HEALTH POLICY FINAL EXAM| ACTUAL QUESTIONS AND
VERIFIED ANSWERS
1. Who makes the rules? Who CONTROLS healthcare?: THE FEDS
- state
- local
- APTA
2. Medicare Title XVIII Social Security Act 1965: - elderly people with certain
disabilities, people with end-stage renal disease
- federal gov administered
- guidelines come from CMS (Center for Medicare/aid Services)
- supplemental coverage with medigap (separate premium)
3. Part A Plan: Organized (institutional care —> hospitals, SNFs): - preferred!
- includes hospital + medical insurance
- any doctor/hospital that takes medicare, anywhere in USA
- Eligibility: FREE w/40 calendar quarters of work in any job where you paid Social
Security taxes in the USA (or if spouse qualifies), but have to pay a premium if no
enough working quarters
4. Part B Plan: Original (physician and suppliers): - eligibility: Eligible for Part A
+ paying monthly premium (income dependent). If not eligible for part A, must be
65+ and US citizen/legal resident for 5+ years
5. NOT COVERED in part A or B: - dental
- eye exams
- dentures
- cosmetic surgery
- massage therapy
- hearing aids
- long-term care
6. Part C Medicare advantage plan: managed care: - pay part B premium, most
include part D
- some have additional services (vision/hearing/dental)
7. Part D Plan: drug benefits: - includes drug coverage (can be separate from
others w/separate premium)
- cost varies by plan
- can add to part A/B plan
8. in number enrolled in original medicare —>
in those enrolled in managed care: DECLINE. ........INCREASE
9. Penalties for late enrollment part A: Premium increases 10%
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, 10. Penalties for late enrollment part B: Premium increases 10% per 12 months
in the period where you could have enrolled but didnt
11. Medicaid Title IXI social security act 1965: - State administered, for the
poor/elderly/disabled not covered by medicare
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VERIFIED ANSWERS
1. Who makes the rules? Who CONTROLS healthcare?: THE FEDS
- state
- local
- APTA
2. Medicare Title XVIII Social Security Act 1965: - elderly people with certain
disabilities, people with end-stage renal disease
- federal gov administered
- guidelines come from CMS (Center for Medicare/aid Services)
- supplemental coverage with medigap (separate premium)
3. Part A Plan: Organized (institutional care —> hospitals, SNFs): - preferred!
- includes hospital + medical insurance
- any doctor/hospital that takes medicare, anywhere in USA
- Eligibility: FREE w/40 calendar quarters of work in any job where you paid Social
Security taxes in the USA (or if spouse qualifies), but have to pay a premium if no
enough working quarters
4. Part B Plan: Original (physician and suppliers): - eligibility: Eligible for Part A
+ paying monthly premium (income dependent). If not eligible for part A, must be
65+ and US citizen/legal resident for 5+ years
5. NOT COVERED in part A or B: - dental
- eye exams
- dentures
- cosmetic surgery
- massage therapy
- hearing aids
- long-term care
6. Part C Medicare advantage plan: managed care: - pay part B premium, most
include part D
- some have additional services (vision/hearing/dental)
7. Part D Plan: drug benefits: - includes drug coverage (can be separate from
others w/separate premium)
- cost varies by plan
- can add to part A/B plan
8. in number enrolled in original medicare —>
in those enrolled in managed care: DECLINE. ........INCREASE
9. Penalties for late enrollment part A: Premium increases 10%
1/8
, 10. Penalties for late enrollment part B: Premium increases 10% per 12 months
in the period where you could have enrolled but didnt
11. Medicaid Title IXI social security act 1965: - State administered, for the
poor/elderly/disabled not covered by medicare
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