chapter 6

Question 1

Medicare eligibility

Answer 1

65 or older
anyone with end stage kidney (renal) disease
persons receiving SS disability benefit for 2 years

Question 2

Medicare part A and B

Answer 2

Initial enrollment period - 3 months before 65 or until 3 months after 65.

Question 3

A and B exclusions

Answer 3

eye exams and prescription glasses 
dental care
elective cosmetic care 
hearing aids 
long term care (nursing home)

Question 4

Part C of Medicare

Answer 4

Medicare advantage. Medicare that is provided by approved HMOs and PPOs

Question 5

Part D of Medicare

Answer 5

Prescription drug benefit. Optional coverage which is provided through private prescription drug plans. It can be stand alone or integrated

Question 6

Medicare supplement policies - medigap

Answer 6

Issued by private insurance companies. These are done to cover gaps. Must have part A and B in order to have medigap

not eligable if they have medicare advanced because they are already fully covered

30 day free look

Question 7

LTC coverage (Long term care)

Answer 7

• indv. LTC policy
• group LTC policy
• LTC rider to a life insurance policy
• must be for at least 12 consecutive months

Question 8

LTC benefit period

Answer 8

30 day elimination period. Do not have coverage during this time.

2-5 years benefit period

Question 9

LTC levels of care

Answer 9

Skilled care - nursing and rehab care
Intermediate Care - occasional nursing or rehab care
Custodial care - nonmedical personnel. institutional setting or home
Adult Day Care - impaired adults community center. Activity, transportation and meals
Home Health care
Respite Care

Question 10

Medicaid

Answer 10

For the needy. For people with little or no assets. Federal and state funded program