Competency 15 Section 3

Question 1

1. The Older Americans Act Program is the largest government source of long-term care funding

Answer 1

False. Medicaid and Medicare are the two largest long-term care funding sources. Medicaid is the largest long-term care funding government program. (LO 15-3-1)

Question 2

2. Medicare was designed to handle the long-term care expenditures of enrolled U.S. citizens over the age of 55.

Answer 2

False. Medicare was designed for people over the age of 65 and was not designed to be a significant financing vehicle for long-term care. (LO 15-3-1)

Question 3

3. If someone qualifies for Medicare post-acute skilled nursing care, the first 20 days are 100% covered by Medicare

Answer 3

True. (LO 15-3-1)

Question 4

4. Medicare eligible post-acute skilled nursing care services include housing in a private room and care from private duty nurses for up to 100 days.

Answer 4

False. Medicare qualified and covered post-acute skilled nursing care includes stay in a semi-private room and nursing services. However, Medicare does not cover private duty nurses. (LO 15-3-1)

Question 5

5. Medicare eligibility for post-acute skilled nursing care services no longer requires that the individual’s health is maintaining or improving

Answer 5

True. In 2012, Medicare decided the focus would remain on the need for care and not on whether the individual’s health is improving. (LO 15-3-1)

Question 6

6. The Deficit Reduction Act of 2006 extended the look-back rules for Medicaid eligibility from 36 to 60 months

Answer 6

True. (LO 15-3-1)

Question 7

7. Veterans Administration benefits for long-term care can include adult day care, housing, and domiciliary care.

Answer 7

True. (LO 15-3-1)

Question 8

8. Some Veterans Administration benefits are only available to eligible veterans with service related injuries

Answer 8

True. (LO 15-3-1)

Question 9

9. Medicaid is federally funded but state operated, requiring all states to enforce the same Medicaid qualification tests

Answer 9

False. Medicaid is a joint funded program, however, states can and do apply different qualification tests. (LO 15-3-2)

Question 10

10.State Medicaid income qualification tests are solely based on Supplemental Security Income Benefit standards.

Answer 10

False. While many states base the income qualification test on SSI benefits, other states set the requirements based on the Federal Poverty level. (LO 15-3-2)

Question 11

11.SSI benefits can be reduced if an individual’s food and shelter is being provided by a third party.

Answer 11

True. SSI benefits are reduced by 1/3 if someone else is providing your food and shelter. (LO 15-3-2)

Question 12

12.Under Medicaid, the community spouse is the individual receiving long-term care services funded by the government

Answer 12

False. The community spouse is the healthy spouse still living in the home or in the community. (LO 15-3-2)

Question 13

13.Under Medicaid spousal impoverishment provisions, a certain amount of a couple’s combined resources are protected for the community spouse

Answer 13

True. (LO 15-3-2)

Question 14

14.The federal government sets a minimum monthly needs allowance for community spouses.

Answer 14

True. The range was from $1,838 to $2,841 in 2012. (LO 15-3-2)

Question 15

15.SSI and Medicaid benefits can both have asset resource eligibility requirements.

Answer 15

True. $2,000 individual/$3,000 with community spouse. (LO 15-3-2)

Question 16

16.A primary residence, automobile, and personal belongings, such as clothing and jewelry, are considered exempt assets and not countable for purposes of Medicaid’s asset resource eligibility requirements

Answer 16

True. (LO 15-3-2)

Question 17

17.Income-cap states require Medicaid applicants to provide for their own cost of care until they spend down their assets below the income cap amount

Answer 17

False. This statement correctly describes a spend-down state, not an income cap state. In an income cap state, if the income is $1 over the cap, you do not qualify for Medicaid. (LO 15-3-2)

Question 18

18.The Deficit Reduction Act of 2006’s “look back” provision prohibits all property transfers within 60 months of the date of application to Medicaid

Answer 18

False. The DRA does not prohibit the transfers, instead it only requires Medicaid to examine transfers below market value in the previous 60 months prior to the application for Medicaid. (LO 15-3-2)

Question 19

19.An invalid or below market transfer could result in a Medicaid applicant becoming ineligible for up to five years.

Answer 19

True. (LO 15-3-2)

Question 20

20.Purchase of a qualified annuity does not violate the Deficit Reduction Act of 2006’s look-back requirements.

Answer 20

True. (LO 15-3-2)

Question 21

21.A Medicaid applicant can transfer his or her assets into exempt assets for the purposes of qualifying for Medicaid without violating the Deficit Reduction Act of 2006’s look-back provisions

Answer 21

True. (LO 15-3-2)

Question 22

22.States can recover assets paid under Medicaid from a beneficiary’s estate.

