MEDICARE SUPPLEMENT/LONG TERM CARE EXAM WITH
VERIFIED ANSWERS
1. Which l of l the l following l Medicare l parts l will l allow l an
l assignment l payment l method?
Part
lB
lPart
lC
lPart
lD
All lMedicare lParts: lPart lB
Assignment lis lan lagreement lby lthe linsured's ldoctor, lprovider, lor lsupplier lto lbe lpaid ldirectly lby
lMedicare, lto laccept lthe lpayment lamount lMedicare lapproves lfor lthe lservice, land lnot lto lbill lthe linsured
lfor lany lmore lthan lthe lMedicare ldeductible land lcoinsurance. lAssignments lare lapplicable lto lMedicare
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,Part lB, lbut lnot lto lParts lC lor lD.
l
2. Which l of l the l following l would l be lcovered l under lMedicare l home
l health l care?
Durable lmedical
lequipment l24-hour la
lday lcare lat lhome
lPrescription ldrugs
Meals ldelivered lto la lhome: lDurable lmedical lequipment
Medicare lhome lhealth lcare lpays l80% lof lthe lcost lof ldurable lmedical lequipment.
3. Which lof lthe lfollowing lis lEXCLUDED lfrom lcoverage lunder
lMedicare lhospice lcare?
Respite l care
Short-term linpatient lcare
l Ambulance ltransportation
l Nursing lcare: lAmbulance
ltransportation
Generally lambulance ltransportation lis lexcluded l(except lfor lwhen larranged lby lthe lhospice lmedical lteam). l
lthe lother lexamples lare lcovered lservices.
4. Which lof lthe lfollowing ldefine la lloss lratio?: lPremiums lcollected lvs. lClaims lpaid
5. A l65-year-old lman ljoined la lPrivate lFee-For-Service lPlan. lHe lis
lworried lthat lhis lnext ldoctor's lvisit lwill lnot lbe lcovered lby lthe lplan.
lWhat lcan lhe ldo?
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, Call l the l service l provider l to l see l if l his l plan l will l cover l the
l services lGet la lwritten ladvance lcoverage ldetermination
lfor lthe lservice lSue lthe lplan lfor lcoverage lif lthe lplan
lrefuses lcoverage
The lpatient lhas lno loptions lat lthis lpoint.: lGet la lwritten ladvance lcoverage
ldetermination lfor lthe lservice
If lthe lpatient lhas lany lquestions lwhether lthe lPFFS lplan lwill lpay lfor la lservice, lincluding linpatient lhospital
lservices, lthe lpatient lhas lthe lright lunder lthe llaw lto lhave la lwritten/binding ladvance lcoverage
ldetermination lmade lfor lthe lservice. lThe lservice lprovider lwould lnot lbe lable lto ldetermine lwhether lor
lnot lthe lPFFS lplan lwill lcover la lservice.
6. A lpatient lhas la l110-day lstay lin la lskilled lnursing lfacility. lAll lMedicare
lrequire- lments lhave lbeen lsatisfied. lFor lhow lmany ldays lwill lMedicare
lparticipate lin lthe lcost lof lthe lpatient's lcare?
20
80
100
110: l100
Medicare ldoes lnot lparticipate lin lthe lcost lof lskilled lnursing lcare lafter l100 ldays.
7. What ldoes lfirst-dollar lcoverage lmean?
No ldeductible
No lcoinsurance lor lany lother lforms lor lcopay
lPatient lpays lfirst, lthen lMedicare lcovers lthe
lrest lFirst lcome, lfirst lserved: lNo ldeductible
First-dollar lcoverage lmeans lthere lis lno ldeductible. lMedicare lpays lall lcost lfor lhome lhealth lcare lvisits.
8. A lwoman lhas la lMedigap lpolicy. lShe lpurchased lthe lpolicy lat
lage l65. lHer lpremium ldoes lnot lincrease lautomatically las lshe
lgets lolder. lThis lpremium lcalculation lmethod lis lknown las
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l30
VERIFIED ANSWERS
1. Which l of l the l following l Medicare l parts l will l allow l an
l assignment l payment l method?
