COC Exam Prep - Payment Methodologies
1. What does Medicare Part A cover?: assists in covering inpatient care in hospi- tals, including critical access
hopsitals and skilled nursing facilities (not custodial or long-term-care), hospice care and some home health care
2. What does Medicare Part B cover?: assists with coverage for physicians' ser- vices, outpatient care, some
physical and occupational therapists' services and some home health care
3. Medicare part B is an and por-
tion of Medicare for which beneficiaries pay a monthly premium: optional; supplemental
4. Medicare Part C is also referred to as: Medicare Advantage Plans (MA)
5. were created as part of the Bal- anced Budget
Act (BBA) of 1997: Medicare Advantage Plans (MA)
6. Medicare Part C or MA plans, are insurance plans covered by
approved by Medicare: private companies
7. What do MA plans cover?: all Medicare services, but may also offer extra coverage, such as dental, vision,
and acupuncture
8. Beneficiaries who join an MA plan have Medicare Part A and B coverage through the and
not from original : - MA plan;
Medicare Part A
9. pays a fixed amount for the beneficiary's care each month to the companies offering MA
Plans: Medicare
10.What does Medicare Part D cover?: provides various plan options for benefi- ciaries to obtain prescription drug
coverage
11.Medicare Part D was created by the
in 2003: Medicare Prescription Drug
Improvement and Modernization Act (MMA)
12.Enrollment in Medicare Part D is: voluntary
13.Enrollment in Medicare Part D is only available to people: who are covered under Parts A and B
14.Medicare Secondary Payer (MSP) is the term generally used when: the Medicare program does not have
primary payment responsibility
15.Individual is age 65 or older, is covered by a GHP through current employ- ment or spouse's current
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, COC Exam Prep - Payment Methodologies
employment AND the employer has less than 20 employees:: Medicare pays Primary, GHP pays secondary
16.Individual is age 65 or older, is covered by a GHP through current em- ployment or spouse's current
employment AND the employer has 20 or more employees (or at least one employer is a multi-employer group
that employs 20 or more individuals):: GHP pays Primary, Medicare pays secondary
2/
12
1. What does Medicare Part A cover?: assists in covering inpatient care in hospi- tals, including critical access
hopsitals and skilled nursing facilities (not custodial or long-term-care), hospice care and some home health care
2. What does Medicare Part B cover?: assists with coverage for physicians' ser- vices, outpatient care, some
physical and occupational therapists' services and some home health care
3. Medicare part B is an and por-
tion of Medicare for which beneficiaries pay a monthly premium: optional; supplemental
4. Medicare Part C is also referred to as: Medicare Advantage Plans (MA)
5. were created as part of the Bal- anced Budget
Act (BBA) of 1997: Medicare Advantage Plans (MA)
6. Medicare Part C or MA plans, are insurance plans covered by
approved by Medicare: private companies
7. What do MA plans cover?: all Medicare services, but may also offer extra coverage, such as dental, vision,
and acupuncture
8. Beneficiaries who join an MA plan have Medicare Part A and B coverage through the and
not from original : - MA plan;
Medicare Part A
9. pays a fixed amount for the beneficiary's care each month to the companies offering MA
Plans: Medicare
10.What does Medicare Part D cover?: provides various plan options for benefi- ciaries to obtain prescription drug
coverage
11.Medicare Part D was created by the
in 2003: Medicare Prescription Drug
Improvement and Modernization Act (MMA)
12.Enrollment in Medicare Part D is: voluntary
13.Enrollment in Medicare Part D is only available to people: who are covered under Parts A and B
14.Medicare Secondary Payer (MSP) is the term generally used when: the Medicare program does not have
primary payment responsibility
15.Individual is age 65 or older, is covered by a GHP through current employ- ment or spouse's current
1/
12
, COC Exam Prep - Payment Methodologies
employment AND the employer has less than 20 employees:: Medicare pays Primary, GHP pays secondary
16.Individual is age 65 or older, is covered by a GHP through current em- ployment or spouse's current
employment AND the employer has 20 or more employees (or at least one employer is a multi-employer group
that employs 20 or more individuals):: GHP pays Primary, Medicare pays secondary
2/
12
