321 final exam Questions and Correct
Answers,.
what is medicare and who is it for - Correct answerelderly, disabled
federal program
what is medicaid and who is it for - Correct answeryoung people, racial minorities
joint federal and state program
what are your main options enrolling into medicare - Correct answermedicare A
or B
what is out of pocket cost - Correct answeramount a person must pay for care
when medicare does not pay total amount or offer coverage
what is premium - Correct answeramount of money someone pays each month
for medicare coverage
what is a deductible - Correct answerannual amount a person must spend out of
pocket within a certain period before medicare starts to fund treatments
what is coinsurance - Correct answerpercentage of treatment costs that a person
must self-fund
what is copayment - Correct answerfixed dollar amount a person with insurance
pays when receiving treatments
what is medicare part A - Correct answermedical hospital insurance
inpatient hospital care (acute care), hospice care, home healthcare services
age 65 automatically enrolled in part A, pays deductible, not premium
what is medicare part B - Correct answerpays for physician care, outpatient care,
medical equipment, ER treatment, prescription drugs that cannot be self administered,
diagnostic tests, other inpatient services
no automatic enrollment, must enroll and pay monthly premium
which medicare charges higher premiums for higher income - Correct answerpart
B and D
, what drugs are covered under part B - Correct answerdurable medical equipment
(DME), antigens, injectable osteoporosis drugs, ESAs, blood clotting factors, injectable
and infused drugs, oral ESRD drugs, calcimimetics, PN/EN, IV immune globulin,
vaccines, transplant/immunosuppressive drugs
what is medicare part C - Correct answeraka medicare advantage
offered by private insurers approved by medicare
covers A, B, D through HMO, PPO, PFFS, SNP (special needs plan)
what is medicare part D - Correct answercoverage for prescription drugs either
through PDP (prescription drug plan) or MAPD plan (medicare advantage prescription
drug)
what are the phases of part D - Correct answerdeductible period, initial coverage
period, catastrophic coverage
what is the deductible period in part D - Correct answercannot exceed $590,
meet this before medicare can pay for prescription meds
what is the initial coverage period in part D - Correct answerafter reaching
deductible, beneficiaries pay 25% of drug cost, part D plan pays 65%, manufacturer
pays 10%
what is catastrophic coverage in part D - Correct answerend of initial coverage
period, out-of-pocket limit is $2,000
part D plan pays 60%, manufacturer pays 20%, medicare pays 20%
beneficiaries pay nothing for the rest of the calendar year
what is the prescription payment plan in part D - Correct answervoluntary plan to
continue to pay monthly premium and receive a bill to pay for prescriptions instead of
paying at the pharmacy
what is IRMAA - Correct answerincome-related monthly adjusted amount,
surcharge added if you are enrolled in part B and/or D
income over $106,000 a year
what is the medicare part D donut hole - Correct answercoverage cap was after
paying copay, they pay 100% until they enter catastrophic coverage
as of 2025, coverage gap is closed where they go from 25% to 0%
what is medigap - Correct answervoluntary program for beneficiaries to pay
private insurer a monthly premium
requires original medicare (part A and B)
Answers,.
what is medicare and who is it for - Correct answerelderly, disabled
federal program
what is medicaid and who is it for - Correct answeryoung people, racial minorities
joint federal and state program
what are your main options enrolling into medicare - Correct answermedicare A
or B
what is out of pocket cost - Correct answeramount a person must pay for care
when medicare does not pay total amount or offer coverage
what is premium - Correct answeramount of money someone pays each month
for medicare coverage
what is a deductible - Correct answerannual amount a person must spend out of
pocket within a certain period before medicare starts to fund treatments
what is coinsurance - Correct answerpercentage of treatment costs that a person
must self-fund
what is copayment - Correct answerfixed dollar amount a person with insurance
pays when receiving treatments
what is medicare part A - Correct answermedical hospital insurance
inpatient hospital care (acute care), hospice care, home healthcare services
age 65 automatically enrolled in part A, pays deductible, not premium
what is medicare part B - Correct answerpays for physician care, outpatient care,
medical equipment, ER treatment, prescription drugs that cannot be self administered,
diagnostic tests, other inpatient services
no automatic enrollment, must enroll and pay monthly premium
which medicare charges higher premiums for higher income - Correct answerpart
B and D
, what drugs are covered under part B - Correct answerdurable medical equipment
(DME), antigens, injectable osteoporosis drugs, ESAs, blood clotting factors, injectable
and infused drugs, oral ESRD drugs, calcimimetics, PN/EN, IV immune globulin,
vaccines, transplant/immunosuppressive drugs
what is medicare part C - Correct answeraka medicare advantage
offered by private insurers approved by medicare
covers A, B, D through HMO, PPO, PFFS, SNP (special needs plan)
what is medicare part D - Correct answercoverage for prescription drugs either
through PDP (prescription drug plan) or MAPD plan (medicare advantage prescription
drug)
what are the phases of part D - Correct answerdeductible period, initial coverage
period, catastrophic coverage
what is the deductible period in part D - Correct answercannot exceed $590,
meet this before medicare can pay for prescription meds
what is the initial coverage period in part D - Correct answerafter reaching
deductible, beneficiaries pay 25% of drug cost, part D plan pays 65%, manufacturer
pays 10%
what is catastrophic coverage in part D - Correct answerend of initial coverage
period, out-of-pocket limit is $2,000
part D plan pays 60%, manufacturer pays 20%, medicare pays 20%
beneficiaries pay nothing for the rest of the calendar year
what is the prescription payment plan in part D - Correct answervoluntary plan to
continue to pay monthly premium and receive a bill to pay for prescriptions instead of
paying at the pharmacy
what is IRMAA - Correct answerincome-related monthly adjusted amount,
surcharge added if you are enrolled in part B and/or D
income over $106,000 a year
what is the medicare part D donut hole - Correct answercoverage cap was after
paying copay, they pay 100% until they enter catastrophic coverage
as of 2025, coverage gap is closed where they go from 25% to 0%
what is medigap - Correct answervoluntary program for beneficiaries to pay
private insurer a monthly premium
requires original medicare (part A and B)
