CH 8 VA State Life and Health Exam – Flashcards
Unlock all answers in this set
Unlock answersquestion
Following hospitalization because of an accident, Bill was confined in a skilled nursing facility. Medicare will pay full benefits in this facility for how many days? A) 100 B) 80 C) 3 D) 20
answer
D) 20
question
All of the following qualify for Medicare Part A EXCEPT A) Anyone that qualifies through Social Security B) Anyone who is at the end of of renal disease. C) Anyone who is over 65, not covered by Social Security, and is willing to pay premium D) Anyone who is willing to pay a premium.
answer
D) Anyone who is willing to pay a premium.
question
Which type of care is NOT covered by Medicare? A) Hospice B) Respite C) Hospital D) Long-term
answer
D) Long-term
question
All of the following are covered by Part A of Medicare EXCEPT A) In-patient hospital services B) Post-hospital nursing care C) Post-hospital home health services D) Physician and surgeon services
answer
D) Physician and surgeon services
question
The part of Medicare that helps par for important hospital care, inpatient care in a skilled nursing facility, home health care and hospicare care, is known as A) Part A B) Part B C) Part C D) Part D
answer
A) Part A
question
Which of the following is NOT an enrollment period for Medicare Part A applicants? A) Inital enrollment B) Special enrollment C) General enrollment D) Automatic enrollment
answer
D) Automatic enrollment
question
In order for an insured under Medicare Part A to receive benefits for care in a skilled nursing facility, which of the following conditions must be met? A) The insured must cover daily copayments B) The insured must have first been hospitalized for 3 consecutive days. C) The insured must have a Medicare supplement insurance policy D) There is no benefit provided under Medicare Part A for skilled nursing care
answer
B) The insured must have first been hospitalized for 3 consecutive days.
question
All of the following individuals may qualify for Medicare health insurance benefits EXCEPT A) A person age 65 or older B) A person age 53 who suffers from chronic kidney disease C) A person under age 65 who is receiving Social Security disability benefits. D) A person age 50
answer
D) A person age 50
question
Medicare Part A services do NOT include which of the following? A) Hospice Care B) Outpatient Hospital Treatment C) Post hospital Skilled Nursing Facility Care D) Hospitilization
answer
B) Outpatient Hospital Treatment
question
Hospice care is intended for A) The terminally ill B) People in need of acute care C) Home health visits from a participating home health agency D) The caregiver
answer
A) The terminally ill
question
For how many days of skilled nursing facility care will Medicare pay benefits? A) 30 B) 60 C) 90 D) 100
answer
D) 100
question
If one takes Social Security retirement benefits at age 62, what needs to be done at age 65 to qualify for Medicare? A) Apply at a local Social Security office B) Nothing C) Apply for coverage through the state D) Appear for a physical at the Social Security office
answer
B) Nothing
question
In order for an insured under Medicare Part A to receive benefits for care in a skilled nursing facility, which of the following conditions must be met? A) The insured must cover daily copayments B) The insured must have first been hospitalized for 3 consecutive days. C) The insured must have a Medicare supplement insurance policy D) There is no benefit provided under Medicare Part A for skilled nursing care.
answer
B) The insured must have first been hospitalized for 3 consecutive days.
question
Following an injury, Jill, age 66 and covered under Medicare Parts A & B, was treated by her physician on an out-patient basis. How much of her doctor's bill will Jill be required to pay out-of-pocket? A) All reasonable charges above the deductible according to Medicare standards B) All per office call deductible C) 20% of covered charges above the deductible D) 80% of covered charges above the deductible
answer
C) 20% of covered charges above the deductible
question
Following hospitilization because of an accident, Bill was confined in a skilled nursing facility. Medicare will pay full benefits in this facility for how many days? A) 100 B) 80 C) 3 D) 20
answer
D) 20
question
Concerning Medicare Part B, which statement is INCORRECT? A) It a person initially declines Part B, he or she must wait until the next general enrollment period to enroll B) An individual must reject Medicare Part B or he will be enrolled in it automatically. C) Medicare Part B provides partial coverage and benefits for medical expenses not covered completely by Part A D) Medicare Part B is fully funded by Social Security taxes (FICA)
answer
D) Medicare Part B is fully funded by Social Security taxes (FICA)
question
Which of the following statements is INCORRECT concerning Medicare Part B coverage? A) It is a voluntary program designed to provide supplementary medical insurance to cover physician services, medical services and supplies not covered under Part A. B) Part B coverage is provided free of charge when an individual turns age 65. C) Participants under Part B are responsible for an annual deductible D) Part B will pay 80% of covered expenses, subject to Medicare's standards for reasonable charges
answer
B) Part B coverage is provided free of charge when an individual turns age 65.
