Study guides, Class notes & Summaries

Margaret currently has an MAPD Plan. What would happen if you enrolled her into a stand-alone PDP? CORRECT ANSWERS: She would be disenrolled automatically from her MAPD Plan. What is Medicare Part D? CORRECT ANSWERS: A voluntary program, offered by private insurance companies that are contracted with the federal government, that provides prescription drug coverage for an additional monthly plan premium Which of the following statements is true about eligibility requirements for stand-alo...

How to qualify for Medicare - Must be 65 years or older If under 65 with certain disabilities: -Lateral Sclerosis -End Stage Renal Disease 4 parts of Medicare - Part A - Hospital services Part B - Outpatient services Part C - Combination of A & B Part D - Prescription drug coverage

If beneficiaries don't automatically receive extra help, they can apply for it to help pay for part D prescription drug cost - True For agent, two kits reference materials, Molina, matters, local and national events virtual trainings, and import contacts agents can visit the Molina age and center - True Partial dual eligibiles do not receive for Medicaid medical benefits - True

No long-term care policy can pay a cash surrender value unless... correct answers The dividends or refunds are applied as a reduction of future premiums or an increase in benefits. Prior to enrolling in the Medigap policy, and insured was covered by a group health plan for 6 months. Which of the following is true regarding coverage for pre-existing conditions under the new Medigap policy? correct answers Pre-existing conditions will be covered immediately. A 72 year old woman works full-ti...

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 fac...

*Group health insurance* is a key aspect of the health insurance market, and it is available to employer groups. correct answers Mike and Joyce's medical expense insurance coverage is provided by their employer, Acme MFG, Inc. As such, how is their insurance provided? A group health plan that offers dependent coverage must continue such coverage for an employee's adult child until the child turns *26 years old*, whether or not the child is married. correct answers Under the Patient Protecti...

Which of the following statements about Medicare Part D prescription drug coverage is CORRECT? Individuals may obtain prescription drug coverage only through stand-alone plans issued by Medicare. Individuals who join a Medicare Part D prescription drug plan must pay a separate monthly premium for the coverage. Medicare Advantage plans never provide prescription drug coverage. Medicare recipients are automatically enrolled in Part D when they enroll in Medicare. correct answers Individuals ...

An insured has 10 years of work experience. She participated in the Social Security program for 10 years. Her medicare Part A premium is most likely to be A. $0 B. $458 per month C. About 5% of monthly income D. $458 per month correct answers $0 EXPLANATION: People do not pay a monthly Part A premium because they or their spouse have 40 or more quarters of Medicare-covered employment. A patient has 20 day stay in Medicare covered SNF. All of these services are covered EXCEPT A. M...

Under Medicare Part A, a beneficiary is entitled to reasonable and medically necessary hospital care lasting how long? 21 days 60 days 30 days Inpatient hospital care is not covered correct answers 60 days M enters a skilled nursing facility after being released from the hospital. Medicare will fully cover her costs for how long? 90 days 60 days 30 days 20 days correct answers 20 days How many days of care in a specialty psychiatric hospital will Medicare Part A cov...

A man is planning to retire after age 65. Until then, he will have his employer's health plan. When should he enroll in Medicare Part B? correct answers Within the 8 months of the day he is no longer employed or when coverage under the group plan ends In the Original Medicare Plan Part B, the percentage of the approved amount paid by the patient is 20%. This is referred to as correct answers Coinsurance What process will the insurance company use to monitor the insured's hospital stay to...