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NC Medicare/LTC Exam With Questions and Answers
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NC Medicare/LTC Exam With Questions andAnswers
Home health care covers occasional visits from who? - ANSWER
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. - ANSWER 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-up policy providing the same benefits for a
shorter period, etc.) - ANSWER Nonforfeiture
When must the outline of coverage for a Medigap policy be provided
to the insured? - ANSWER At the time of application.
Home health equipment such as dialysis equipment and supplies are
covered under which part of Medicare? - ANSWER Medicare Part B
(Considered an outpatient service)
What is the Medicare Part B enrollment period for an individual who
is turning 65? - ANSWER 3 months before the month in which the
individual turns 65, as well as the 3 months following that month (7
months).
What is the copayment of the Medicare approved amount? -
ANSWER 20% paid by the insured individual.
Prospective review (Precertification provision) - ANSWER Physician
submits claim information prior to providing treatment to know in
advance if the procedure is covered and what the rate will be.
What options does an insured person have for prescription drug
, coverage if they are enrolled in a Medicare Advantage Plan? -
ANSWER 1) Receive prescription drug coverage through the
Medicare Advantage Plan.
2) Sign up for separate prescription drug plan through Medicare Part
D.
Who facilitates processing Medicare applications, collects Medicare
premiums, and provides general information about Medicare? -
ANSWER The Social Security Administration
Who administers Medicare? - ANSWER Centers for Medicare and
Medicaid Services (CMS)
How are LTC benefits triggered? - ANSWER Insured must be unable
to perform at least 2 ADLs without substantial assistance.
(Cannot be triggered solely due to medical necessity)
T/F. Relating to a tax qualified LTC policy, the premiums paid for the
policy may be a deductible expense, and the benefits paid are also
not considered taxable income. - ANSWER True.
Skilled nursing facility coinsurance is how much per day and starts
after how many days of care? - ANSWER $170.50 per day,
beginning on after the first 20 days. (100 days of coverage)
What is a qualifying hospital stay? - ANSWER 3 days hospitalization
(Provides Medicare coverage after 30 days have elapsed)
Qualified medical expenses paid for from a Medical Savings Account
(MSA) are taxed how? - ANSWER Not taxable. (Funds are used to
pay deductibles during the year)
*Only taxable when funds are used for anything other than qualified
medical expenses.
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