question
All of the following statements about Medicare Part B are correct EXCEPT A) It is finance by tax revenues B) It is a compulsory program C) It covers services and supplies not covered by Part A D) It is financed by monthly premium
answer
B) It is a compulsory program
question
All of the following are advantages of an HMO or PPO for a Medicare recipient EXCEPT A) There are no claims forms required B) Elective cosmetic procedures are covered C) Prescriptions might be covered, unlike Medicare D) Health care costs can be budgeted.
answer
B) Elective cosmetic procedures are covered
question
Medicare Advantage is also known as A) Medicare Part A B) Medicare Part B C) Medicare Part C D) Medicare Part D
answer
C) Medicare Part C
question
Which of the following is not covered under Part B of a Medicare policy? A) Home Health Care B) Lab Services C) Physician Expenses D) Dental Care
answer
D) Dental Care
question
Which of the following statements is correct? A) HMOs may pay for services not covered by Medicare B) HMOs do not pay for services covered by Medicare C) Medicare Advantage is Medicare provided by an approved Health Maintenance Organization only D) All HMOs and PPOs charge premiums beyond what is paid by Medicare
answer
A) HMOs may pay for services not covered by Medicare
question
An insured has Medicare Part D coverage. He has reached his initial benefit limit and must now pay 50% of his prescription drug costs. What is the term for this gap in coverage? A) Blackout period B) Latency period C) Donut hole D) Bridge
answer
C) Donut hole
question
Medicare Part D provides A) Prescription drug benefit B) Hospital insurance C) Medical insurance D) Private fee-for-service plans.
answer
A) Prescription drug benefit
question
A 63-year-old man is planning to be employed until age 68. When will he be eligible for Medicare? A) Age 65, regardless of his employment status B) As soon as he retires at age 68 C) 70, if still employed D) 70, regardless of his employment status
answer
A) Age 65, regardless of his employment status
question
To sign up for a Medicare prescription drug plan, individuals must first be enrolled in A) Medicare Part A B) Medicare Part B and C C) Medicare Parts A and C D) Medicare Part D
answer
A) Medicare Part A
question
For an individual who is eligible for Medicare at age 65, and who is still employed and covered under the employer's plan, which of the following is true? A) The employer plan is primary coverage, and Medicare is secondary coverage. B) The employer plan is secondary coverage, and Medicare is primary coverage. C) The employer plan is discontinued, and Medicare is primary coverage. D) The employer plan continues, and Medicare is not available until the individual is retired
answer
A) The employer plan is primary coverage, and Medicare is secondary coverage
question
A man is enrolled in Part A of Medicare and not Part B. Three months into coverage, he applies for a Medicare supplement policy. Which of the following is true? A) The insurer cannot exclude pre-existing conditions from coverage for 6 months B) The insurer cannot deny coverage but can raise premium amounts. C) The insurer can deny coverage. D) The application must be approved by the state department of insurance
answer
C) The insurer can deny coverage.
