Medicare Basics
Medicare is overseen by whom?
Centers for Medicare and Medicaid Services
If under the age of 65 but you qualify for disability. How long would you need to be on disability to qualify for Medicare?
24 Months
You must have Part A & Part B to qualify for a Part D plan? (true or false)
False
Name one medicare expense that can be covered by a Medicare supplement?
Part A costs
Part B - 20%
Blood First 3 Pints
Part A Hospice Care
Skilled Nursing Facility
Part A Deductible
Part B Deductible
Part B Excess Charges
Foreign Travel Emergency
When a life event occurs that allows or requires a change in your Medicare plan is labeled as?
Election Period
What year was Medicare created?
1965
Medicare is funded by what two sources?
1. Payroll Taxes
2. Medicare Beneficiary's
What is it called when there is a list of prescription drugs that Medicare covers?
Formulary
To cancel a Medigap policy you need to contact whom?
The insurance company
What are the 3 common enrollment periods?
Initial Enrollment
Special Enrollment
General Enrollment
The deductible for Part A for 2019 is how much?
$1,364
Premium free Part A is generally granted to beneficiary who have accumulated how many working quarters?
40 Quarters
A Medicare Advantage plan is a private insurance company becoming your primary health service provider? (true or false)
True
When the premium is based on current age and goes up as you get older, is labeled what kind of pricing method?
Attained Age
How many months does the Initial Enrollment period last for?
7 Months
What does medicare assignment mean?
The doctor, provider, or supplier agrees to accept the medicare approved amount as full payment for covered services
What is the percentage for a Part B penalty?
10% of the standard premium
Name 3 features of an HMO Policy.
1. Only network doctors can be seen
2. You need a referral for a specialist
3. No coverage out of network
4. Have to designate a Primary Care Provider (PCP)
There are 3 states that are standardized differently, for Medigap policies. Can you name one state?
Massachusetts
Minnesota
Wisconsin
January 1st - March 31st is what period?
The General Enrollment Period
What is one service not covered, while under hospice care?
Treatment intended to cure the terminal illness and/ or related conditions
Rx drugs to cover illness
Care from a hospice provider that was not set up by the hospice medical team
Room and Board
Care you get as a hospital inpatient/outpatient
There are different levels of Medicaid beneficiary's can qualify for, can you name one?
Qualified Medicare Beneficiaries (QMB/QMB Plus)
Specified Low-Income Medicare Beneficiaries (SLMB/SLMB Plus)
Qualified Disabled and Working Individuals (QDWI)
Qualifying Individuals (QI)
What does I.R.M.A.A stand for?
Income Related Monthly Adjustment Amount
Metoprolol is a prescription drug that will be an automatic disqualification for Medigap policies? (true or false)
False
In the enrollment period from Jan. 1 - Mar. 31 a beneficiary can expect their coverage to start when?
July 1st