PubH 6012 Exam 3 Final Test
Questions with Correct Answers 2026
Updated.
3 paths to medicare eligibility - Answer - Over 65 years and qualify for social security benefits
- disability: must qualify for social security disability income (SSDI) and collecting for at least 24
months
- diagnosis of end-stage renal disease (ESRD), Lou Gehrig's disease (ALS), and receiving SSDI
payments
Another Medicare eligibility criteria - Answer must be US citizen or permanent legal resident
medicare enrollment (december 2018) - Answer 60,418,955
Part A covers: - Answer hospital/inpatient services
part B covers: - Answer physician/outpatient services
part C covers: - Answer managed care plans
part D covers: - Answer prescription drug plans
Part A details: - Answer - mandatory enrollment
- no premiums
- benefits: inpatient hospital care, SNF post-acture care, hospice
- Long-term care NOT covered
- financed by: 2.9% payroll tax (1.45% by employers and employees)
2.35% for higher income via 2013 ACA
- deductibes for each day in patient stay
- cost sharing: after 60 days in hospital, SNF after 20 days
Part B details - Answer - voluntary (95% enrolled)
- covers: physician services, outpatient services, durable medical equipment, drugs given by
physicians, specified preventive services, home health visit
, - financed by: general federal tax revenue (73% part B costs), monthly premium ($134/month in
2018), 10% penalty for each year eligible but not enrolled, higher premiums for higher incomes
- annual deductible ($183 in 2018)
- cost sharing
Beneficiary costs - Answer $134 part b premium
$183 part b annual deductible
sometimes $422/month for part A if not enough quarters worked
$232 part a standard premium
part A hospital:
- $1340 deductible/benefit period
- $0 days 1-60 in hospital
- $335 days 61-90
- $670 91+ days
Medigap overview: - Answer 10 plans, strictly regulated, over 50% choose plan F, C and F
cover part A and B deductibles
medigap prices - Answer vary greatly between states
part C details - Answer - aka medicare advantage
- voluntary (25% enrolled)
- comprehensive coverage including prescriptions
- can restrict providers (networks)
- financed through parts A, B and D
part c medicare advantage history - Answer available since 1970s, 1998: medicare plus choice
(balanced budget act of 1997), 2003: medicare advantage (medicare modernization act)
part d details - Answer created by medicare modernization act of 2003, effective 2006
- voluntary (71% in 2018)
- penalty if not enrolled when eligible and go without equivalent coverage
- 90% medicare beneficiaries have creditable drug coverage
- covers outpatient prescription drugs
- offered through stand-alone plane or medicare advantage (part c)
Questions with Correct Answers 2026
Updated.
3 paths to medicare eligibility - Answer - Over 65 years and qualify for social security benefits
- disability: must qualify for social security disability income (SSDI) and collecting for at least 24
months
- diagnosis of end-stage renal disease (ESRD), Lou Gehrig's disease (ALS), and receiving SSDI
payments
Another Medicare eligibility criteria - Answer must be US citizen or permanent legal resident
medicare enrollment (december 2018) - Answer 60,418,955
Part A covers: - Answer hospital/inpatient services
part B covers: - Answer physician/outpatient services
part C covers: - Answer managed care plans
part D covers: - Answer prescription drug plans
Part A details: - Answer - mandatory enrollment
- no premiums
- benefits: inpatient hospital care, SNF post-acture care, hospice
- Long-term care NOT covered
- financed by: 2.9% payroll tax (1.45% by employers and employees)
2.35% for higher income via 2013 ACA
- deductibes for each day in patient stay
- cost sharing: after 60 days in hospital, SNF after 20 days
Part B details - Answer - voluntary (95% enrolled)
- covers: physician services, outpatient services, durable medical equipment, drugs given by
physicians, specified preventive services, home health visit
, - financed by: general federal tax revenue (73% part B costs), monthly premium ($134/month in
2018), 10% penalty for each year eligible but not enrolled, higher premiums for higher incomes
- annual deductible ($183 in 2018)
- cost sharing
Beneficiary costs - Answer $134 part b premium
$183 part b annual deductible
sometimes $422/month for part A if not enough quarters worked
$232 part a standard premium
part A hospital:
- $1340 deductible/benefit period
- $0 days 1-60 in hospital
- $335 days 61-90
- $670 91+ days
Medigap overview: - Answer 10 plans, strictly regulated, over 50% choose plan F, C and F
cover part A and B deductibles
medigap prices - Answer vary greatly between states
part C details - Answer - aka medicare advantage
- voluntary (25% enrolled)
- comprehensive coverage including prescriptions
- can restrict providers (networks)
- financed through parts A, B and D
part c medicare advantage history - Answer available since 1970s, 1998: medicare plus choice
(balanced budget act of 1997), 2003: medicare advantage (medicare modernization act)
part d details - Answer created by medicare modernization act of 2003, effective 2006
- voluntary (71% in 2018)
- penalty if not enrolled when eligible and go without equivalent coverage
- 90% medicare beneficiaries have creditable drug coverage
- covers outpatient prescription drugs
- offered through stand-alone plane or medicare advantage (part c)
