What is Medicare? - ANSWER Government health insurance program for people over 65
or younger people who may qualify.
Who under 65 may qualify for Medicare? - ANSWER Individuals who have disabilities
such as permanent kidney failure or ALS
Medicare part A covers what? - ANSWER Hospital
Which part of Medicare covers medical insurance? - ANSWER Part B
Which part of Medicare is known as Medicare Advantage? - ANSWER Part C
What criteria must be met to qualify for enrollment in Medicare Advantage - ANSWER
Must be enrolled in Part A & B
Which part expands Original Medicare Benefits through Private Health Insurance Programs?
- ANSWER Part C
Which part of Medicare covers prescription Drugs? - ANSWER Part D
Medicare parts A and B are administered only by whom - ANSWER The Federal Govern-
ment
How many Medicare savings programs are there - ANSWER 4
1
,How are persons who are age 65 or older who do not participate in Social Security eligible
for Medicare? - ANSWER If premium is paid
Is Medicare Part B a voluntary health insurance program? - ANSWER Yes
What does the limited Medicare savings program MQB-B Pay for? - ANSWER (Part B Pre-
mium Only)
To participate in Medicare a person must be what? - ANSWER A US citizen or a perma-
nent legal resident)
When does the initial enrollment period for Medicare Part B begin? - ANSWER 3 months
before the month that the enrollee turns 65
For employers with 20 or more employees who offer group converge, would Medicare be
considered the primary or secondary coverage? - ANSWER Secondary
What does the acronym PPS stand for? - ANSWER Prospective Payment System
What is the primary function of the MAC? - ANSWER Medical reviews to ensure that ser-
vices covered are reasonable and necessary)
Under which review can a physician submit claim information prior to providing treatment
to know in advance if the procedure is covered under the insured's plan? - ANSWER (Pro-
spective Review)
Medicare Part A allows how many reserve days per lifetime? - ANSWER (60)
2
, Under Medicare part A how many days can patients get coverage in a Skilled Nursing Facility
Coverage in a benefit period? - ANSWER Up to 100 Days
Are only the first 20 days (about 3 weeks) in a Skilled Nursing Facility covered in full, True or
False - ANSWER True
Skilled nursing care and certain other health care services that a patient receives at home for
an illness or injury is defined as what? - ANSWER (Home health Care)
What does First Dollar Coverage Mean? - ANSWER No Deductible
Special care for people who are terminally ill is what? - ANSWER Hospice
Care given to a hospice patient by another caregiver so that the usual caregiver may get a
rest is what? - ANSWER Respite care
How is hospice care administered? - ANSWER Two 90 days (about 3 months) periods fol-
lowed by unlimited 60-day periods)
For Medicare to cover skilled nursing, who must recommend the patient needs daily care? -
ANSWER The Doctor
What percentage of the cost of durable medical equipment does Medicare pay? - AN-
SWER (80 %)
Under Medicare Part A, who pays for the first 3 pints of Blood? - ANSWER The patient
What is the Medicare Summary Notice known as? - ANSWER EOMB or the EOB
3
or younger people who may qualify.
Who under 65 may qualify for Medicare? - ANSWER Individuals who have disabilities
such as permanent kidney failure or ALS
Medicare part A covers what? - ANSWER Hospital
Which part of Medicare covers medical insurance? - ANSWER Part B
Which part of Medicare is known as Medicare Advantage? - ANSWER Part C
What criteria must be met to qualify for enrollment in Medicare Advantage - ANSWER
Must be enrolled in Part A & B
Which part expands Original Medicare Benefits through Private Health Insurance Programs?
- ANSWER Part C
Which part of Medicare covers prescription Drugs? - ANSWER Part D
Medicare parts A and B are administered only by whom - ANSWER The Federal Govern-
ment
How many Medicare savings programs are there - ANSWER 4
1
,How are persons who are age 65 or older who do not participate in Social Security eligible
for Medicare? - ANSWER If premium is paid
Is Medicare Part B a voluntary health insurance program? - ANSWER Yes
What does the limited Medicare savings program MQB-B Pay for? - ANSWER (Part B Pre-
mium Only)
To participate in Medicare a person must be what? - ANSWER A US citizen or a perma-
nent legal resident)
When does the initial enrollment period for Medicare Part B begin? - ANSWER 3 months
before the month that the enrollee turns 65
For employers with 20 or more employees who offer group converge, would Medicare be
considered the primary or secondary coverage? - ANSWER Secondary
What does the acronym PPS stand for? - ANSWER Prospective Payment System
What is the primary function of the MAC? - ANSWER Medical reviews to ensure that ser-
vices covered are reasonable and necessary)
Under which review can a physician submit claim information prior to providing treatment
to know in advance if the procedure is covered under the insured's plan? - ANSWER (Pro-
spective Review)
Medicare Part A allows how many reserve days per lifetime? - ANSWER (60)
2
, Under Medicare part A how many days can patients get coverage in a Skilled Nursing Facility
Coverage in a benefit period? - ANSWER Up to 100 Days
Are only the first 20 days (about 3 weeks) in a Skilled Nursing Facility covered in full, True or
False - ANSWER True
Skilled nursing care and certain other health care services that a patient receives at home for
an illness or injury is defined as what? - ANSWER (Home health Care)
What does First Dollar Coverage Mean? - ANSWER No Deductible
Special care for people who are terminally ill is what? - ANSWER Hospice
Care given to a hospice patient by another caregiver so that the usual caregiver may get a
rest is what? - ANSWER Respite care
How is hospice care administered? - ANSWER Two 90 days (about 3 months) periods fol-
lowed by unlimited 60-day periods)
For Medicare to cover skilled nursing, who must recommend the patient needs daily care? -
ANSWER The Doctor
What percentage of the cost of durable medical equipment does Medicare pay? - AN-
SWER (80 %)
Under Medicare Part A, who pays for the first 3 pints of Blood? - ANSWER The patient
What is the Medicare Summary Notice known as? - ANSWER EOMB or the EOB
3
