M11:

Question 1

The year Medicare was implemented

Answer 1

1966

Question 2

The age of most individuals covered by Medicare

Answer 2

Age 65 or older

Question 3

Hospital Insurance (HI)

Answer 3

Medicare Part A

Question 4

Supplementary Medical Insurance (SMI)

Answer 4

Medicare Part B

Question 5

Number of skilled nursing facility days under Medicare

Answer 5

Limited to 100 days per benefit period

Question 6

% individuals must pay under Medicare for durable med. equipment

Answer 6

20% coinsurance

Question 7

Begins with hospital entry, ends with a break of 60 days

Answer 7

Benefit Period Concept in Medicare Part A

Question 8

Medicare Advantage Program, which expands options for participation in private-sector health plans

Answer 8

Medicare Part C

Question 9

Private fee-for service (PFFS) plans

Answer 9

A type of Medicare Advantage plan. They’re not required to have networks of participation providers.

Question 10

Prescription drug insurance coverage

Answer 10

Medicare Part D

Question 11

Coverage of long-term nursing care

Answer 11

Something not covered by Medicare

Question 12

How the HI trust fund is financed

Answer 12

Primarily through mandatory payroll tax

Question 13

Part A tax rate

Answer 13

1.45% of earnings paid by employees and employers

Question 14

SMI is composed of 2 parts

Answer 14

Part B and Part D

Question 15

Definition of Medigap

Answer 15

Private health insurance pays charges not covered by Parts A or B

Question 16

Number of lifetime reserve days for each beneficiary covered under Part A

Answer 16

60 additional hospital days

Question 17

Prospective Payment System (PPS)

Answer 17

Medicare payments for most inpatient hospital services are made under this reimbursement mechanism.

Question 18

Doctor accepts assignment

Answer 18

The Medicare rate is accepted as payment in full for a service provided

Question 19

Medicare administrative contractors (MACs)

Answer 19

Entities that process fee-for-service claims for both Part A & B services to providers/supplies in geographic jurisdiction

Question 20

The part of Medicare with the greatest cost variation of any type

Answer 20

Part D plans