Answer 22

True. (LO 15-3-2)

Question 23

23.The Older American Act Programs provide long-term care services in the form of Alzheimer’s Disease services

Answer 23

True. (LO 15-3-3)

Question 24

24.The Own Your Future Awareness Campaign offers a variety of State and Federal funded long-term care living facilities

Answer 24

False. The Own Your Future Awareness Campaign was designed to help individuals plan for long-term care and disseminate free planning information. (LO 15-3-3)

Question 25

25.State Partnership Long-Term Care Insurance Programs offer government funded long-term care insurance policies.

Answer 25

False. The program was designed to incentivize the purchase of policies but not to provide the funding for them. (LO 15-3-4)

Question 26

26.While the Deficit Reduction Act of 2006’s “look back” period changes made it easier to qualify for Medicaid, the Partnership Program made it more difficult to spend down assets to qualify for Medicaid

Answer 26

False. The Deficit Reduction Act of 2006 extended the “look back” period making it harder to qualify for Medicaid. The Partnership Programs make it easier to spend down assets to qualify for Medicaid by exempting more of the applicant’s assets from the limits. (LO 15-3-4)

Question 27

27.Most states put a $100,000 policy limit on qualified State Partnership Program long-term care policies

Answer 27

False. Most states do not put any policy amount limitations on qualified long-term care insurance policies for State Partnership Program eligibility. (LO 15-3-4)

Question 28

28.Qualified State Partnership Program long-term care insurance policies must have specific inflation protections built into the contracts.

Answer 28

True. (LO 15-3-4)

Question 29

29.Qualified State Partnership Program long-term care insurance policies can be used to protect an individual’s legacy goals.

Answer 29

True. These policies can be used in conjunction with other planning techniques to protect assets against Medicaid spend-down. (LO 15-3-4)

Question 30

30.Qualified State Partnership Program long-term care insurance policies are almost always the most affordable policies available.

Answer 30

False. These policies, because of the inflation protections, are typically expensive compared to policies without the inflation protections. (LO 15-3-4)

Question 31

24. Andrew, preparing to enter a nursing home, files his Medicaid application. Because the average nursing home cost in his area is $5,000/month, Andrew wants to make sure he qualifies for Medicaid. As such, Andrew gives away $200,000 to his sister. How long will Andrew be ineligible for Medicaid due to this transfer? (LO 15-3-2) A. Andrew will not be ineligible for Medicaid. B. Andrew will be ineligible for the full 60-month look-back period. C. Andrew will be ineligible for 40 months. D. Andrew will be ineligible for 20 months

Answer 31

24. The answer is C. Transfer/average Nursing Home care = 200,000/5,000 – 40 months

Question 32

25. Which of the following statements is true regarding The Older American Act Program? (LO 15-3-3) A. It was initially enacted to provide coordination of Alzheimer’s disease care services. B. It provides long-term care housing. C. It worked in conjunction with the Federal government to create “The Own Your Future Awareness Campaign,” designed to raise awareness about Alzheimer’s disease. D. It provides respite care services to family caregivers

Answer 32

25. The answer is D. The Older American Act Program – Life-Span Respite Care Program helps provide respite care to family caregivers.

Question 33

26. Which of the following is a benefit of a qualified State Partnership Program long-term care insurance policy? (LO 15-3-4) A.Qualified plans are typically the most affordable. B.Qualified plans do not need expensive inflation protections. C.Qualified plans are partially funded by the State. D.Qualified plans enable more effective Medicaid “spend-down” planning.

Answer 33

26. The answer is D. The benefit of the qualified policy is to protect assets from Medicaid spend-down and asset eligibility requirements.

Question 34

52. Which of the following statements concerning the Deficit Reduction Act of 2005 (DRA) is (are) correct? (LO 15-3-1) I. The DRA tightened the Medicare long-term care coverage eligibility requirements. II. The DRA shortened the look-back period from 60 months to 36 months. A. I only B. II only C. Both I and II D. Neither I nor II

Answer 34

52. The answer is D. The DRA restricted Medicaid not Medicare eligibility requirements and lengthened the look-back period

Question 35

``` 53. Which of the following is (are) often exempt from the Medicaid resource eligibility tests? (LO 15-3-2) I. Pre-paid burial plots and contracts II. Household belongings and furnishings A. I only B. II only C. Both I and II D. Neither I nor II ```

Answer 35

53. The answer is C. Both of these assets are typically exempt from Medicaid resource eligibility tests

Question 36

82. All of the following are excluded from impacting the amount of Supplemental Security Income benefits EXCEPT (LO 15-3-2) A. $30/month from any source B. Food and shelter provided by a family member C. A small amount of monthly wages D. $20/month of nonrecurring items

Answer 36

82. The answer is B. Food and shelter provided by a family member can decrease the SSI benefit by 1/3.