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Exam (elaborations)

NC STATE EXAM- Simulated practice questions 1 || All Answers Are Correct 100%

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If a person is a member of a private Fee-For-Service plan, where can he or she receive emergency medical care? correct answers Anywhere in the U.S. **Members of a PFFS plan may receive emergency care anywhere in the U.S. when needed. Medicare Part B will cover services received from a doctor if performed correct answers Anywhere. **Medicare Part B covers medically necessary services received from a doctor regardless where performed: in the office, in a hospital, in a skilled nursing facility, in the patient's home, or any other location. All of the following statements are true about HMOs EXCEPT correct answers A Medicare HMO is not a Medicare Advantage Plan. ** IT IS ** **A Medicare HMO is a Medicare Advantage Plan. All of the following statements are true about a Preferred Provider Organization (PPO) EXCEPT correct answers A PPO does not have to pay for covered services received out-of-network. **Every PPO plan must pay for all covered services received out-of-network, but every plan is different in what the patient must pay. An insured receives health care through both Medicare and Medicaid. She currently has prescription drug coverage through Medicaid. Does the insured need to enroll in Medicare Part D? correct answers Yes, she must begin receiving her prescription drug coverage through Part D. **Anyone enrolled in both Medicare and Medicaid, and who receives prescription drug coverage through Medicaid should enroll in Medicare Part D for prescription drug coverage. Those with Medicaid who are not enrolled in Medicare can continue to receive prescription drug coverage through Medicaid. When a patient is in a facility receiving care at the Medicaid rate and has limited resources, the patient's income must be correct answers Less than the cost of care at the facility. **Medicaid pays for medically necessary nursing home care for patients in skilled or intermediate care nursing homes or in intermediate care facilities for the mentally retarded. The patient's income must be less than the cost of care in the facility at the Medicaid rate, and there is a limit on resources. A long-term care insurance sales representative replaced a long-term care policy belonging to an elderly insured. The premium and benefits were the same in the new policy as in the old

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Uploaded on
April 25, 2024
Number of pages
7
Written in
2023/2024
Type
Exam (elaborations)
Contains
Questions & answers

Subjects

R192,11
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