MEDICARE COMPREHENSIVE EXAM ACTUAL
QUESTIONS AND ANSWERS RATED A+
✔✔What does Medicare Part B cover? - ✔✔covers outpatient services such as
outpatient hospital care, physician visits, and preventive services; ambulance services,
clinical laboratory services, durable medical equipment (such as wheelchairs and
oxygen), kidney supplies and services, outpatient mental health care, and diagnostic
tests
✔✔Medicare Part B - ✔✔Managed by the government
✔✔What does Medicare Part C cover? - ✔✔covers all Medicare-covered benefits
covered under other parts, but as private health plans can vary the benefit design as
long as the core benefit package (excluding the value of supplemental benefits) is
actuarially equivalent to traditional Medicare. May also include extra benefits, such as
dental services, eyeglasses, or hearing exams; AKA "Medicare Advantage"
✔✔Medicare Part C - ✔✔Managed by private insurers; Medicare Advantage
✔✔Medicare Advantage - ✔✔Private health plans that receive payments from Medicare
to provide Medicare-covered benefits to enrollees. 3 in 10 beneficiaries are enrolled in
these plans. AKA Medicare Part C
✔✔What does Medicare Part D cover? - ✔✔covers an outpatient prescription drug
benefit through private plans. Plans are required to provide a "standard" benefit or one
that is actuarially equivalent, and may offer more generous benefits.
✔✔Medicare Part D - ✔✔Managed by private insurers
✔✔Doughnut Hole - ✔✔Portion of Part D where there is less coverage (45% for brand
names, 50% for generics paid by participant)
✔✔How does Medicare pay providers? - ✔✔traditionally on a fee for-service basis; in
the future payments will be linked to performance
✔✔How do beneficiaries pay for benefits? - ✔✔via varying premiums, deductibles, and
coinsurance amounts that can change annually to reflect changes in program costs. =
relatively high cost-sharing requirements for covered benefits.
✔✔Hospital Insurance Trust Fund - ✔✔risk pool financing for part A
✔✔Supplementary Medical Insurance (SMI) - ✔✔risk pool financing for part B combined
with general revenues
QUESTIONS AND ANSWERS RATED A+
✔✔What does Medicare Part B cover? - ✔✔covers outpatient services such as
outpatient hospital care, physician visits, and preventive services; ambulance services,
clinical laboratory services, durable medical equipment (such as wheelchairs and
oxygen), kidney supplies and services, outpatient mental health care, and diagnostic
tests
✔✔Medicare Part B - ✔✔Managed by the government
✔✔What does Medicare Part C cover? - ✔✔covers all Medicare-covered benefits
covered under other parts, but as private health plans can vary the benefit design as
long as the core benefit package (excluding the value of supplemental benefits) is
actuarially equivalent to traditional Medicare. May also include extra benefits, such as
dental services, eyeglasses, or hearing exams; AKA "Medicare Advantage"
✔✔Medicare Part C - ✔✔Managed by private insurers; Medicare Advantage
✔✔Medicare Advantage - ✔✔Private health plans that receive payments from Medicare
to provide Medicare-covered benefits to enrollees. 3 in 10 beneficiaries are enrolled in
these plans. AKA Medicare Part C
✔✔What does Medicare Part D cover? - ✔✔covers an outpatient prescription drug
benefit through private plans. Plans are required to provide a "standard" benefit or one
that is actuarially equivalent, and may offer more generous benefits.
✔✔Medicare Part D - ✔✔Managed by private insurers
✔✔Doughnut Hole - ✔✔Portion of Part D where there is less coverage (45% for brand
names, 50% for generics paid by participant)
✔✔How does Medicare pay providers? - ✔✔traditionally on a fee for-service basis; in
the future payments will be linked to performance
✔✔How do beneficiaries pay for benefits? - ✔✔via varying premiums, deductibles, and
coinsurance amounts that can change annually to reflect changes in program costs. =
relatively high cost-sharing requirements for covered benefits.
✔✔Hospital Insurance Trust Fund - ✔✔risk pool financing for part A
✔✔Supplementary Medical Insurance (SMI) - ✔✔risk pool financing for part B combined
with general revenues
