WebCE Exam Questions with Answers | Latest Update Graded A+

On what basis are benefits payable under a long-term care insurance policy typically triggered? A) the diagnosis of an acute medical condition B) the number and types of medications prescribed C) the inability to perform of medications prescribed D) all of the above - Answer- C) The inability to perform defined ADLs The inability to perform defined ADLs. Benefits payable under a long-term care policy are typically based on (or "triggered" by) the inability to perform a certain number of activities of daily living (ADLs) as specified in the policy. Another common benefit trigger is cognitive impairment. What is a primary goal of long-term care? A) to maintain functionality B) to find a permanent cure for the affliction C) to prolong life D) to prevent the spread of disease - Answer- A) to maintain functionality Long-term care is chronic care with the aim of management and control of symptoms and maintenance of function. Long-term care occurs only in nursing facilities. A) True B) False - Answer- B) False Long-term care can occur in a variety of places, including in an individual's home, at community sites and centers, and in care facilities. Which of the following most precisely defines the fundamentals of self-care and the basic tasks of everyday life? A) instrumental activities of daily living B) activities of daily living C) self-awareness D) mental activity - Answer- B) Activities of daily living Activities of daily living are the fundamentals of self-care. They are the basic tasks of everyday life, which include eating, bathing, dressing, toileting, and transferring. Instrumental activities are those that are associated with interacting with one's community or home. Which level of care has as its chief characteristic assistance with ADLs? A) Custodial B) Intermediate C) Skilled D) Managed - Answer- A) Custodial The primary characteristic of which is to provide assistance with the activities of daily living, helps meet personal rather than medical needs. All of the following are examples of formal caregiving EXCEPT: A) home health aides B) intermediate care facilities C) volunteer charitable groups D) daily transportation to a senior center provided by a neighbor - Answer- D) daily transportation to a senior center provided by a neighbor Formal caregiving is paid, or volunteer care is provided through a service system. Informal care is delivered by family or friends. All of the following are services commonly offered by assisted living residences EXCEPT: A) health care management B) help with medications C) housekeeping D) continuous post-operative monitoring - Answer- D) continuous post-operative monitoring Assisted living residences generally provide most personal and health care services except for skilled nursing care, such as continuous post-operative monitoring, which can only be offered by a skilled nursing facility. Which of the following is NOT an example of home or community-based long-term care? A) adult day care B) CCRCs C) respite care D) hospice care - Answer- B) CCRCs Continuing care retirement communities, or CCRCs, are large, campus-like facilities that house residents and provide a complete range of long-term care. A long-term care ombudsman represents people in a given geographical area who live in assisted living residences or skilled nursing facilities. A) True B) False - Answer- A) True A long-term care ombudsman, as a local representative for those in assisted living facilities or SNFs, can be a valuable source of information about various local facilities for those seeking housing for the elderly. Which of the following is a correct statement about Medicare Part D Prescription Drug coverage? A) Enrollment in Part D is mandatory. B) All prescriptions are paid in full under Part D. C) No additional premium is required for this coverage. D) Enrollment in Part D is voluntary. - Answer- D) Enrollment in Part D is voluntary. Medicare Part D provides coverage for prescription drugs, but it does not cover all prescription drug costs. The cost of a stand-alone Part D plan requires a premium payment. (Those who enroll in a Medicare Part C plan may have prescription drug coverage as part of the plan, and the plan's premium would likely include this coverage.) Enrollment in Part D is voluntary. Which of the following only covers inpatient hospital care and hospice? A) Medicare Part A B) Medicare Part B C) Medicare Part C D) Medicare Part D - Answer- A) Medicare Part A Part A helps pay for inpatient care in a hospital or skilled nursing facility (following a hospital stay), some home health care, and hospice care. Which of the following is a correct statement about Medicare? A) Medicare is available only to those 65 and older. B) Medicare pays all of the costs of health care for those 65 and older. C) Medicare does not cover long-term