NY INDEPENDENT GENERAL ADJUSTER
SERIES 17 70 EXAM STUDY GUIDE 2026
LATEST QUESTIONS AND ANSWERS
ACCURATE GRADED A+
⩥ Medicaid.
Answer: -funded by federal and state govs
-for anyone whose income is insufficient to meet the cost of care, must
be a certain % under federal poverty level
⩥ Original Medicare.
Answer: -For persons 65+, with CKD, or those who qualify for social
security
-Parts A&B
⩥ Medicare Part A.
Answer: -inpatient hospital related services (inpt, skilled nursing, home
health, hospice, inpt psych)
-first 60 days covered completely (minus deductible)
-61-90 reduced benefits
-daily co-payment after this, 1/4 of initial deductible
-compulsory, meaning auto enrolled when applying for soc. sec
,⩥ Benefit period (medicare pt A).
Answer: starts when a patient enters the hospital and ends when they
have been out of the hospital for 60 days
⩥ Medicare Part B.
Answer: -pays for physician services, outpatient hospital services,
durable medical equipment, and other services and supplies
-Voluntary, financed through premiums paid by enrollees and the fed
gov
-monthly premium and deductible
-After deductible has been met, pt b will cover 80% of expenses and
insured pays 20%
⩥ Medicare exclusions.
Answer: -Private duty nursing
-Private hospital rooms
-First 3 pints of blood products
-Skilled nursing facility after 100 days
-Unapproved physician charges
-Care outside the US
-Custodial care received at home
-Wellness and preventative exams
,⩥ Medicare primary and secondary payor.
Answer: -For individuals eligible for Medicare coverage who continue
to work, the employer's health plan would be primary coverage while
Medicare would be secondary coverage
⩥ Medicare Part C.
Answer: -"Medicare Advantage"
-health plan options approved by medicare and offered by private
insurance companies or managed care orgs
-PPO, HMO, PFFS, specialty plans
-Must be enrolled in both A & B to be eligible
⩥ Medicare Part D.
Answer: -Prescription drug coverage
-most under C offer prescription drug coverage too
-monthly premium and annual deductible, co-pay after deduct. has been
met
-Annual limit
⩥ Donut hole.
Answer: -period when benefits are not being paid
, -medicare supplement policies known as medi-gap insurance are
available for this
⩥ High Deductible Health Plans (HDHP).
Answer: -lower premiums and higher deductibles than a traditional
health plan
-Being covered by an HDHP is a requirement for having a health savings
account.
-tax free and collect interest but can only be used for qualified medical
expenses
⩥ Medical Savings Account (MSA).
Answer: -employer funded linked to a HDHP
-high deductible in exchange for a portion of savings being put into
MSA
-Can withdraw what is left EOY but taxed
-not been available for newbies since 2007
⩥ Health Savings Account (HSA).
Answer: -must be enrolled in a HDHP and cannot be enrolled in
medicare or claimed on anyone else's tax return
-tax free savings
-roll over to next year if not used in current year
-invested in stocks, bonds, and mutual funds while in the acct
SERIES 17 70 EXAM STUDY GUIDE 2026
LATEST QUESTIONS AND ANSWERS
ACCURATE GRADED A+
⩥ Medicaid.
Answer: -funded by federal and state govs
-for anyone whose income is insufficient to meet the cost of care, must
be a certain % under federal poverty level
⩥ Original Medicare.
Answer: -For persons 65+, with CKD, or those who qualify for social
security
-Parts A&B
⩥ Medicare Part A.
Answer: -inpatient hospital related services (inpt, skilled nursing, home
health, hospice, inpt psych)
-first 60 days covered completely (minus deductible)
-61-90 reduced benefits
-daily co-payment after this, 1/4 of initial deductible
-compulsory, meaning auto enrolled when applying for soc. sec
,⩥ Benefit period (medicare pt A).
Answer: starts when a patient enters the hospital and ends when they
have been out of the hospital for 60 days
⩥ Medicare Part B.
Answer: -pays for physician services, outpatient hospital services,
durable medical equipment, and other services and supplies
-Voluntary, financed through premiums paid by enrollees and the fed
gov
-monthly premium and deductible
-After deductible has been met, pt b will cover 80% of expenses and
insured pays 20%
⩥ Medicare exclusions.
Answer: -Private duty nursing
-Private hospital rooms
-First 3 pints of blood products
-Skilled nursing facility after 100 days
-Unapproved physician charges
-Care outside the US
-Custodial care received at home
-Wellness and preventative exams
,⩥ Medicare primary and secondary payor.
Answer: -For individuals eligible for Medicare coverage who continue
to work, the employer's health plan would be primary coverage while
Medicare would be secondary coverage
⩥ Medicare Part C.
Answer: -"Medicare Advantage"
-health plan options approved by medicare and offered by private
insurance companies or managed care orgs
-PPO, HMO, PFFS, specialty plans
-Must be enrolled in both A & B to be eligible
⩥ Medicare Part D.
Answer: -Prescription drug coverage
-most under C offer prescription drug coverage too
-monthly premium and annual deductible, co-pay after deduct. has been
met
-Annual limit
⩥ Donut hole.
Answer: -period when benefits are not being paid
, -medicare supplement policies known as medi-gap insurance are
available for this
⩥ High Deductible Health Plans (HDHP).
Answer: -lower premiums and higher deductibles than a traditional
health plan
-Being covered by an HDHP is a requirement for having a health savings
account.
-tax free and collect interest but can only be used for qualified medical
expenses
⩥ Medical Savings Account (MSA).
Answer: -employer funded linked to a HDHP
-high deductible in exchange for a portion of savings being put into
MSA
-Can withdraw what is left EOY but taxed
-not been available for newbies since 2007
⩥ Health Savings Account (HSA).
Answer: -must be enrolled in a HDHP and cannot be enrolled in
medicare or claimed on anyone else's tax return
-tax free savings
-roll over to next year if not used in current year
-invested in stocks, bonds, and mutual funds while in the acct
