Insurance For Senior Citizens & Special Needs Individuals Flashcards
If an individual is covered by Medicare, and is also covered by his employer’s health plan, which plan would be considered primary?
The employer plan
Who issues medigap policies?
Private insurers
What Medicare part will cover lab services or diagnostic tests?
Part B
What Medicare part provides a prescription drugs benefit?
Part D
What is the required free look period for Medicare Supplement policies?
30 days
What is the purpose of Medicare supplement plans?
To fill in the gaps in Medicare coverage
Who is eligible for Part B Medicare?
Part B is optional and is offed to everyone who enrolle said in Part A
What Medicare part helps pay for inpatient hospital care, inpatient care in a skilled nursing facility, home health care and hospice care?
Part A
At what age do individuals qualify for Medicare?
65 years of Age
What benefits are provided by Medicare Part C?
Expanded benefits for a fee through private insurance programs such as HMOs or PPOs
When must the outline of coverage be provided to the insured?
No later than policy delivery
What is the purpose of respite care in long term care insurance?
To provide relief for a major caregiver (usually a family member)
Medicare Part A will pay for what type of services?4
1 Inpatient hospital care
2 skilled nursing facility care
3 home health care
4 hospice care
In which Medicare supplemental policies are the core benefits found?
All plans (A-N)
Who qualified for Medicare coverage?3
1 people age 65 or older
2 anyone entitled to social security disability income benefits for 2 years
3 those with chronic kidney disease
Can Alzheimer’s disease be excluded from coverage under long term care policy?
No, organic cognitive disorders such as Alzheimer’s or Parkinson’s must be covered
What is another name for Medicare Supplement plans?
Medigap
What part of Medicare is known as hospital insurance?
Part A
What are the activities of daily living?6
1 mobility 2 bathing 3 dressing 4 eating 5 toileting 6 continence
An insured with Medicare part d has reached the initial benefit limit and must now pay a portion of prescription drug costs. What is the term for this gap in coverage?
The donut whole
What is another name for Medicare Advantage plans?
Part c
What part of Medicare is known as medical insurance?
Part b
What type of Medicare policy requires insured’s to use specific healthcare providers and hospitals (in other words has restricted network provisions?
Medicare SELECT
How many pints of blood will be paid for Medicare Supplement core benefits?
First 3 pints
How is Part B Medicare funded?
By monthly premiums and from general revenues of the federal government
When is the initial enrollment period for Medicare Part A?
When an individual first becomes eligible for Medicare, starting 3 months before turning age 65 and ending 3 months after the 65th birthday
How many parts does Medicare have?
4 parts a through d
