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Medicare Supplement -Long-Term Insurance NC Exam Questions and Answers
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Medicare Supplement -Long-Term Insurance NC Exam Questions and Answers
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Medicare Supplement / Long-TermInsurance NC Exam Questions and
Answers
Part A Medicare - Answer -this coverage includes care in a hospital, nursing facility,
nursing home, hospice or even a home
Utilization Review Committees - Answer -In addition to QIO, hospitals have these
committees that help to ensure that the hospital will follow Medicare guidelines.
Because Medicare payments are based on the DRGS, this committee works in
conjunction with QIO to ensure that a high standard of care is provided
Respite Care - Answer -Temporary inpatient care provided by a nursing home, hospice,
or hospital care so that a family member or friend who is the patients caregiving can rest
or take some time off
Medicare Part D - prescription plan options - Answer -Stand alone plan - adding
Medicare part d to other coverage
Medicare advantage - obtaining the drug coverage as well as other Medicare coverage
through a Medicare advantage plan
LTC - levels of care - Answer -- Skilled Nursing Care
- Intermediate Care
- Custodial Care
- Home Health Care
Describe Part D - Medicare - Answer -Added to Medicare in 2006. Subsidize the cost of
prescription drugs
Benefit Period for Medicare Part A - Answer -- It begins the first day receiving service in
a hospital or snf and ending when the person has been out of the facility and is not
receiving care in any other facility for 60 days in a row.
- No limit to the number of permissible benefit periods
- Coverage may last up to 90 days
- 60 lifetime reserve days
, - Medicare A deductibles restart every new benefit period whereas Medicare B
deductibles apply once a year
Blood Deductible - Medicare Part A and B - Answer -Medicare will not pay for the first 3
pints of blood received in a calendar year. This deductible applies in addition to any
other deductible
Part A and B can have a combined deductible
Medicaid - definition - Answer -Joint state-federal gov program that provides health care
for US citizens with low income;
- nursing home care
- inpatient and outpatient hospital services
- lab services
- home health services
- physical therapy
- prescription drug and hospice care
LTC - Inflation Protection - Answer -Many states that require this benefit are offered with
LTC insurance. A daily benefit amount that is adequate today may not be adequate ten
years form now. Helps to keep pace with inflation and increased expenses
Perspective Payment Systems - Answer -A way of controlling costs. Stipulates a
method of reimbursement for healthcare providers under which predetermined amounts
must be set for each service that may be provided.
Home Health Care - Medicare Part A - Answer -- Intermittent skilled nursing care
- Physical therapy
- Speech therapy
- Occupational therapy
Medicare Part C - Answer -- Gives the insured the option to enroll in Medicare
Advantage plan instead of the traditional Medicare plan. This coverage is often
enhanced and often requires higher premiums than Original Medicare
Medicaid - Non-countable assets - Answer -- A persons home
- Personal belongings
- One automobile
- IRA's specifically structures as annuities
- Prepaid funeral plans
Part B Medicare - Answer -This coverage includes medically necessary services or
supplies or diagnosis or treatment of a medical condition, as well as preventive
services. Mainly physician services
Medicare Administration Contractor - Answer -Function as a regional contractor,
covering multiple states, and to process and administer claims for Original Medicare (A
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