Social Insurance

Question 1

federal medical expense insurance program for people 65 and older even if they continue to work

Answer 1

medicare

Question 2

4 parts of medicare

Answer 2

hospital insurance (payroll tax) , medical insurance (financed through monthly premiums) , medicare advantage (receive health services through providers) , prescription drug (for medicines)

Question 3

helps pay for inpatient hospital care, inpatient care in a skilled nursing facility, home health care, and hospice care

Answer 3

Part A

Question 4

when an individual first becomes eligible for medicare

Answer 4

initial enrollment period

Question 5

between Jan 1st and March 31st

Answer 5

general enrollment period

Question 6

any time during the year if the individual or their spouse is still employed and covered under a group health plan

Answer 6

special enrollment period

Question 7

must cover all services covered under the Original Medicare except hospice care and some care in qualifying clinical research studies

Answer 7

medicare advantage

Question 8

provides more focused and specialized health care for specific groups of people

Answer 8

special needs plan

Question 9

offer coverage on a fee-for-service basis

Answer 9

standalone plans

Question 10

group coverages together

Answer 10

integrated plans

Question 11

when the beneficiary is responsible for a portion of prescription drug costs

Answer 11

donut hole

Question 12

when the beneficiary hits their spending limit during the donut hole

Answer 12

catastrophic coverage

Question 13

policies issued by private insurance companies that are designed to fill in some of the gaps in Medicare

Answer 13

Medigap

Question 14

the purpose of this law was to eliminate questionable marketing practices and to provide customers with a degree of protection and to standardize the protection afforded.

Answer 14

OBRA

Question 15

How long is an open enrollment period for Medicare supplement policies?

Answer 15

6 months

Question 16

how long is the medigap free look period?

Answer 16

30 days

Question 17

federal and state funded program for those whose income and resources are insufficient to meet the cost of necessary medical care

Answer 17

medicaid

Question 18

how long is the waiting period to receive benefits for social security?

Answer 18

5 months. they start on the 6th

Question 19

based on the persons average indexed earnings on which social security taxes have been paid

Answer 19

Primary insurance amount (PIA)

Question 20

what is an eligibility requirement for social security disability income benefits

Answer 20

fully insured status

Question 21

A insured is covered under a medicare policy that provides a list of network health care providers that the insured must use to receive coverage. In exchange for this limitation, the insured is offered a lower premium. What type of Medicare policy does the insured own?

Answer 21

MEDICARE select

Question 22

Which of the following is NOT a factor determining qualifications for Social Security disability benefits?

Answer 22

Workers occupation

Question 23

What is not covered by part A of medicare?

Answer 23

physicians and surgeons services

Question 24

In order for an insured under Medicare part A to receive benefits for care in a skilled nursing facility, which of the following conditions would have to be met?

Answer 24

the insured must have been hospitalized for 3 days

Question 25

if a person is disabled at age 27 and meets social securities definition of total disability, how many work credits must he or she have earned to receive benefits?

Answer 25

12 credits

Question 26

who is medicaid funded by?

Answer 26

federal and state

Question 27

Following hospitalization because of an accident, Bill was confined in a skilled nursing facility. Medicare will pay full benefits in this facility for how many days?

Answer 27

20