Private Insurance Plans for Seniors Vocab & Notes Chap 5B

Question 1

Health insurance that provides coverage to fill the gaps in Medicare coverage.

Answer 1

Medicare Supplements (medigaps)

Question 2

A type of Medicare supplement (Medigap) plan sold in some states that can be any of the standardized Medigap plans (A-N) but which requires policy holder to receive services from within a defined network of hospitals and - in some cases - doctors in order to be eligible for full benefits.

Answer 2

Medicare Select

Question 3

A program that offers a prescription drug benefit to help Medicare beneficiaries pay for the drugs they need. The drug benefit is optional and is available to anyone who is entitled to Medicare Part A or enrolled in Part B. This benefit is available through private prescription drug plans (POPs) or Medicare Advantage (PPO) plans.

Answer 3

Medicare Part D

Question 4

The broad range of medical and personal services for individuals (often the elderly) who need assistance with daily activities for an extended period of time.

Answer 4

Long-Term Care Insurance

Question 5

Daily nursing care ordered by a doctor; often medically necessary. It can only be performed by or under the supervision of skilled medical professionals and is available hours a day.

Answer 5

Skilled Nursing Care

Question 6

The level of health or medical care given to meet daily personal needs, such as dressing, bathing, getting out of bed, and soon. Though it does not require medical training, it must be administered under a physician’s order.

Answer 6

Custodial Care

Question 7

Skilled or unskilled care provided in an individual’s home, usually on a part-time basis.

Answer 7

Home Health Care

Question 8

A type of care (usually custodial) designed for individuals who require assistance with various activities of daily living, while their primary caregivers are absent. Offered in care centers.

Answer 8

Adult Day Care

Question 9

A type of health or medical care designed to provide a short rest period for a caregiver. Characterized by its temporary status.

Answer 9

Respite Care

Question 10

All Medicare Supplement plans cover coinsurance on hospital costs, up to an additional 365 days after Medicare Part A hospital benefits run out.

Answer 10

Core Benefits

Question 11

A Federally-supported, state-operated initiative that allows individuals who purchase a qualified long term care insurance policy or coverage to protect a portion of their assets that they would typically need to spend down prior to qualifying for Medicaid coverage.

Answer 11

The Long-Term Care Partnership Program

Question 12

Designed to provide a benefit for elderly individuals who live in a __________________ retirement community.

Answer 12

Continuing Care

Question 13

A basic unit for determining whether a worker is insured under the Social Security program.

Answer 13

Quarter of Coverage

Question 14

Used to fund the Social Security program if a person hasn’t contributed through their payroll program, they are not eligible for benefits.

Answer 14

FICA taxes (Federal Insurance Contributions Act)

Question 15

The determining factor between being classified as fully insured or currently insured. Once a person becomes fully insured, death benefits are extended to his (or her) family. In other words, the family becomes eligible for survivorship benefits. Four _________ is the maximum any one person can earn in a given year; therefore, for the 40-quarter rule to apply, an individual must have been employed and have paid FICA taxes for 10 years at least.

Answer 15

Credits

Question 16

A status of complete eligibility for the full range of Social Security benefits: death benefits, retirement benefits, disability benefits, and Medicare benefits. A person must have contributed for 40 quarters of employment.

Answer 16

Fully Insured

Question 17

Under Social Security, a status of limited eligibility that provides only death benefits.

Answer 17

Currently Insured

Question 18

The benefit (before rounding down to next lower whole dollar) a person would receive if he/she elects to begin receiving retirement benefits at his/her normal retirement age. At this age, the benefit is neither reduced for early retirement nor increased for delayed retirement.

Answer 18

The Primary Insurance Amount (PIA)

Question 19

A period following the death of a family breadwinner during which no Social Security benefits are available to the surviving spouse.

Answer 19

Blackout period

Question 20

When Social Security uses both medical disability criteria and non- medical criteria to determine whether you qualify for Social Security disability (SSDI, the program based on work credits) or Supplemental Security Income (SSI, the low-income program). First, you must be able to prove that you are medically disabled.

Answer 20

Disability Benefit Qualifications

Question 21

When Social Security retirement benefits are only available to covered workers who are fully insured upon retirement. Benefits are paid monthly. If a covered worker retires at the normal retirement age, he or she will receive 100% of the PIA. However, if a covered worker retires early at the age of 62, the maximum Social Security benefits is 80% of the PIA. This reduction remains all through retirement. Retirement benefits pay covered retired workers, their spouses, and other eligible dependents a monthly retirement income.

Answer 21

Retirement Benefits

Question 22

This states that Social Security benefits are subject to federal income tax if the beneficiary files an individual tax return and his or her annual income is greater than $25,000. Joint filers will pay federal income tax on their Social Security benefits if their income is greater than $32,000

Answer 22

Taxation of Social Security Benefits