LTC / Medicare – NC North Carolina Medicare Supplement & Long-term Care Final Exam

LTC / Medicare – NC North Carolina Medicare Supplement & Long-term Care Final Exam Under Part B, individuals pay a deductible each... - CORRECT ANSWER-Year After deductible is satisfied, Part B pays what percentage of all approved charges? - CORRECT ANSWER-80% Doctors and suppliers who agree to accept the amount medicare will pay are said to have agreed to... - CORRECT ANSWER-Assignment An optional long-term carer insurance benefit that provides a reduced paid-up benefit amount is the... - CORRECT ANSWER-Nonforfeiture benefit A man has just completed an inpatient hospital stay of 100 consecutive days. How many lifetime reserve days has he used? - CORRECT ANSWER-10 After initial deductible is met, Medicare pays for all covered hospital charges for how many days when first hospitalized? After first benefit days, how many days does Medicare cover expenses with a daily copay? How many days is the lifetime reserve? - CORRECT ANSWER-60 30 60 Doctors and hospitals who join a Medicare HMO are called the plan's... - CORRECT ANSWER-Network Every insurer providing long-term care insurance in North Carolina is required to issue a Shopper's Guide, when? - CORRECT ANSWER-Before Sale / As requested but no later than sale Medicare may pay for ambulance transportation to... - CORRECT ANSWER-Nearest medical facility Immunosuppressive drugs are... - CORRECT ANSWER-Needed for life An insured receives health care through both Medicare and Medicaid. She currently has prescription drug coverage through Medicaid. Does the insured need to enroll in Medicare Part D? - CORRECT ANSWER-Yes, she must begin receiving her prescription drug coverage through Part D When does enrollment begin for a person that becomes age 65? - CORRECT ANSWER-Enrollment begins on the first day of the month the person becomes age 65 Automatic Enrollment - CORRECT ANSWER-If you are receiving Social Security your enrolled in Medicare automatically. General Enrollment Period Dates? - CORRECT ANSWER-January 1 through March 31 Medicare Part B is financed by... - CORRECT ANSWER-Copayments, deductibles, a monthly premium and a government subsidy What would a physician utilize if he/she wanted to know if a treatment is covered under an insured's plan and at what rate it will be paid? - CORRECT ANSWER-Prospective Review What is Medicare Part A deductible? - CORRECT ANSWER-$1,408 Standard monthly premium for Medicare Part B - CORRECT ANSWER-$144.60 What is the penalty for individuals who drop out of Medicare Part B and then re-enroll? - CORRECT ANSWER-the premium will be increased by 10% for each full 12 months the individual could have been enrolled but was not What is First-Dollar Coverage? - CORRECT ANSWER-A term applied to medical expense policies that pay covered expenses from the first dollar up to the specified limits without the use of deductibles or waiting periods. Applies to Home Health Care. How many days is Skilled Nursing Facility Coverage paid at no cost to insured? - CORRECT ANSWER-20 Days Day 21-200 for skilled nursing care what will the patient pay daily? - CORRECT ANSWER-$170.50 What are characteristics of a Medical Savings Account? - CORRECT ANSWER-- Available to groups of 50 or fewer employees - The employee can use the funds to cover health insurance deductibles during the year - It is an employer-funded account linked to a high-deductible medical insurance plan - If there is a balance at the end of the year, the employee can allow it to earn interest or withdraw What is a Private Fee-for-Service Plan? - CORRECT ANSWER-A medicare approved private insurance plan in which Medicare pays the plan premium for Medicare-covered services and the plan provides all Medicar