3 - Medicare Part B

Question 1

Medicare’s Medical Insurance is a _______ program.

Answer 1

-Voluntary

Question 2

Medicare Part B has an annual deductible for 2018 of _____ which must be met before Medicare Part B pays.

Answer 2

-$183

Question 3

Medicare Part B also has a ________ blood deductible coordinated with Medicare Part A.

Answer 3

-3 pint annual

Question 4

Medicare Part B will generally pay ____ of Medicare “approved charges.”

Answer 4

-80%

Question 5

Physicians and Suppliers that do not accept assignment are referred to as nonparticipating and may charge an _______ above the Medicare Part B approved amount.

Answer 5

-excess amount of 15%

Question 6

Any physician who provides services that the physician knows or has reason to believe Medicare will determine to be medically unnecessary and will not pay is required to provide the Medicare Beneficiary with a document called an ______________).

Answer 6

-Advance Beneficiary Notice (ABN)

Question 7

The typical Medicare Beneficiary participating in Medicare Part B pays _____ of the cost of his or her Medicare Part B premium.

Answer 7

-25%

Question 8

In 2018, the standard Part B premium amount will be ______.

Answer 8

-$134

Question 9

Failure to enroll (or continue enrollment) in Medicare Part B during the Initial Enrollment Period will result in an additional ______ of premium for each full ______ delayed enrollment from the end of the individual’s Initial Enrollment Period (IEP)

Answer 9

• 10%

- 12 months

Question 10

Medicare will pay for mental health services with a _____ coinsurance for outpatient services and _____ coinsurance for inpatient services.

Answer 10

• 40%

- 20%

Question 11

During the first twelve (12) months that a Medicare Beneficiary has Medicare Part B, he or she can get a ________ preventive care visit.

Answer 11

-“Welcome to Medicare”

Question 12

Yearly Wellness exams are provided if the Medicare Beneficiary has Medicare Part B for longer than ______. There is no charge for this exam if the physician accepts assignment. This exam is covered once every twelve ______.

Answer 12

• 12 months

- 12 months

Question 13

Individuals enrolling in Medicare Part B during 2018, not eligible for a special enrollment period, and earning up to ___________ will have a monthly premium of $134.00.

Answer 13

-$85,000

Question 14

Medicare Part B has an annual deductible of ______ in 2018

Answer 14

-$183

Question 15

Physicians who accept assignment of a Medicare Part B claim are referred to as:

Answer 15

-Participating Physicians

Question 16

Typically a Medicare Part B Beneficiary is paying in premiums what percentage of the premium cost of his or her Medicare Part B program with the rest subsidized by the government?

Answer 16

-25%

Question 17

The Medicare Part B enrollee pays approximately _______ of the cost of his or her Medicare program.

Answer 17

-25%

Question 18

A Medicare Beneficiary eligible for Medicare Part B will have what penalty assessed if he or she waits 36 months beyond the end of his or her Initial Enrollment Period (IEP)?

Answer 18

-a permanent 30% additional premium over the current monthly rate

Question 19

The Medicare Part B coinsurance percentage paid by Medicare is generally which of the following:

Answer 19

-80%

Question 20

A physician that knows that Medicare Part B will not pay for a service must provide the Medicare Beneficiary with a _______________.

Answer 20

-Advance Beneficiary Notice (ABN)

Question 21

Yearly “Wellness” exams are provided if the Medicare Beneficiary has Medicare Part B for longer than ___.

Answer 21

-12 months

Question 22

The annual blood “deductible” under Medicare Part B is:

Answer 22

-3 pints

Question 23

When a Medicare Beneficiary goes to a Physician that does not accept “assignment” or the “limiting charge” for Medicare approved charges, the beneficiary may enter into a ________ with the doctor for his services.

Answer 23

-Private Contract

Question 24

Nonparticipating physicians may charge _________ of the charges approved by Medicare Part B.

Answer 24

-115%

Question 25

Medicare Part B uses the term “__________” to determine what items the Medicare Part B program should provide.

Answer 25

-Medically Necessary

Question 26

The “notice” sent to a Medicare Part B claimant explaining how the claim was settled is called a:

Answer 26

-Medicare Summary Notice

Question 27

The maximum allowable Medicare Part B “excess charge” by participating physicians is:

Answer 27

-Participating Physicians cannot receive excess charge payments