Chapter 11.7 to 11.11 - Standardized Medicare Supplement Coverage Requirements Exam Questions and Answers
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Course
Medicare Supplements
Institution
Medicare Supplements
Standardized Medicare Supplement Coverage Requirements - Answer-The NAIC Model Law, with respect to Medicare supplement policies, was amended to revise the standardized Medicare Supplement plans delivered or issued for delivery in any state. Plans A, B, C, D, F, F with High Deductible, G, K, L, M, ...
Chapter 11.7 to 11.11 - Standardized
Medicare Supplement Coverage
Requirements Exam Questions and
Answers
Standardized Medicare Supplement Coverage Requirements - Answer-The NAIC Model
Law, with respect to Medicare supplement policies, was amended to revise the
standardized Medicare Supplement plans delivered or issued for delivery in any state.
Plans A, B, C, D, F, F with High Deductible, G, K, L, M, and N are available.
Plan A - Core Benefits - Answer-Plan A is the basic Medicare Supplement plan and
must be offered by all insurers marketing Medicare Supplements. Plan A provides the
core benefits that must also be included in all other Medigap plans. The core benefits
include:
-Coverage of Part A Medicare eligible expenses for hospitalization to the extent not
covered by Medicare from the 61st day through the 90th day in any Medicare benefit
period
-Coverage of Part A Medicare eligible expenses incurred for hospitalization to the extent
not covered by Medicare for each Medicare lifetime inpatient reserve day used
-Upon exhaustion of the Medicare hospital inpatient coverage including the lifetime
reserve days, coverage of 100% of the Medicare Part A eligible expenses for
hospitalization subject to a lifetime maximum benefit of an additional 365 days
-Coverage under Medicare Parts A and B for the reasonable cost of the first 3 pints of
blood
-Coverage for the coinsurance amount of Medicare eligible expenses under Part B
regardless of hospital confinement, subject to the Medicare Part B deductible
-*Hospice Care* - Coverage of cost sharing for all Part A Medicare eligible hospice care
and respite care expenses
Additional Benefits - Answer-In addition to the basic benefits, a number of other benefits
are included in Plans B through N in different combinations and with some limitations.
Those Plans and benefits include:
-Plans C and F pay the Part B deductible.
-All plans, except A and B, pay for skilled nursing facility care: Covers the coinsurance
amount from the 21st day through the 100th day in a benefit period for post-hospital
skilled nursing facility care eligible under Medicare Part A.
-Plans C, D, F, G, M and N pay for foreign travel emergency care: Pays 80% of the
billed charges for foreign emergency care that Medicare would have covered if it was
provided in the United States. Care must begin during the first 60 days outside the U.S.
The calendar year deductible is $250 and the lifetime maximum benefit is $50,000.
-Plans F and G pay Medicare Part B excess doctor charges: Pays 100% of a doctor's
excess fees.
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