care. D) Medicare covers custodial care in the home whenever help with ADLs is needed. - Answer- C) Medicare does not cover long-term care. Medicare helps with the cost of health care, but it does not cover all medical expenses or the cost of long-term care. With regard to Medicare and long-term care, which of the following statements is true? A)Medicare covers long-term care for as long as necessary, but only if the individual requires skilled nursing care in an institution. B) Medicare covers long-term care for as long as necessary, but only if the care is delivered in the individual's home. C) Medicare covers care in a skilled nursing facility for a limited time, but only if the care follows an admitted hospital stay and is ordered by a physician. D) Medicare covers custodial care for up to one year regardless of whether the custodial care is delivered in a facility or in the individual's home. - Answer- C) Medicare covers care in a skilled nursing facility for a limited time, but only if the care follows an admitted hospital stay and is ordered by a physician. How much of a community spouse's own income must be spent on care for an institutionalized spouse who is receiving Medicaid assistance? A) All of it B) 50% C) 25% D) None of it - Answer- D) None of it. None of the income that a community spouse receives in his or her name, such as wages of Social Security or a pension, must be diverted to the cost of care for the institutionalized spouse. Under current Medicaid rules, what is the look-back period for the transfer of assets? A) 12 months B) 24 months C) 36 months D) 60 months - Answer- D) 60 months For purposes of determining Medicaid eligibility, the look-back period is 60 months. This period was extended from 36 months to 60 months under the Deficit Reduction Act of 2005. The federal government: A) has no role in state-run Medicaid programs B) tells states how much they can pay for LTC services and supplies C) gives states flexibility in administering their Medicaid programs D) shares equally in Medicaid expenses with each state - Answer- C) gives states flexibility in administering their Medicaid programs. States have flexibility to design and implement their own programs, but funding is not shared equally by the federal and state governments. Annually, a determination is made comparing states' average per capita income to the national average. States with higher per capita incomes receive less federal funding; states with lower per capita incomes receive more federal funding A burial plot is exempt when determining Medicaid eligibility. A) True B) False - Answer- A) True The burial plot exemption is available for the applicant and immediate family members. Of the factors below, which does a state review to determine a person's eligibility for Medicaid? I. assets II. income III. transfers of assets A) I only B) I and II only C) II and III only D) I, II, and III - Answer- D) I, II, and III Primary factors that are used to determine Medicaid eligibility are exempt and nonexempt assets, level of income, and the proper or improper transfer of assets. Medicaid is available to pay for LTC expenses for anyone without private LTC insurance. A) True B) False - Answer- B) False Medicaid is limited to those with low incomes or those who incur catastrophic medical expenditures. Group LTCI policies are contracts between the insurance company and each individual member of the group. A) True B) False - Answer- B) False Group long-term care insurance is a contract between an insurer and a group sponsor, such as an employer on behalf of its employees. Members in a group plan do not receive insurance on behalf of its employees. Members in a group plan do not receive insurance policies; they receive certifications of insurance as evidence of their coverage. Most LTC insurance policies are issued as guaranteed renewable. As such, which statement is true? A) Policy premiums cannot be increased for any reason. B) The insurer must renew the policy as long as premiums are paid. C) The insurer must renew the policy as long as the insured continues to be insurable. D) Premiums can be increased selectively for individual policies, based on the insured's health. - Answer- B) The insurer must renew the policy as long as premiums are paid. For the insured, a policy that is issued as guaranteed renewable 1) the policy must be renewed as long as premiums are paid 2) the policy cannot be canceled or nonrenewed because of the insured's age or health and 3) premiums cannot be increased, except on a class basis. An insurance company can increase the premiums on its LTCI policies after policy inception if the insured's health declines. A) True B) False - Answer- B) False However, while companies cannot increase premiums because of individual circumstances such as age or health, they can increase premiums for an entire class of insureds.