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Examen

MEDICARE_SUPPLEMENT_LONG_TERM_CARE_ACTUAL_PAPER_2026_QUESTIONS_WITH

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MEDICARE_SUPPLEMENT_LONG_TERM_CARE_ACTUAL_PAPER_2026_QUESTIONS_WITH

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MEDICARE SUPPLEMENT LONG TERM
CARE ACTUAL PAPER 2026 QUESTIONS
WITH ANSWERS GRADED A+

●● CMS. 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.


●● MAC. Answer: Medicare Administrative Contractor - company
contracted to administer Part A & Part B claims.


●● Medicare Part A. 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. 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. 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. 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. Answer: Part A & B are
automatically conducted by SSA when individual age 65+ enrolls for
their Social Security retirement benefits


●● Initial Enrollment Period. 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. 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. 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. 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. 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.

Información del documento

Subido en
22 de agosto de 2026
Número de páginas
23
Escrito en
2026/2027
Tipo
Examen
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