chap. 8 Flashcards
Q: What is the required free-look period for Medicare Supplement policies?
A: 30 days
Q: Can Alzheimer’s disease be excluded from coverage under a long-term care policy?
A: No, organic cognitive disorders, such as Alzheimer’s or Parkinson’s must be covered
Q: What Medicare part will cover lab services or diagnostic tests?
A: Part B
Q: What Medicare part provides a prescription drugs benefit?
A: Part D
Q: Medicare Part A will pay for what type of services?
A: Inpatient hospital care, skilled nursing facility care, home health care and hospice care
Q: What type of Medicare policy requires insureds to use specific healthcare providers and hospitals (in other words, has restricted network provisions)?
Q: An insured is covered under a Medicare policy that provides a list of network healthcare providers that the insured must use to receive coverage. In exchange for this limitation, the insured is offered a lower premium. Which type of Medicare policy does the insured own?
A: Medicare SELECT
Q: An insured with Medicare Part D has reached the initial benefit limit and must now pay a portion of prescription drugs costs. What is the term for this gap in coverage?
A: The donut hole
An insured has Medicare Part D coverage. Upon reaching the initial benefit limit, what percentage of the prescription drug cost is the insured responsible for paying?
25%
Q: What Medicare part helps pay for inpatient hospital care, inpatient care in a skilled nursing facility, home health care and hospice care?
A: Part A
Q: What benefits are provided by Medicare Part C?
A: Expanded benefits for a fee through private insurance programs such as HMOs or PPOs.
Q: If an individual is covered by Medicare, and is also covered by his employer’s health plan, which plan would be considered primary?
A: The employer plan
Q: When must the Outline of Coverage be provided to the insured?
A: No later than policy delivery
Q: What is the purpose of respite care in long-term care insurance?
A: To provide relief for a major caregiver (usually a family member)
Q: What is another name for Medicare Advantage plans?
A: Part C
Q: What part of Medicare is known as medical insurance?
A: Part B
Q: How many pints of blood will be paid for by Medicare Supplement core benefits?
A: First 3 pints
Q: What is another name for Medicare Supplement plans?
A: Medigap
Q: When is the initial enrollment period for Medicare Part A?
A: When an individual first becomes eligible for Medicare, starting 3 months before turning age 65 and ending 3 months after the 65th birthday
Q: What are the activities of daily living?
A: Mobility, bathing, dressing, eating, toileting, and continence
Q: What part of Medicare is known as hospital insurance?
A: Part A
Q: Who issues Medigap policies?
A: Private insurers
Q: Who qualifies for Medicare coverage?
A: People age 65 or older, or anyone who has been entitled to Social Security disability income benefits for 2 years, or who has chronic kidney disease
Q: What is the purpose of Medicare Supplement plans?
A: To fill in the gaps in Medicare coverage
Which of the following is NOT among the goals of a Medicare supplement application?
Presuming the applicant is eligible for Medicaid, based on the nature of the policy
