Study Guide for North Carolina Medicare Supplement-Long Term

What is Medicare? - Answer - Government health insurance program for people over 65 or younger people who may qualify. Who under 65 may qualify for Medicare? - Answer - Individuals who have disabilities such as permanent kidney failure or ALS Medicare part A covers what? - Answer - Hospital Which part of Medicare covers medical insurance? - Answer - Part B Which part of Medicare is known as Medicare Advantage? - Answer - Part C What criteria must be met to qualify for enrollment in Medicare Advantage - Answer - Must be enrolled in Part A & B Which part expands Original Medicare Benefits through Private Health Insurance Programs? - Answer - Part C Which part of Medicare covers prescription Drugs? - Answer - Part D Medicare parts A and B are administered only by whom - Answer - The Federal Government How many Medicare savings programs are there - Answer - 4 How are persons who are age 65 or older who do not participate in Social Security eligible for Medicare? - Answer - If premium is paid Is Medicare Part B a voluntary health insurance program? - Answer - Yes What does the limited Medicare savings program MQB-B Pay for? - Answer - (Part B Premium Only) To participate in Medicare a person must be what? - Answer - A US citizen or a permanent legal resident) When does the initial enrollment period for Medicare Part B begin? - Answer - 3 months before the month that the enrollee turns 65 For employers with 20 or more employees who offer group converge, would Medicare be considered the primary or secondary coverage? - Answer - Secondary What does the acronym PPS stand for? - Answer - Prospective Payment System What is the primary function of the MAC? - Answer - Medical reviews to ensure that services covered are reasonable and necessary) Under which review can a physician submit claim information prior to providing treatment to know in advance if the procedure is covered under the insured's plan? - Answer - (Prospective Review) Medicare Part A allows how many reserve days per lifetime? - Answer - (60) Under Medicare part A how many days can patients get coverage in a Skilled Nursing Facility Coverage in a benefit period? - Answer - Up to 100 Days Are only the first 20 days (about 3 weeks) in a Skilled Nursing Facility covered in full, True or False - Answer - True Skilled nursing care and certain other health care services that a patient receives at home for an illness or injury is defined as what? - Answer - (Home health Care) What does First Dollar Coverage Mean? - Answer - No Deductible Special care for people who are terminally ill is what? - Answer - Hospice Care given to a hospice patient by another caregiver so that the usual caregiver may get a rest is what? - Answer - Respite care How is hospice care ad