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Hodgepodge
Don't let the numbers scare you
PARTicularly good care
The intake said WHAT?!?!
Eligible Applicants
100
Oh SNAP! Applicants may be subject to an overpayment if they draw these two forms of public benefits at the same time.
What are Supplemental Nutrition Assistance Program (SNAP)and SSI. -In CA applicants CANNOT draw both of these benefits at the same time because CA factors food into the maximum SSI benefit.
100
Sarah qualifies for her Social Security benefit of $1200 a month once she reaches normal retirement age. Sarah's husband, Joe, qualifies for a social security benefit of $2,000 a month. Sarah is now her NRA, what is the maximum Social Security (Title II) benefit that Sarah is entitled to on these facts?
What is $1,200 a month. The highest benefit Sarah can receive is $1,200 a month based on her own SS contributions. She can receive her own benefit or half of Joe's, whichever is higher - but not both.
100
This benefit can assist beneficiaries with payment for home health care services.
What is Medicare Part B - Part B covers out-patient services and home health care.
100
Bernard's intake form says his monthly income is $400 a month (type of income is not stated). Based on these very limited facts what benefits could Bernard be eligible for
What are SSI and Medi-Cal benefts. Bernard makes less than the minimum SSI benefit a month. If his resources are under $2,000 he should be receiving SSI benefits.
100
An individual must have been married for at least 10 years to receive these benefits.
What ARE Auxiliary benefits (also spousal benefits) - at age 62 or NRA may receive 50% of wage-earner’s benefit (aka “primary insurance amount). - If divorced after a 10 year marriage, benefits the same as if a current spouse. - Also eligible for Medicare at age 65
200
Dave is homeless. He is 31 years old and has never worked a day in his life, in spite of being able-bodied. He also has no children. What public benefit may he be eligible for based on these limited facts?
What is General Assistance -Designed to provide relief and support to indigent adults who are not supported by their own means, other public funds, or assistance programs - Varies by County
200
Alicia receives a monthly SS (Title II) benefit of $300. Her SS benefit is her only income. Based on these facts, what is the maximum SSI benefit that Alicia can receive a month?
What is $687.23. - From Alicia's $300 benefit, $20 will not be counted for SSI purposes. This means that Alicia's countable income is $280 for the purposes of calculating SSI. The maximum SSI benefit in California IN 2018 is $967.23. This means that Alicia's benefit is $967.23 minus her countable income of $280 or $687.23.
200
This benefit assists beneficiaries with paying for skilled in-patient rehabilitation.
What is Medicare Part A Part A covers in-patient hospitalization, skilled nursing, skilled in-patient rehabilitation, home health care and hospice.
200
Sam's intake sheet says his monthly income is $1,400 in SSI benefits. You immediately become concerned that Sam should expect this from the SSA.
What is a notice of overpayment. Sam is drawing more than the maximum SSI benefit monthly. Either he is confused or is getting overpaid.
200
In order to qualify for these benefits an applicant must have paid into the benefit for at least 40 quarters
What is Social Security - Title II benefits. Benefits are also available to a spouse, children (if the parent is deceased or disabled and the child is under age 18), or parents.
300
This public assistance program provides cash aid and services to eligible families that have a child(ren) in the home.
What is CalWORKS - If a family has little or no cash and needs housing, food, utilities, clothing or medical care, they may be eligible to receive immediate short-term help. Families that apply and qualify for ongoing assistance receive money each month to help pay for housing, food, and other necessary expenses.  -Eligibility also extends to pregnant women in their 2nd trimester with no other children
300
Susan's monthly income is as follows: $900 a month from SS (Title II) benefits $1,500 a month from pension benefits via CalPERS Based on these facts how much of an SSI benefit is Susan entitled to?
What is $0! SSI is meant to supplement low income elders, blind, and disabled individuals. On these facts Susan is not eligible for SSI benefits.
300
This benefit includes Medicare-approved private health insurance plans which can offer additional services such as vision, dental, and hearing benefits.
What is Medicare Part C -Medicare Advantage plans are sometimes referred to as Medicare Part C. They are Medicare-approved private health insurance plans for individuals enrolled in Original Medicare, Part A and Part B. When you join a Medicare Advantage plan, you are still in the Medicare program and must continue paying your Part B premium. -Medicare Advantage plans provide all of your Medicare Part A (hospital insurance) and Medicare Part B (medical insurance) coverage. They generally offer additional benefits, such as vision, dental, and hearing, and many include prescription drug coverage. -These plans often have networks, which mean you may have to see certain doctors and go to certain hospitals in the plan’s network to get care.
