Medicare Final exam With Complete Solution 2023

Medicare Final exam With Complete Solution 2023 Quiz #1 Medicare Parts (A, B, C, D) - Premium? - Premium is the fixed amount the insured has to pay to participate. Deductible? - Deductible is a preset amount that you have to pay FIRST, before Medicare or a private insurance company begins to help with your costs. Copay? - Copayment is a fixed amount that you pay, like $10 or $20, for a service or product. Coinsurance? - Coinsurance is splitting your health costs with the plan on a percentage basis. Define Part A and describe 3 benefits it covers? - Part A is (Hospital Insurance) 1. Skilled nursing services (20 Days) 2. Hospital meals 3. A semi privite room Define Part B and describes 3 benefits it covers? - Part B is (Medical/ Doctors' Insurance) 1. Outpatient medical services 2. Emergency Room services 3. X-rays, MRIs, and more Define Part C - (Medicare Advantage plans) is another health coverage choice you may have as part of Medicare. offered by a private company thats approved by Medicare. Name 3 ways Part C is different from Original Medicare - 1. Needs a referral 2. Combines A &B Prescription Drug coverage What does Part D Primarily cover? - Prescription Drugs What percentage does Part B typically cover? - 80% 2018 Part B Deductible? - $183 If I receive Social Security benefits and am turning 65 next month, it's mandatory that I elect Part B? - False Days 1- 60 out - of- pocket cost? - 0 Days 61-90 out-of- pocket cost? - $335 Days 91-150 out- of Pocket cost? - $670 Part A Copay Days 91-150 are also known as? - Lifetime reserve What is the Part A deductible amount? - $1,340 If you only have Part A of Medicare you qualify for Part C? - False AEP is a popular time to Join, switch or drop a MA plan. When is this period? - Oct 15- Dec 7 Spring Health Plans is contracted with multiple carriers that offer Part D? - True A person can pick up Part D during all of the following except? - After 60 days without drug coverage. If a client is outside his or her enrollment period for Part D, Spring Health Plans will? - Advise the client, but nothing else Although individuals can't sign up for Part D until 3- months prior to their 65th birthday, agents may send clients to SHP up to 6 - months prior to their 65th birthday? - True Name and describe the three stages Part D coverage? - 1. Initial - you pay a flat fee or percentage of a drug's total cost and insurer remaining balance. 2. Donut Hole - Once you out-of pocket cost reach 5k you move to Catastrophic Coverage 3. Catastrophic. - You only pay a small copay amount for each filled perscription The Donut Hole will Phase out in? - 2020 What Part of Medicare does Skilled Nursing typically fall under? - Part A Days 1-20 out-of pocket costs for SNF? - 0 Days 21- 100 out of pocket cost for SNF? - Full When I turn 65, I always get Medicare automatically? - False Which individuals get Medicare automatically? - 1.Turning 65 and already receiving Social Security benefits. 2.Receiving disability due to ALS. 3.Turning 65 and receiving Railroad Retirement Board benefis. Quiz #2 Enrollment Periods and Medigap Chart - Define Initial Enrollment Period? - (IEP) Can Enroll 3 months - Before, during and 3 months after 65th Birthday. An individual's Birthday is April 5th... When is their IEP? - January 1- July 31 Define General Enrollment Period - (GEP) You can enroll Jan 1 - March 31st, coverage takes effect on July 1st An individual's Birthday is April 5th, they missed IEP and don't have a SEP, what do you tell the client? - To sign up during the General Enrollment Period that takes place January through March Define Special Enrollment Period - Can enrool during the 8- month period that begins the months after the insured loses creditable coverage (i.e. loses their job), and also happens to take place outside of their IEP, to enroll