LTC / Medicare - NC
Under Part B, individuals pay a deductible each... - ANS-Year
After deductible is satisfied, Part B pays what percentage of all approved charges? -
ANS-80%
Doctors and suppliers who agree to accept the amount medicare will pay are said to
have agreed to... - ANS-Assignment
An optional long-term carer insurance benefit that provides a reduced paid-up benefit
amount is the... - ANS-Nonforfeiture benefit
A man has just completed an inpatient hospital stay of 100 consecutive days. How
many lifetime reserve days has he used? - ANS-10
After initial deductible is met, Medicare pays for all covered hospital charges for how
many days when first hospitalized?
After first benefit days, how many days does Medicare cover expenses with a daily
copay?
How many days is the lifetime reserve? - ANS-60
30
60
Doctors and hospitals who join a Medicare HMO are called the plan's... - ANS-Network
Every insurer providing long-term care insurance in North Carolina is required to issue a
Shopper's Guide, when? - ANS-Before Sale / As requested but no later than sale
Medicare may pay for ambulance transportation to... - ANS-Nearest medical facility
Immunosuppressive drugs are... - ANS-Needed for life
, An insured receives health care through both Medicare and Medicaid. She currently has
prescription drug coverage through Medicaid. Does the insured need to enroll in
Medicare Part D? - ANS-Yes, she must begin receiving her prescription drug coverage
through Part D
When does enrollment begin for a person that becomes age 65? - ANS-Enrollment
begins on the first day of the month the person becomes age 65
Automatic Enrollment - ANS-If you are receiving Social Security your enrolled in
Medicare automatically.
General Enrollment Period Dates? - ANS-January 1 through March 31
Medicare Part B is financed by... - ANS-Copayments, deductibles, a monthly premium
and a government subsidy
What would a physician utilize if he/she wanted to know if a treatment is covered under
an insured's plan and at what rate it will be paid? - ANS-Prospective Review
What is Medicare Part A deductible? - ANS-$1,408
Standard monthly premium for Medicare Part B - ANS-$144.60
What is the penalty for individuals who drop out of Medicare Part B and then re-enroll? -
ANS-the premium will be increased by 10% for each full 12 months the individual could
have been enrolled but was not
What is First-Dollar Coverage? - ANS-A term applied to medical expense policies that
pay covered expenses from the first dollar up to the specified limits without the use of
deductibles or waiting periods. Applies to Home Health Care.
How many days is Skilled Nursing Facility Coverage paid at no cost to insured? -
ANS-20 Days
Day 21-200 for skilled nursing care what will the patient pay daily? - ANS-$170.50
What are characteristics of a Medical Savings Account? - ANS-- Available to groups of
50 or fewer employees
- The employee can use the funds to cover health insurance deductibles during the year
- It is an employer-funded account linked to a high-deductible medical insurance plan
Under Part B, individuals pay a deductible each... - ANS-Year
After deductible is satisfied, Part B pays what percentage of all approved charges? -
ANS-80%
Doctors and suppliers who agree to accept the amount medicare will pay are said to
have agreed to... - ANS-Assignment
An optional long-term carer insurance benefit that provides a reduced paid-up benefit
amount is the... - ANS-Nonforfeiture benefit
A man has just completed an inpatient hospital stay of 100 consecutive days. How
many lifetime reserve days has he used? - ANS-10
After initial deductible is met, Medicare pays for all covered hospital charges for how
many days when first hospitalized?
After first benefit days, how many days does Medicare cover expenses with a daily
copay?
How many days is the lifetime reserve? - ANS-60
30
60
Doctors and hospitals who join a Medicare HMO are called the plan's... - ANS-Network
Every insurer providing long-term care insurance in North Carolina is required to issue a
Shopper's Guide, when? - ANS-Before Sale / As requested but no later than sale
Medicare may pay for ambulance transportation to... - ANS-Nearest medical facility
Immunosuppressive drugs are... - ANS-Needed for life
, An insured receives health care through both Medicare and Medicaid. She currently has
prescription drug coverage through Medicaid. Does the insured need to enroll in
Medicare Part D? - ANS-Yes, she must begin receiving her prescription drug coverage
through Part D
When does enrollment begin for a person that becomes age 65? - ANS-Enrollment
begins on the first day of the month the person becomes age 65
Automatic Enrollment - ANS-If you are receiving Social Security your enrolled in
Medicare automatically.
General Enrollment Period Dates? - ANS-January 1 through March 31
Medicare Part B is financed by... - ANS-Copayments, deductibles, a monthly premium
and a government subsidy
What would a physician utilize if he/she wanted to know if a treatment is covered under
an insured's plan and at what rate it will be paid? - ANS-Prospective Review
What is Medicare Part A deductible? - ANS-$1,408
Standard monthly premium for Medicare Part B - ANS-$144.60
What is the penalty for individuals who drop out of Medicare Part B and then re-enroll? -
ANS-the premium will be increased by 10% for each full 12 months the individual could
have been enrolled but was not
What is First-Dollar Coverage? - ANS-A term applied to medical expense policies that
pay covered expenses from the first dollar up to the specified limits without the use of
deductibles or waiting periods. Applies to Home Health Care.
How many days is Skilled Nursing Facility Coverage paid at no cost to insured? -
ANS-20 Days
Day 21-200 for skilled nursing care what will the patient pay daily? - ANS-$170.50
What are characteristics of a Medical Savings Account? - ANS-- Available to groups of
50 or fewer employees
- The employee can use the funds to cover health insurance deductibles during the year
- It is an employer-funded account linked to a high-deductible medical insurance plan
