MEDICARE SUPPLEMENT/LTC NC
2025/ 2026 QUESTIONS WITH
VERIFIED ANSWERS
Medicare Summary Notice (MSN) - correct answer -A summary sent to the patient from
Medicare that summarizes all services provided over a period of time with an explanation of
benefits provided
For inpatient psychiatric care, Medicare part a will pay for - correct answer -The same services
as if the beneficiary was an inpatient in a general care hospital. Deductibles and coinsurance
cost are the same as a regular inpatient hospital stay. The inpatient psychiatric facility must be a
participating provider though
Regarding the Medicare part a blood deductible - correct answer -The blood required by a
beneficiary to receive treatment is paid for except the first 3 pints
Medicare part B (medical insurance) - correct answer -Provide coverage for medical care
receives in other settings: Doctors office, outpatient clinic or laboratory, or a hospital emergency
room or outpatient department
Before Medicare begins paying for part B services - correct answer -Medicare beneficiaries must
satisfy the part B deductible which applies on an annual basis from January to December
,For Medicare part B, beneficiaries are generally responsible for paying - correct answer -20% on
part B coverage services while Medicare pays the other 80% of the Medicare approved charge
Medicare Part C (Medicare Advantage) - correct answer -managed care health plans under the
Medicare program
Beneficiaries that use a Medicare advantage plan must continue to - correct answer -Pay for
their part B premium (and part a premium if they did not receive that coverage premium free).
Medicare Advantage Plans - correct answer -Commonly called Plan C, these plans provide
Medicare benefits to eligible people, but they differ in that they are administered by private
providers rather than by the government. Common supplemental benefits include vision,
hearing, dental, general checkups, and health and wellness programs.
Medicare advantage plans are able to control cost - correct answer -By maintaining their own
provider network
To enroll in a Medicare advantage beneficiaries must - correct answer -Reside in the plans
service area. Beneficiaries may not belong to more than one Medicare advantage plan at a time
Health Maintenance Organization (HMO) plans - correct answer -A Medicare advantage plan
that has a network of providers that beneficiaries must use exclusively, except for emergencies.
, Some HMO plans offer - correct answer -Point of service (POS) plans that allow beneficiaries to
obtain out of network services, but they must pay higher copayment for coinsurance than in
network care
Preferred Provider Organization (PPO) - correct answer -Allows beneficiaries to go to Obtain
services from any provider, but they will pay lower coinsurance or co-pay payments if they use
providers in the PPO network
Private fee for service (PFFS) - correct answer -Allows beneficiaries to go to any provider as long
as they except the plans payment terms. The plan determines how much it will pay providers
and how much beneficiaries must pay for care
Special needs plans (SNP) - correct answer -Provide specialized care for specific groups of
people such as beneficiaries who: Are eligible for both Medicare and Medicaid, live in a nursing
home, or suffer from certain chronic medical conditions
The two most common types of Medicare advantage plans are - correct answer -HMOs and
PPOs
Health maintenance organization(HMO) plans include: - correct answer -- prescription drug
coverage
- beneficiary must choose a primary care physician
2025/ 2026 QUESTIONS WITH
VERIFIED ANSWERS
Medicare Summary Notice (MSN) - correct answer -A summary sent to the patient from
Medicare that summarizes all services provided over a period of time with an explanation of
benefits provided
For inpatient psychiatric care, Medicare part a will pay for - correct answer -The same services
as if the beneficiary was an inpatient in a general care hospital. Deductibles and coinsurance
cost are the same as a regular inpatient hospital stay. The inpatient psychiatric facility must be a
participating provider though
Regarding the Medicare part a blood deductible - correct answer -The blood required by a
beneficiary to receive treatment is paid for except the first 3 pints
Medicare part B (medical insurance) - correct answer -Provide coverage for medical care
receives in other settings: Doctors office, outpatient clinic or laboratory, or a hospital emergency
room or outpatient department
Before Medicare begins paying for part B services - correct answer -Medicare beneficiaries must
satisfy the part B deductible which applies on an annual basis from January to December
,For Medicare part B, beneficiaries are generally responsible for paying - correct answer -20% on
part B coverage services while Medicare pays the other 80% of the Medicare approved charge
Medicare Part C (Medicare Advantage) - correct answer -managed care health plans under the
Medicare program
Beneficiaries that use a Medicare advantage plan must continue to - correct answer -Pay for
their part B premium (and part a premium if they did not receive that coverage premium free).
Medicare Advantage Plans - correct answer -Commonly called Plan C, these plans provide
Medicare benefits to eligible people, but they differ in that they are administered by private
providers rather than by the government. Common supplemental benefits include vision,
hearing, dental, general checkups, and health and wellness programs.
Medicare advantage plans are able to control cost - correct answer -By maintaining their own
provider network
To enroll in a Medicare advantage beneficiaries must - correct answer -Reside in the plans
service area. Beneficiaries may not belong to more than one Medicare advantage plan at a time
Health Maintenance Organization (HMO) plans - correct answer -A Medicare advantage plan
that has a network of providers that beneficiaries must use exclusively, except for emergencies.
, Some HMO plans offer - correct answer -Point of service (POS) plans that allow beneficiaries to
obtain out of network services, but they must pay higher copayment for coinsurance than in
network care
Preferred Provider Organization (PPO) - correct answer -Allows beneficiaries to go to Obtain
services from any provider, but they will pay lower coinsurance or co-pay payments if they use
providers in the PPO network
Private fee for service (PFFS) - correct answer -Allows beneficiaries to go to any provider as long
as they except the plans payment terms. The plan determines how much it will pay providers
and how much beneficiaries must pay for care
Special needs plans (SNP) - correct answer -Provide specialized care for specific groups of
people such as beneficiaries who: Are eligible for both Medicare and Medicaid, live in a nursing
home, or suffer from certain chronic medical conditions
The two most common types of Medicare advantage plans are - correct answer -HMOs and
PPOs
Health maintenance organization(HMO) plans include: - correct answer -- prescription drug
coverage
- beneficiary must choose a primary care physician
