NC Medicare Supplement & Long Term
|\ |\ |\ |\ |\ |\
Care Insurance Licensing exam with |\ |\ |\ |\ |\
answers
Medicare - CORRECT ANSWERS ✔✔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 ANSWERS ✔✔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. |\ |\
MAC - CORRECT ANSWERS ✔✔Medicare Administrative Contractor
|\ |\ |\ |\ |\ |\
- company contracted to administer Part A & Part B claims.
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
Medicare Part A - CORRECT ANSWERS ✔✔-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 ANSWERS ✔✔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 ANSWERS ✔✔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 ANSWERS ✔✔-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 ANSWERS ✔✔Part
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A & B are automatically conducted by SSA when individual age
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
65+ enrolls for their Social Security retirement benefits
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Initial Enrollment Period - CORRECT ANSWERS ✔✔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 ANSWERS ✔✔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 ANSWERS ✔✔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 ANSWERS
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
✔✔-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 ANSWERS ✔✔-In
|\ |\ |\ |\ |\ |\ |\ |\ |\
cases of Workers' Comp when it applies to an injury or illness
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
|\ |\ |\ |\ |\ |\
Care Insurance Licensing exam with |\ |\ |\ |\ |\
answers
Medicare - CORRECT ANSWERS ✔✔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 ANSWERS ✔✔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. |\ |\
MAC - CORRECT ANSWERS ✔✔Medicare Administrative Contractor
|\ |\ |\ |\ |\ |\
- company contracted to administer Part A & Part B claims.
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
Medicare Part A - CORRECT ANSWERS ✔✔-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 ANSWERS ✔✔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 ANSWERS ✔✔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 ANSWERS ✔✔-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 ANSWERS ✔✔Part
|\ |\ |\ |\ |\ |\ |\
A & B are automatically conducted by SSA when individual age
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
65+ enrolls for their Social Security retirement benefits
|\ |\ |\ |\ |\ |\ |\
Initial Enrollment Period - CORRECT ANSWERS ✔✔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 ANSWERS ✔✔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 ANSWERS ✔✔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 ANSWERS
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
✔✔-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 ANSWERS ✔✔-In
|\ |\ |\ |\ |\ |\ |\ |\ |\
cases of Workers' Comp when it applies to an injury or illness
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
