Study guides, Class notes & Summaries

Z sells a MSP to a sick 72-year-old person, that he knows already has a Medicare supplement. The sale is correct answers Not allowed because a person cant have multiple MSPs Which of the following does not qualify for Medicare under 65 years old? correct answers Z who has pancreatic cancer All of the following are NOT correct regarding Medicare Advantage HMO and PPO plans EXCEPT: correct answers Medicare Advantage PPOs do NOT use a gatekeeper. Which of the following is the primary point...

An individual who is not eligible for premium-free Medicare Part A coverage may apply for coverage during which of the following enrollment periods? A. All of the above B. Initial enrollment period C. General enrollment period D. Special enrollment period correct answers A. All of the above Medicare makes what payment for services in which another payer may be responsible: A. Conditional payment B. Interim payment C. Transitional payment D. Temporary payment correct answers A. Con...

Home health care covers occasional visits from who? correct answers Registered nurses, licensed practical nurses, community-based professionals (like hospice). **Does NOT cover visits from attending physicians. Programs that are provided to people who are too poor to qualify for Medicaid. correct answers State-only Medicaid programs LTC provision that provides a guarantee that certain policy benefits will remain available even if the insured stops paying premiums. (Offers option of a paid...

Medicare correct answers Health insurance for those over age 65, people under 65 with certain disabilities & those with ESRD (end stage renal disease - permanent kidney failure requiring dialysis or kidney transplant) CMS correct answers 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 correct answers Medicare Administrative Contractor - company contracted ...

Supportive services provided by qualified para-professionals who are trained, equipped, assigned, and supervised by professionals within an agency to help maintain, strengthen, and safeguard the care of the elderly in their own homes is called correct answers Homemaker services. Homemaker service standards must, at a minimum, meet standards established by the North Carolina Division of Social Services and may include assistance in management of household budgets, planning nutritious meals, pu...

Federal Program correct answers Medicare is a federal health insurance program. Part of the Social Security program, Medicare is run by the Centers for Medicare & Medicaid Services of the Department of Health and Human Services. Private firms contract with the federal government to handle the paperwork, review claims, and disburse claim payments. Medicare Part A correct answers Designed primarily to provide hospital insurance and to pay for certain other types of institutional care. Medica...

Under Part B, individuals pay a deductible each... correct answers Year After deductible is satisfied, Part B pays what percentage of all approved charges? correct answers 80% Doctors and suppliers who agree to accept the amount medicare will pay are said to have agreed to... correct answers Assignment An optional long-term carer insurance benefit that provides a reduced paid-up benefit amount is the... correct answers Nonforfeiture benefit A man has just completed an inpatient hospi...

Medicare correct answers - federal health insurance program, administered by the Centers for Medicare & Medicaid Services (CMS), for people age 65 and older and for certain disabled individuals. Medicare is a Social Security program that covers medical expenses for qualified individuals. Like Social Security, Medicare is funded primarily by payroll taxes. - Health care providers bill Medicare directly for services rendered to Medicare patients, so patients do not submit claim forms. Medicare be...

North Carolina Medicare Supplement and Long-Term Care Question and Answer 100% Correct An individual who is not eligible for premium-free Medicare Part A coverage may apply for coverage during which of the following enrollment periods? A. All of the above B. Initial enrollment period C. General enrollment period D. Special enrollment period - A. All of the above Medicare makes what payment for services in which another payer may be responsible: A. Conditional payment B. Interim payme...