Ch. 6 - Specialized Health Insurance For Qualified Individuals

Question 1

Medicare is for people who have been entitled to social security disability income for how many years?

Answer 1

Two

Question 2

What health condition automatically qualifies one for Medicare?

Answer 2

Permanent kidney failure (ESRD)

Question 3

Part A medicare is _____ insurance

Answer 3

Hospital insurance

Question 4

Pat A medicare is financed by whom

Answer 4

Through FICA

Question 5

Part B medicare is _____ insurance and finances by whom?

Answer 5

Medical; by insureds and general revenues

Question 6

Part C medicare is ___________ and allows for receipt of care through available _________ _________

Answer 6

Medicare advantage; provider organizations

Question 7

Part D Medicare is for what?

Answer 7

Prescription drug coverage

Question 8

Initial enrollment for Medicare part A

Answer 8

3 months before and after turning 65

Question 9

General enrollment for Medicare part A

Answer 9

Jan 1 - March 31

Question 10

Special enrollment period for Medicare Part A

Answer 10

Anytime during the year if they or spouse is employed and covered by geouo

Question 11

Which Medicare plan covers inpatient hospital care, skilled nursing facility care, home health care, and hospice care

Answer 11

Medicare plan A

Question 12

Optional coverage that must be offered to anyone who enrolls in plan A. Covers doctor services. Outpatient hospital, home health visits, other medical health services, rx limited coverage, outpatient treatment of mental Illness, and yearly wellness visit

Answer 12

Plan b Medicare

Question 13

Part C Medicare

Answer 13

Medicare advantage

Question 14

What Medicare plan requires enrollment in parts a and b and is provided by an hmo or ppo

Answer 14

Medicare advantage - part C

Question 15

Part D Medicare covers what?

Answer 15

Prescription drug benefit

Question 16

Optional coverage through private prescription plans that contract with Medicare

Answer 16

Part D - prescription drug benefit

Question 17

For those eligible for Medicare who continue to work which of their coverages pays first.

Answer 17

Employers health plan, then Medicare

Question 18

Medical enrollment period is how long?

Answer 18

6 mos.

Question 19

Plan that covers core benefits such as coinsurance/copayment, hospital costs, hospice care coinsurance/copayments, and 3 pints of blood

Answer 19

Medigap plan A

Question 20

All Medigap plans must include what coverage

Answer 20

Core benefits

Question 21

An insured with Medicare part D has reached the initial benefit limit and just now pay a portion of rx drug costs. What is the term for this gap in coverage.

Answer 21

The donut hole

Question 22

What Medicare part helps pay for inpatient hospital care, inpatient care in a skilled nursing facility, home healthcare and hospice care.

Answer 22

Part A

Question 23

An open enrollment period is a _________ period that guarantees applicants the right to buy Medigap once they first sign up for Medigap part B.

Answer 23

6 month

Question 24

A Medicare policy that requires insureds to use specific healthcare providers and hospitals, except in emergency situations. I’m return, the insured pays lower premium amounts.

Answer 24

Medicare select

Question 25

Employer health plans must provide coverage for individuals with end stage renal disease before Medicare becomes primary for how many months?

Answer 25

30

Question 26

Following hospitalization, how many days will Medicare pay full benefits in a skilled nursing facility?

Answer 26

20

Question 27

Regarding Medicare select policies, what are restricted network provisions?

Answer 27

They condition the payment of benefits