Part
lB
lPart
lC
lPart
lD
All lMedicare lParts: lPart lB
Assignment lis lan lagreement lby lthe linsured's ldoctor, lprovider, lor lsupplier lto lbe lpaid ldirectly lby
lMedicare, lto laccept lthe lpayment lamount lMedicare lapproves lfor lthe lservice, land lnot lto lbill lthe linsured
lfor lany lmore lthan lthe lMedicare ldeductible land lcoinsurance. lAssignments lare lapplicable lto lMedicare
1 l/
l30
,Part lB, lbut lnot lto lParts lC lor lD.
l
2. Which l of l the l following l would l be lcovered l under lMedicare l home
l health l care?
Durable lmedical
lequipment l24-hour la
lday lcare lat lhome
lPrescription ldrugs
Meals ldelivered lto la lhome: lDurable lmedical lequipment
Medicare lhome lhealth lcare lpays l80% lof lthe lcost lof ldurable lmedical lequipment.
3. Which lof lthe lfollowing lis lEXCLUDED lfrom lcoverage lunder
lMedicare lhospice lcare?
Respite l care
Short-term linpatient lcare
l Ambulance ltransportation
l Nursing lcare: lAmbulance
ltransportation
Generally lambulance ltransportation lis lexcluded l(except lfor lwhen larranged lby lthe lhospice lmedical lteam). l
lthe lother lexamples lare lcovered lservices.
4. Which lof lthe lfollowing ldefine la lloss lratio?: lPremiums lcollected lvs. lClaims lpaid
5. A l65-year-old lman ljoined la lPrivate lFee-For-Service lPlan. lHe lis
lworried lthat lhis lnext ldoctor's lvisit lwill lnot lbe lcovered lby lthe lplan.
lWhat lcan lhe ldo?
2 l/
l30
, Call l the l service l provider l to l see l if l his l plan l will l cover l the
l services lGet la lwritten ladvance lcoverage ldetermination
lfor lthe lservice lSue lthe lplan lfor lcoverage lif lthe lplan
lrefuses lcoverage
The lpatient lhas lno loptions lat lthis lpoint.: lGet la lwritten ladvance lcoverage
ldetermination lfor lthe lservice
If lthe lpatient lhas lany lquestions lwhether lthe lPFFS lplan lwill lpay lfor la lservice, lincluding linpatient lhospital
lservices, lthe lpatient lhas lthe lright lunder lthe llaw lto lhave la lwritten/binding ladvance lcoverage
ldetermination lmade lfor lthe lservice. lThe lservice lprovider lwould lnot lbe lable lto ldetermine lwhether lor
lnot lthe lPFFS lplan lwill lcover la lservice.
6. A lpatient lhas la l110-day lstay lin la lskilled lnursing lfacility. lAll lMedicare
lrequire- lments lhave lbeen lsatisfied. lFor lhow lmany ldays lwill lMedicare
lparticipate lin lthe lcost lof lthe lpatient's lcare?
20
80
100
110: l100
Medicare ldoes lnot lparticipate lin lthe lcost lof lskilled lnursing lcare lafter l100 ldays.
7. What ldoes lfirst-dollar lcoverage lmean?
No ldeductible
No lcoinsurance lor lany lother lforms lor lcopay
lPatient lpays lfirst, lthen lMedicare lcovers lthe
lrest lFirst lcome, lfirst lserved: lNo ldeductible
First-dollar lcoverage lmeans lthere lis lno ldeductible. lMedicare lpays lall lcost lfor lhome lhealth lcare lvisits.
8. A lwoman lhas la lMedigap lpolicy. lShe lpurchased lthe lpolicy lat
lage l65. lHer lpremium ldoes lnot lincrease lautomatically las lshe
lgets lolder. lThis lpremium lcalculation lmethod lis lknown las
3 l/
l30
