathing, and continence, also known as personal care, is called Answer Custodial care Which of the following best defines the pre-existing condition waiting period in Medigap policies? Answer The insurer can refuse to cover a health problem that was diagnosed or treated during the 6 months before the policy issue date, for a specified amount of time A long-term care policy may exclude coverage for Answer Mental disorders If an insured appeals a service on the Medicare Summary Notice (MSN) and sends a request to the Medicare Administrative Contractor, within how many days will the MAC generally send the decision to the insured? Answer 60 days Medicare Part A is Answer Hospital insurance The outline of coverage for Medicare supplement policies is Answer A summary of the policy applied for or issued Which of the following is true about the benefit periods in Medicare Part A? Answer With each new benefit period, most of Part A hospital benefits are renewed Certain kinds of previous health insurance coverage that can be used to shorten or eliminate a pre-existing condition waiting period is called Answer Creditable coverage Long-term care is primarily Answer Personal care a 65-year old man joined a Private Fee-For-Service Plan. He is worried that his next doctor's visit will not be covered by the plan. What can he do? Answer Get a written advance coverage determination for the service Skilled care includes all of the following except Answer Custodial care A man will be 65 on October 18. He is eligible for Medicare Part A because he has participated in the Social Security program. His enrollment period in Medicare Part A will begin on Answer October 1 Each year, insurance companies offering Private Fee-For-Service Plans Answer Can decide to join or leave the Medicare program North Carolina spousal protection rules provide that Answer The protected assets, including the homesite, must be transferred to the name of the community spouse A North Carolina resident has elected to purchase a long-term care insurance option which can increase the maximum daily and lifetime benefits by 5% compounded each year. This option is Answer Known as inflation protection A patient has a 20-day stay in a Medicare-covered Skilled Nursing Facility. All of these services are covered except Answer Home Health Care To receive Medicare benefits, a 65-year old individual must apply with Answer The Social Security Administration Which of the following Medicare parts will allow an assignment payment method? Answer Part B Which of the following can be defined as the services provided by a substitute provider Answer Respite care What will Medicare Part B pay for a patient's tooth extraction? Answer Nothing A man has Medicare Part B. He goes to his doctor for treatment on January 1 and then again on July 15. On December 29, he returns to his doctor to treat another injury. What is the total deductible the insured will have to pay for these 3 visits? Answer $198 A new retiree has received his Medicare card and is eligible for Medicare. The Medicare program is administered by Answer The center for Medicare and Medicaid Services Which of the following provides a level of care between custodial care and skilled nursing care? Answer Intermediate care According to North Carolina law, an information brochure must be delivered to the prospective insured concurrently with delivery of the outline of coverage. The information brochure for direct response insurance policies may be delivered Answer Upon request of the prospective insured but no later than at the time of delivery According to pre-existing provision in Medicare supplement policies, an insurer cannot deny a claim for issues incurred more than how many months from the effective date of coverage? Answer 6 months A woman has a Medigap policy. She purchased the policy at age 65. Her premium does not increase automatically as she gets older. This premium calculation method is known as Answer Issue age If an insured has to receive blood in the hospital, what portion of the cost will Medicare Part A cover Answer Anything after the first 3 pints An outline of coverage for a Medicare supplement policy must be delivered to the applicant Answer At the time of policy application All the following are provisions of a tax qualified long-term care policy except Answer Medical necessity can be used as a trigger for benefits For personal long-term care insurance for a 65 year old individual, premiums are deductible to the extent they exceed what minimum percentage of adjusted gross income? Answer 7.5% To qualify for skilled nursing care, a patient must Answer Have a qualifying hospital stay of at least 3 consecutive days A retiree who turned 65 on February 1 waits until October to enroll in Medicare Part B. What are the consequences of this delay? Answer He missed the Medicare Part B initial enrollment period A man is covered under Medicare Part A. He has a 10 day stay in a Medicare certified skilled nursing facility which he entered after a 2 day stay in the hospital. The cost per day is $400. How much will this insured have to pay for skilled nursing facility care? Answer $4,000 (the entire cost) An individual has Medicare Part A. After a 3 day stay in the hospital, what would his hospital stay coinsurance be? Answer 0$ Which of the following would be covered under Medicare home health care? Answer Durable medical equipment In an inpatient hospital setting, radiation therapy is covered by? Answer Medicare Part A