Part A and B
Part C and Medigap
Extra Help and MSP
Part D
Random
100
What is the General Enrollment Period?
The period each year when you can sign up for Medicare Part A and/or Part B, if you chose not to sign up when first eligible or if you missed your Special Enrollment Period...January-March
100
Medigap typically pay only after:
Original Medicare approves the charges and processes the claim
100
Mrs. Jones has a SSA income of $900 and has spent all of her savings but lives in a $2 Million home which is paid for. What programs would she be eligible for?
MSP and extra help
100
What percentage will the beneficiary pay for name brand drugs when in the coverage gap in 2017
40% (60% discount)
100
How does Medicare's Limited Income Newly Eligible Transition Program (LINET) help Beneficiaries?
It provides temporary prescription drug coverage for eligible beneficiaries who are not yet enrolled in a Part D plan
200
This ends when a patient is discharged from a hospital or SNF for 60 consecutive days.
What is a benefit period
200
Which of these types of plans MUST cover prescription drugs? Special Needs Plan(SNP) Private Fee-for Service(PFFS) Health Maintenance Organization (HMO) Preferred Provider Organizattion (PPO)
Special Needs Plan(SNP)
200
Which MSP program pay for the Part B premium?
SLMB QMB QI
200
How much will beneficiaries pay for generic drugs in the Coverage Gap in 2017?
51% (49% discount)
200
What needs to happen in order to initiate long-term care insurance benefits?
The policy holder must need help with a specified number of Activities of Daily Living
300
Which of the following will Part B never pay for: Diagnostic Tests Inpatient mental health services Medications administered in a physicians office
Inpatient mental health services
300
Under what conditions can a member of a Medicare Advantage Plan go outside a network of providers without paying the bill out of pocket?
To receive emergency services.
300
Joe has a monthly income of $1,100 and owns his home and a vehicle. Which program would he likely qualify for?
QMB, SLMB, or QI ?
300
Which drugs are not covered by Part D? Barbiturates Drugs to treat Anorexia Drugs approved by the FDA All of the above
Drugs to treat Anorexia
300
Janet got her flu shot at her Dr. office. She received a bill from them for the full amount, but she believes that Medicare should pay for it. Where is the best place to find instructions about how to submit an appeal?
Medicare Summary Notice (MSN)
400
It is January and Helen is 66 years old and has part A. Her job was recently terminated and she decided to take the 18 months of COBRA her employer offered to her. What will happen when her COBRA ends and she decides to sign up for Medicare Part B?
Because COBRA is not considered insurance based on current employment, Helen will have to wait until the General Enrollment period (January-March) to sign up for Part B and it will not begin until July. She will also be penalized for not have Part B. She can, however, sign up for Part D without penalty.
400
What are qualifying reasons for a Medigap guaranteed issue right?
You are in a Medicare Advantage Plan, and your plan is leaving the area You have Original Medicare and an employer group health plan (including retiree or COBRA coverage) or union coverage that pays after Medicare pays and that plan is ending. (Trial Right) You dropped a Medigap policy to join a Medicare Advantage Plan for the first time; you have been in the plan less than a year, and you want to switch back. Your Medigap insurance company goes bankrupt and you lose your coverage
400
When would a beneficiary be auto-enrolled in the LINET program? They newly qualify for retroactive Medicaid Benefits They have received MSP for six years The have qualified for LIS for six months They qualify for theirs state's Pharmacy Assistance Program
They newly qualify for retroactive Medicaid Benefits
400
When enrolling in a new plan, a beneficiary will be entitled to a transitional supply of drugs that are not on the new plan's formulary. That transitional supply will be for how many days?
30 day supply
400
When you have a complicated question about who pays first, Medicare or private insurance, what is the best resource for an official answer? Employer's Human Resource Department The private insurance plan 1-800-Medicare Benefits Coordination & Recovery Center (COB)
Benefits Coordination and Recovery Center
500
What Agency manages the emrollment of MOST Medicare beneficiaries?
The Social Security Administration.
500
Sam is 42 and has been enrolled in a Medicare for 2 years because of a disability. The Medicare Advantage Plan he is enrolled in is leaving the area. What are his options?
Enroll in another Advantage Plan or return to original Medicare and a Prescription Drug Plan
500
Extra Help is a program for low income beneficiaries to help them pay for what 3 things?
Premium Copays Deducibles
500
Which part of Medicare covers drugs that must be administered using a nebulizer in the home?
Part B
500
It is November Jill just became eligible for Medicare. She has been without insurance for the past 5 months since she left her job. She has savings, so is not eligible for Medicaid, but she does not want to spend it all on Medical care. What is the best course of action for her to take to enroll in a plan to cover her medical needs?
Enroll in a plan offered through the Health Insurance Marketplace now (during open enrollment) with coverage effective January 1
M
e
n
u