question
Which type of Medicare policy requires insureds to use specific healthcare providers and hospitals, EXCEPT in emergency situations? A) SELECT B) Limited C) HMO D) Preferred
answer
A) SELECT
question
All of the following statements about Medicare supplement insurance policies are correct EXCEPT A) Medigap policies supplement Medicare benefits B) Medigap policies are issued by private insurers C) Medigap policies cover the cost of extended nursing home care D) Medigap policies cover Medicare deductibles and copayments
answer
C) Medigap policies cover the cost of extended nursing home care
question
How many pints of blood will be paid for by Medicare Supplement core benefits? A) 1 pint B) First 3 C) None; Medicares pays for it all D) Everything after first 3
answer
B) First 3
question
Which law was passed to authorize the NAIC to develop a standardized model for Medicare supplements policies? A) Act Against Deceptive Advertising B) Advertising Regulation Act C) OBRA D) COBRA
answer
C) OBRA
question
A Medicare supplement plan must have at least which of the following renewal provisions? A) Noncancellable B) Guaranteed renewable C) Conditionally renewable D) Nonrenewable
answer
B) Guaranteed renewable
question
In reference to the standard Medicare Supplement benefits plans, what does the term "standard" mean? A) All providers will have the same coverage options and conditions for each plan B) Coverage options and conditions comply with the law, but will vary from provider to provider C) All plans must include basic benefits A - N. D) Coverage options and conditions are developed for average individuals
answer
A) All providers will have the same coverage options and conditions for each plan
question
In which Medicare supplemental policies are the core benefits found? A) Plan A only B) Plans A-D only C) All plans D) Plans A and B only
answer
C) All plans
question
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 inconvenience, the insured is offered a lower premium. Which type of Medicare policy does the insured own? A) SELECT B) Limited C) HMO D) In-network
answer
A) SELECT
question
Medicaid provides all of the following benefits EXCEPT A) Income assistance for work-related injury B) Home health care services C) Eyeglasses D) Family planning services
answer
A) Income assistance for work-related injury
question
A primary requirement in order to receive Medicaid benefits is based upon A) Age B) Number of dependent children C) Need D) Whether the claimant is insurable
answer
C) Need
question
Which benefit is based on the person's Primary Insurance Amount (PIA)? A) Long-term care benefit B) Social Security disability benefit C) Death benefit in a universal life policy D) Accidental death benefit
answer
B) Social Security disability benefit
question
Once the person meets the stringent requirements for disability benefits under Social Security, how long is the waiting period before any benefits will be paid? A) Benefits will be paid immediately. B) 90 days C) 5 months D) 12 months
answer
C) 5 months
question
Which of the following is an eligibility requirement for Social Security disability income benefits? A) Being at least 50 years of age B) Currently employed status C) Fully insured status D) Experiencing at least one year of disability
answer
C) Fully insured status
question
Which statement regarding qualification for Social Security disability benefits is NOT true? A) The individual must have proper insured status. B) The individual must be at least 65 years old. C) The individual must satisfy the waiting period D) The individual must meet the definition of disability
answer
B) The individual must be at least 65 years old.
question
In which of the following situations would Social Security Disability benefits NOT cease? A) The individual's son gets a part-time job to help support the family B) The individual reaches age 65 C) The individual dies D) The individual has undergone therapy and is no longer disable
answer
A) The individual's son gets a part-time job to help support the family
question
Which of the following is NOT a factor in determining qualification for Social Security disability benefits? A) Worker's age B) Number of work credits earned C) Worker's occupation D) Worker's PIA
answer
C) Worker's occupation
question
What is another name for social security benefits? A) Old Age, Survivors, and Disability Insurance B) Medicare benefits C) Disability and long-term care insurance D) Survivor benefits
answer
A) Old Age, Survivors, and Disability Insurance
question
Regarding Medicare SELECT policies, what are restricted network provision? A) They determine who can be insured. B) They determine premium rates C) They help avoid adverse selection D) They condition the payment of benefits
answer
D) They condition the payment of benefits
question
Which of the following statements pertaining to Medicare Part A is correct? A) Medicare Part A is automatically provided when an individual qualifies for Social Security benefits at age 65. B) For the first 90 days of hospitalization, Medicare Part A pays 100% of all covered services, except for the initial deductible C) Individuals with ESRD do not qualify for Part A D) Each individuals covered by Medicare Part A is allowed one 90-day benefit period per year
answer
A) Medicare Part A is automatically provided when an individual qualifies for Social Security benefits at age 65.
question
Which of the following statements is CORRECT about Social Security? A) It is very easy to qualify for disability benefits B) It is designed for people over 59.g C) To be eligible, one must meet certain requirements D) It is more than income receive while employed
answer
C) To be eligible, one must meet certain requirements
