NCCT INTERACTIVE REVIEW MEDICAL INSURANCE EXAM
QUESTIONS AND ANSWERS
An initial enrollment period (IEP) that provides an opportunity for the individual to
enroll in Medicare Part A and/or Part B is for a period of _____ months.
7
A Medicare medical necessity denial is a denial of otherwise covered services
that were found to be not ____.
reasonable and necessary
Mary Smith is working full-time and enrolled in Medicare Part A at age 65. She
decided not to enroll in Medicare Part B at that time because her employer group
health insurance coverage reimburses for physician and other outpatient
encounters. Mary is eligible to enroll in Medicare Part B anytime during a(n) _____
enrollment period, which is a set time when individuals can sign up for Medicare
Part B if they did not enroll when they applied for Medicare Part A.
special
Which program added prescription medication coverage to the original Medicare
plan, some Medicare cost plans, some Medicare private fee-for-service plans, and
Medicare medical Savings Account Plans?
Medicare Part D
When a patient has Medicare and retiree group health plan coverage, Medicare
pays _____.
second
The Children's Health Insurance Program (CHIP) was implemented in accordance
with the Balanced Budget Act (BBA) to allow states to create or expand existing
insurance programs, providing more federal funds to states for the purpose of
expanding __________ eligibility to include a greater number of currently
uninsured children.
Medicaid
The Medicare Catastrophic Coverage Act of 1988 implemented Spousal
Impoverishment Protection Legislation in 1989 to prevent married couples from
being required to spend down income and other liquid assets (cash and property)
, before one of the partners could be declared eligible for Medicaid coverage for
nursing facility care. The spouse residing at home is called the __________
spouse.
community
Programs of All-inclusive Care for the Elderly (PACE) use a capitated payment
system to provide a comprehensive package of community-based services as an
alternative to institutional care for persons age 55 or older who require a(n)
__________ level of care.
nursing facility
States that opt to include a medically needy eligibility group in their Medicaid
program allow currently ineligible individuals to become eligible by _____.
spending down the amount of income that is above a state's income eligibility standard
When a patient has Medicaid coverage in addition to other, third-party coverage,
Medicaid is always considered the _____.
payer of last resort
Which is a comprehensive health care program for which the Department of
Veterans Affairs shares costs of covered health care services and supplies with
eligible beneficiaries?
CHAMPVA
Which is the entire health care system of the U.S. uniformed services and
includes military treatment facilities as well as various programs in the civilian
health care market, such as TRICARE?
Military Health System (MHS)
TRICARE __________ are available 24/7 for advice and assistance with treatment
alternatives and to discuss whether a sponsor should see a provider based on a
discussion of symptoms, and they will also discuss preventive care and ways to
improve a family's health.
nurse advisors
Which is a health care program for active duty members of the military and their
qualified family members?
TRICARE
QUESTIONS AND ANSWERS
An initial enrollment period (IEP) that provides an opportunity for the individual to
enroll in Medicare Part A and/or Part B is for a period of _____ months.
7
A Medicare medical necessity denial is a denial of otherwise covered services
that were found to be not ____.
reasonable and necessary
Mary Smith is working full-time and enrolled in Medicare Part A at age 65. She
decided not to enroll in Medicare Part B at that time because her employer group
health insurance coverage reimburses for physician and other outpatient
encounters. Mary is eligible to enroll in Medicare Part B anytime during a(n) _____
enrollment period, which is a set time when individuals can sign up for Medicare
Part B if they did not enroll when they applied for Medicare Part A.
special
Which program added prescription medication coverage to the original Medicare
plan, some Medicare cost plans, some Medicare private fee-for-service plans, and
Medicare medical Savings Account Plans?
Medicare Part D
When a patient has Medicare and retiree group health plan coverage, Medicare
pays _____.
second
The Children's Health Insurance Program (CHIP) was implemented in accordance
with the Balanced Budget Act (BBA) to allow states to create or expand existing
insurance programs, providing more federal funds to states for the purpose of
expanding __________ eligibility to include a greater number of currently
uninsured children.
Medicaid
The Medicare Catastrophic Coverage Act of 1988 implemented Spousal
Impoverishment Protection Legislation in 1989 to prevent married couples from
being required to spend down income and other liquid assets (cash and property)
, before one of the partners could be declared eligible for Medicaid coverage for
nursing facility care. The spouse residing at home is called the __________
spouse.
community
Programs of All-inclusive Care for the Elderly (PACE) use a capitated payment
system to provide a comprehensive package of community-based services as an
alternative to institutional care for persons age 55 or older who require a(n)
__________ level of care.
nursing facility
States that opt to include a medically needy eligibility group in their Medicaid
program allow currently ineligible individuals to become eligible by _____.
spending down the amount of income that is above a state's income eligibility standard
When a patient has Medicaid coverage in addition to other, third-party coverage,
Medicaid is always considered the _____.
payer of last resort
Which is a comprehensive health care program for which the Department of
Veterans Affairs shares costs of covered health care services and supplies with
eligible beneficiaries?
CHAMPVA
Which is the entire health care system of the U.S. uniformed services and
includes military treatment facilities as well as various programs in the civilian
health care market, such as TRICARE?
Military Health System (MHS)
TRICARE __________ are available 24/7 for advice and assistance with treatment
alternatives and to discuss whether a sponsor should see a provider based on a
discussion of symptoms, and they will also discuss preventive care and ways to
improve a family's health.
nurse advisors
Which is a health care program for active duty members of the military and their
qualified family members?
TRICARE
