NC MEDICARE/LTC EXAM WITH
COMPLETE SOLUTIONS
Home ihealth icare icovers ioccasional ivisits ifrom iwho? i- icorrect ianswers i-Registered
inurses, ilicensed ipractical inurses, icommunity-based iprofessionals i(like ihospice).
**Does iNOT icover ivisits ifrom iattending iphysicians.
Programs ithat iare iprovided ito ipeople iwho iare itoo ipoor ito iqualify ifor iMedicaid. i-
icorrect ianswers i-State-only iMedicaid iprograms
LTC iprovision ithat iprovides ia iguarantee ithat icertain ipolicy ibenefits iwill iremain
iavailable ieven iif ithe iinsured istops ipaying ipremiums. i(Offers ioption iof ia ipaid-up
ipolicy iproviding ithe isame ibenefits ifor ia ishorter iperiod, ietc.) i- icorrect ianswers i-
Nonforfeiture
, When imust ithe ioutline iof icoverage ifor ia iMedigap ipolicy ibe iprovided ito ithe iinsured?
i- icorrect ianswers i-At ithe itime iof iapplication.
Home ihealth iequipment isuch ias idialysis iequipment iand isupplies iare icovered iunder
iwhich ipart iof iMedicare? i- icorrect ianswers i-Medicare iPart iB i(Considered ian
ioutpatient iservice)
What iis ithe iMedicare iPart iB ienrollment iperiod ifor ian iindividual iwho iis iturning i65? i-
icorrect ianswers i-3 imonths ibefore ithe imonth iin iwhich ithe iindividual iturns i65, ias iwell
ias ithe i3 imonths ifollowing ithat imonth i(7 imonths).
What iis ithe icopayment iof ithe iMedicare iapproved iamount? i- icorrect ianswers i-20%
ipaid iby ithe iinsured iindividual.
Prospective ireview i(Precertification iprovision) i- icorrect ianswers i-Physician isubmits
iclaim iinformation iprior ito iproviding itreatment ito iknow iin iadvance iif ithe iprocedure iis
icovered iand iwhat ithe irate iwill ibe.
What ioptions idoes ian iinsured iperson ihave ifor iprescription idrug icoverage iif ithey iare
ienrolled iin ia iMedicare iAdvantage iPlan? i- icorrect ianswers i-1) iReceive iprescription
idrug icoverage ithrough ithe iMedicare iAdvantage iPlan.
2) iSign iup ifor iseparate iprescription idrug iplan ithrough iMedicare iPart iD.
Who ifacilitates iprocessing iMedicare iapplications, icollects iMedicare ipremiums, iand
iprovides igeneral iinformation iabout iMedicare? i- icorrect ianswers i-The iSocial iSecurity
iAdministration
Who iadministers iMedicare? i- icorrect ianswers i-Centers ifor iMedicare iand iMedicaid
iServices i(CMS)
How iare iLTC ibenefits itriggered? i- icorrect ianswers i-Insured imust ibe iunable ito
iperform iat ileast i2 iADLs iwithout isubstantial iassistance.
(Cannot ibe itriggered isolely idue ito imedical inecessity)
T/F. iRelating ito ia itax iqualified iLTC ipolicy, ithe ipremiums ipaid ifor ithe ipolicy imay ibe ia
ideductible iexpense, iand ithe ibenefits ipaid iare ialso inot iconsidered itaxable iincome. i-
icorrect ianswers i-True.
Skilled inursing ifacility icoinsurance iis ihow imuch iper iday iand istarts iafter ihow imany
idays iof icare? i- icorrect ianswers i-$170.50 iper iday, ibeginning ion iafter ithe ifirst i20
idays. i(100 idays iof icoverage)
What iis ia iqualifying ihospital istay? i- icorrect ianswers i-3 idays ihospitalization i(Provides
iMedicare icoverage iafter i30 idays ihave ielapsed)
COMPLETE SOLUTIONS
Home ihealth icare icovers ioccasional ivisits ifrom iwho? i- icorrect ianswers i-Registered
inurses, ilicensed ipractical inurses, icommunity-based iprofessionals i(like ihospice).
**Does iNOT icover ivisits ifrom iattending iphysicians.
Programs ithat iare iprovided ito ipeople iwho iare itoo ipoor ito iqualify ifor iMedicaid. i-
icorrect ianswers i-State-only iMedicaid iprograms
LTC iprovision ithat iprovides ia iguarantee ithat icertain ipolicy ibenefits iwill iremain
iavailable ieven iif ithe iinsured istops ipaying ipremiums. i(Offers ioption iof ia ipaid-up
ipolicy iproviding ithe isame ibenefits ifor ia ishorter iperiod, ietc.) i- icorrect ianswers i-
Nonforfeiture
, When imust ithe ioutline iof icoverage ifor ia iMedigap ipolicy ibe iprovided ito ithe iinsured?
i- icorrect ianswers i-At ithe itime iof iapplication.
Home ihealth iequipment isuch ias idialysis iequipment iand isupplies iare icovered iunder
iwhich ipart iof iMedicare? i- icorrect ianswers i-Medicare iPart iB i(Considered ian
ioutpatient iservice)
What iis ithe iMedicare iPart iB ienrollment iperiod ifor ian iindividual iwho iis iturning i65? i-
icorrect ianswers i-3 imonths ibefore ithe imonth iin iwhich ithe iindividual iturns i65, ias iwell
ias ithe i3 imonths ifollowing ithat imonth i(7 imonths).
What iis ithe icopayment iof ithe iMedicare iapproved iamount? i- icorrect ianswers i-20%
ipaid iby ithe iinsured iindividual.
Prospective ireview i(Precertification iprovision) i- icorrect ianswers i-Physician isubmits
iclaim iinformation iprior ito iproviding itreatment ito iknow iin iadvance iif ithe iprocedure iis
icovered iand iwhat ithe irate iwill ibe.
What ioptions idoes ian iinsured iperson ihave ifor iprescription idrug icoverage iif ithey iare
ienrolled iin ia iMedicare iAdvantage iPlan? i- icorrect ianswers i-1) iReceive iprescription
idrug icoverage ithrough ithe iMedicare iAdvantage iPlan.
2) iSign iup ifor iseparate iprescription idrug iplan ithrough iMedicare iPart iD.
Who ifacilitates iprocessing iMedicare iapplications, icollects iMedicare ipremiums, iand
iprovides igeneral iinformation iabout iMedicare? i- icorrect ianswers i-The iSocial iSecurity
iAdministration
Who iadministers iMedicare? i- icorrect ianswers i-Centers ifor iMedicare iand iMedicaid
iServices i(CMS)
How iare iLTC ibenefits itriggered? i- icorrect ianswers i-Insured imust ibe iunable ito
iperform iat ileast i2 iADLs iwithout isubstantial iassistance.
(Cannot ibe itriggered isolely idue ito imedical inecessity)
T/F. iRelating ito ia itax iqualified iLTC ipolicy, ithe ipremiums ipaid ifor ithe ipolicy imay ibe ia
ideductible iexpense, iand ithe ibenefits ipaid iare ialso inot iconsidered itaxable iincome. i-
icorrect ianswers i-True.
Skilled inursing ifacility icoinsurance iis ihow imuch iper iday iand istarts iafter ihow imany
idays iof icare? i- icorrect ianswers i-$170.50 iper iday, ibeginning ion iafter ithe ifirst i20
idays. i(100 idays iof icoverage)
What iis ia iqualifying ihospital istay? i- icorrect ianswers i-3 idays ihospitalization i(Provides
iMedicare icoverage iafter i30 idays ihave ielapsed)
