NC Medicare Supplement & Long Term Care Insurance
Licensing Exam: Questions With A+ Solutions
MAC Correct Answer - Medicare Administrative Contractor - company
contracted to administer Part A & Part B claims.
Medicare Part A Correct Answer - -hospital coverage
-no premium requirements for those with 40 "work credits" of FICA or Self
Employment tax credits.
-Those who don't qualify can voluntarily participate by paying a monthly
premium
Medicare Part B Correct Answer - The part of the Medicare program that
pays for physician services, outpatient hospital services, durable medical
equipment, and other services and supplies.
-Has a monthly premium of $135.50 in 2019 which is deducted from SS check.
-Part B enrollment is optional. You can reject Part B by signing a rejection
form.
Medicare Part C Correct Answer - Medicare Advantage Plans that are
offered through private insurance companies that provide both hospital and
physician coverage and possible prescriptions - financed by Social Security
and monthly premiums
Medicare Eligibility Correct Answer - -Over age 65 who have earned 40
"work credits" in order to receive premium free part A benefits
-Permanently disabled prior to age 65 for at least 24 months
-ESRD or kidney disease requiring dialysis or kidney transplant
Medicare enrollment requirements Correct Answer - Part A & B are
automatically conducted by SSA when individual age 65+ enrolls for their
Social Security retirement benefits
Medicare Correct Answer - Health insurance for those over age 65,
people under 65 with certain disabilities & those with ESRD (end stage renal
disease - permanent kidney failure requiring dialysis or kidney transplant)
, CMS Correct Answer - Centers for Medicare and Medicaid Services
administers the Medicare program. Social Security Administration handles
most of the enrollment & plays a role in claims appeal process.
Initial Enrollment Period Correct Answer - 7 month period straddling 3
months before and ends 3 months after the individual turns 65, including the
birthday month.
-If enrollment is during the 3 mos prior to 65th birthday, coverage begins on
1st day of 65th birthday month
-If enrollment is during or after 65th birthday month, coverage begins on 1st
day of month after enrollment
General Enrollment Period Correct Answer - Medicare enrollment
period - January 1st through March 31st annually.
-Coverage begins July 1st of that year
-Monthly premium for part B may go up 10% for each full 12 month period
that you're eligible but didn't sign up.
Special Enrollment Period Correct Answer - Individual can enroll at 8
months beginning with the month employment ends or when group coverage
ends whichever is earlier without subject to late enrollment surcharge
Medicare as a secondary or primary payer Correct Answer - -Medicare is
the secondary payer for the 'working aged' who has a group health plan if the
group has 20+ enrollees
-For single employer with <20 employees with a group health plan, Medicare
is the primary payer.
-If individual retains coverage thru the group plan, the group contract is the
primary unless person is retired & still covered under the group plan. In that
case, Medicare is the primary.
-If individual rejects the employer plan, Medicare is the primary payer
Medicare as a secondary payer Correct Answer - -In cases of Workers'
Comp when it applies to an injury or illness
- In cases where no-fault insurance or liability insurance is available as
primary payer.
Medicare & the VA Correct Answer - Can choose to get treatment under
either plan. Medicare usually will not pay benefits if services are rendered in a
Licensing Exam: Questions With A+ Solutions
MAC Correct Answer - Medicare Administrative Contractor - company
contracted to administer Part A & Part B claims.
Medicare Part A Correct Answer - -hospital coverage
-no premium requirements for those with 40 "work credits" of FICA or Self
Employment tax credits.
-Those who don't qualify can voluntarily participate by paying a monthly
premium
Medicare Part B Correct Answer - The part of the Medicare program that
pays for physician services, outpatient hospital services, durable medical
equipment, and other services and supplies.
-Has a monthly premium of $135.50 in 2019 which is deducted from SS check.
-Part B enrollment is optional. You can reject Part B by signing a rejection
form.
Medicare Part C Correct Answer - Medicare Advantage Plans that are
offered through private insurance companies that provide both hospital and
physician coverage and possible prescriptions - financed by Social Security
and monthly premiums
Medicare Eligibility Correct Answer - -Over age 65 who have earned 40
"work credits" in order to receive premium free part A benefits
-Permanently disabled prior to age 65 for at least 24 months
-ESRD or kidney disease requiring dialysis or kidney transplant
Medicare enrollment requirements Correct Answer - Part A & B are
automatically conducted by SSA when individual age 65+ enrolls for their
Social Security retirement benefits
Medicare Correct Answer - Health insurance for those over age 65,
people under 65 with certain disabilities & those with ESRD (end stage renal
disease - permanent kidney failure requiring dialysis or kidney transplant)
, CMS Correct Answer - Centers for Medicare and Medicaid Services
administers the Medicare program. Social Security Administration handles
most of the enrollment & plays a role in claims appeal process.
Initial Enrollment Period Correct Answer - 7 month period straddling 3
months before and ends 3 months after the individual turns 65, including the
birthday month.
-If enrollment is during the 3 mos prior to 65th birthday, coverage begins on
1st day of 65th birthday month
-If enrollment is during or after 65th birthday month, coverage begins on 1st
day of month after enrollment
General Enrollment Period Correct Answer - Medicare enrollment
period - January 1st through March 31st annually.
-Coverage begins July 1st of that year
-Monthly premium for part B may go up 10% for each full 12 month period
that you're eligible but didn't sign up.
Special Enrollment Period Correct Answer - Individual can enroll at 8
months beginning with the month employment ends or when group coverage
ends whichever is earlier without subject to late enrollment surcharge
Medicare as a secondary or primary payer Correct Answer - -Medicare is
the secondary payer for the 'working aged' who has a group health plan if the
group has 20+ enrollees
-For single employer with <20 employees with a group health plan, Medicare
is the primary payer.
-If individual retains coverage thru the group plan, the group contract is the
primary unless person is retired & still covered under the group plan. In that
case, Medicare is the primary.
-If individual rejects the employer plan, Medicare is the primary payer
Medicare as a secondary payer Correct Answer - -In cases of Workers'
Comp when it applies to an injury or illness
- In cases where no-fault insurance or liability insurance is available as
primary payer.
Medicare & the VA Correct Answer - Can choose to get treatment under
either plan. Medicare usually will not pay benefits if services are rendered in a
