SC Health, Life, Accident Insurance exam questions with 100% correct answers

Part A Hospital Insurance, helps pay for inpatient hospital care, inpatient care in a skilled nursing facility, home health care and hospice care Part B Medical Insurance, financed from monthly premiums paid by insureds and from the general revenues of the federal government Brainpower Read More Previous Play Next Rewind 10 seconds Move forward 10 seconds Unmute 0:00 / 0:15 Full screen Part C Allows people to receive all of their health care services through available provider organizations Part D Prescription Drug coverage Part A - Initial Enrollment when an individual first becomes eligible for Medicare (starting 3 months before turning 65, ending 3 months after their 65th birthday) Part A - General Enrollment between January 1st and March 31st each year Part A - Special Enrollment at any time during the year if the individual or his/her spouse is still employed and covered under a group health plan Failure to Sign up for Part A If an individual fails to sign up for Part A when they are first eligible, the monthly premium may go up 10% unless the person become eligible for a special enrollment period. Part B - Enrollment You will get and have to pay for Part B unless you decline, when you become eligible for Part A. Once declined, you must wait until the next general enrollment period. Medicare Advantage Was originally called Medicaere + Choice. Was changed in 2003 as a result of The Medical Modernization Act of 2003. Medicare Advantage Eligibility Beneficiaries must be enrolled in Parts A and B. Medigap Policies issued by private insurance companies that are designed to fill in some of the gaps in Medicare. Medicare Supplement Plan A Core Benefits (1) Coinsurance/copayment (2) Hospital costs up to an additional 365 days after Medicare benefits are used up. (3) Hospice care coinsurance/copayment (4) Part B coinsurance/copayment (5) The first 3 pints of blood Medicare Select policy A Medicare supplement policy that contains restricted network provisions - provisions that condition the payment of benefits, in whole or part, on the use of network providers. Each Medicare SELECT policy must be approved by the head of a state's department of insurance. Open Enrollment 6 month period that guarantees the applicants the right to buy Medigap one they first sign up for Medicare Part B. Medicare Supplement Plans K and L Lower premium plans with higher out-of-pocket costs. Right to Return (Free Look) All Medicare Supplement policies must contain at 30-day free lock period where the insured may return the policy for a complete refund for any reason. Uniform Individual Accident and Sickness Policy Provisions Law Developed by the National Association of Insurande Commissioners (NAIC), has been adopted in all states. Established standard provisions that are to be included in all individual health insurance policies. Entire Contract Health insurance policy; copy of the signed application; attached riders and amendments constitutes an entire contract. Time Limit on certain defenses or Incontestability provision No statement or misstatement (except for fraudulent misstatements) made in the applicatin at the time of issue will be used to deny a claim after the policy has been in force for 2 years. Notice of Claim Required within 20 days of the loss, or as soon as