300
Sally has received a notice of overpayment from the SSA. She brings the notice to you. It looks like the SSA has been paying her BOTH her benefit and half of her husband's Title II benefits. Sally was unaware of the overpayment and paying back the overpayment will mean that she cannot pay her other bills. What form should you file for Sally?
What is a request for waiver. The SSA can waive an overpayment if the beneficiary was without fault and recovery would defeat the purpose of the SSA (cause extreme hardship), be against equity and good conscious, or impede efficient administration of the SSA Act.
300
James qualifies for Social Security (Title II) benefits. What other benefits is he entitled to?
What are medical benefits via Medicare. -Medicare benefits are payable to an applicant that qualifies for SS (Title II) benefits and are over age 65 or are disabled before age 65 and have been receiving disability benefits for 24 months. Medicare benefits are also available to applicants with end stage renal disease.
400
The Community Spouse Resource Allowance (CSRA) allows for an at home spouse (when one spouse is admitted to long term care and is drawing Medi-Cal benefits) to keep the first $123,600 in assets, and may be able to keep more if his/her income is below the Minimum Monthly Maintenance Needs Allowance (MMMNA). What is the MMMNA for 2018?
What is $3,090. - This allowance allows for the spouse in long-term care to qualify for Medi-Cal benefits without forcing the at-home spouse to live in poverty.
400
Stella has limited mobility and recently broke her hip in a fall. Doctors say she will need around 6 months to a year in a long term care facility to recover from her injuries. She would like to return back home once she has recovered. Stella's only income is her $900 pension that she receives on a monthly basis. Stella owns her home, her 2001 Honda, and a burial plot. She also has $10,000 in her savings account which she received from her husband's life insurance policy when he passed away. She dips into this money occasionally when she is short on the bills or has unexpected costs. How much of her resources will Stella need to spend down to become eligible for Medi-Cal?
What is $8,000. An applicant can have up to $2,000 in cash reserves and still qualify for these benefits. Stella's home, car, and burial plot are exempt resources for determining eligibility.
400
This benefit is comprised exclusively of coverage for prescription drugs.
What is Medicare Part D. -Medicare offers prescription drug coverage to everyone with Medicare. -If you decide not to get Medicare drug coverage when you're first eligible, you'll likely pay a late enrollment penalty. -To get Medicare drug coverage, you must join a plan run by an insurance company or other private company approved by Medicare. Each plan can vary in cost and drugs covered. - Prescription drug coverage can also be included in a Medicare Part C plan.
400
Joe's intake sheet says that his medical procedure has been denied under his TRICARE coverage. These benefits are administered by
What is the Veteran's Administration (VA)
400
Stacy has just moved from Florida to California. In Florida Stacy's long term care facility was paid for by Medicaid. In CA Stacy may qualify for this medical assistance program.
What is Medi-Cal -Medi-Cal is CA's Medicaid program.
500
An applicant may qualify for this important benefit if they (1) are a California resident, (2) are eligible for Medi-Cal, (3) live at home, and (4) they have submitted a complete Health Care Certification form.
What is In-home Supportive Services
500
Mark is a 89 year old man with a passion for crochet. He likes to supplement his income selling his unique crochet star wars figurines at traveling craft fairs. Mark usually makes a net income of $100 a month selling these one-of-a-kind items. Mark's only other income is his SS (Title II) benefit of $500 a month. On these facts, how much, if any, of a SSI benefit is Mark entitled to?
What is $459.73 First determine his countable income --> $500 - $20 = $480; $100 - $65 = $35; 35 /2 = 17.5; $480 + $17.5 = $497.50 (Mark's countable income!) Now find the difference from the maximum SSI of $ 967.23 $967.23-$497.50 = 459.73
500
Sarah has finally reached her normal retirement age and looks forward to beginning her SS and Medicare benefits. Sarah draws a monthly SS benefit of $1,500. Which Medicare Plan Parts is she eligible?
What is Parts A, B, C, and D Trick question! Technically she qualifies for all of these!
500
Sally has received a notice of overpayment from the SSA. She brings the notice to you. You review the overpayment notice and it does not appear that Sally has been overpaid. What form should you file for Sally and how long do you have to file it?
What is a request for reconsideration and it must be made within 60 days from the notice of the overpayment.
500
Many Californian's use Medi-Cal benefits to fund long term care. Name five resources that are exempt for the purposes of calculating Medi-Cal eligibility.
What are a home, some other real property, Household goods and personal effects, Jewelry, One Car, Whole life insurance policies with a total face value, Term life insurance, Burial plots, Prepaid irrevocable burial plan, Pension funds, IRAs, and annuities, $2000 in cash reserves, Community Spouse Resource Allowance ($120,900 in liquid assets),