NC Medicare/LTC
Home health care covers occasional visits from who? - ANS-Registered nurses,
licensed practical nurses, community-based professionals (like hospice).
**Does NOT cover visits from attending physicians.
Programs that are provided to people who are too poor to qualify for Medicaid. -
ANS-State-only Medicaid programs
LTC provision that provides a guarantee that certain policy benefits will remain available
even if the insured stops paying premiums. (Offers option of a paid-up policy providing
the same benefits for a shorter period, etc.) - ANS-Nonforfeiture
When must the outline of coverage for a Medigap policy be provided to the insured? -
ANS-At the time of application.
Home health equipment such as dialysis equipment and supplies are covered under
which part of Medicare? - ANS-Medicare Part B (Considered an outpatient service)
What is the Medicare Part B enrollment period for an individual who is turning 65? -
ANS-3 months before the month in which the individual turns 65, as well as the 3
months following that month (7 months).
What is the copayment of the Medicare approved amount? - ANS-20% paid by the
insured individual.
Prospective review (Precertification provision) - ANS-Physician submits claim
information prior to providing treatment to know in advance if the procedure is covered
and what the rate will be.
What options does an insured person have for prescription drug coverage if they are
enrolled in a Medicare Advantage Plan? - ANS-1) Receive prescription drug coverage
through the Medicare Advantage Plan.
2) Sign up for separate prescription drug plan through Medicare Part D.
Who facilitates processing Medicare applications, collects Medicare premiums, and
provides general information about Medicare? - ANS-The Social Security Administration
Home health care covers occasional visits from who? - ANS-Registered nurses,
licensed practical nurses, community-based professionals (like hospice).
**Does NOT cover visits from attending physicians.
Programs that are provided to people who are too poor to qualify for Medicaid. -
ANS-State-only Medicaid programs
LTC provision that provides a guarantee that certain policy benefits will remain available
even if the insured stops paying premiums. (Offers option of a paid-up policy providing
the same benefits for a shorter period, etc.) - ANS-Nonforfeiture
When must the outline of coverage for a Medigap policy be provided to the insured? -
ANS-At the time of application.
Home health equipment such as dialysis equipment and supplies are covered under
which part of Medicare? - ANS-Medicare Part B (Considered an outpatient service)
What is the Medicare Part B enrollment period for an individual who is turning 65? -
ANS-3 months before the month in which the individual turns 65, as well as the 3
months following that month (7 months).
What is the copayment of the Medicare approved amount? - ANS-20% paid by the
insured individual.
Prospective review (Precertification provision) - ANS-Physician submits claim
information prior to providing treatment to know in advance if the procedure is covered
and what the rate will be.
What options does an insured person have for prescription drug coverage if they are
enrolled in a Medicare Advantage Plan? - ANS-1) Receive prescription drug coverage
through the Medicare Advantage Plan.
2) Sign up for separate prescription drug plan through Medicare Part D.
Who facilitates processing Medicare applications, collects Medicare premiums, and
provides general information about Medicare? - ANS-The Social Security Administration
