NC Medicare/LTC Exam Questions and Answers (VERIFIED ANSWERS) (latest Update 2024) GRADED A+

NC Medicare/LTC Exam Questions and Answers (VERIFIED
ANSWERS) (latest
Update 2024) GRADED A+



T/F. Relating to a tax qualified LTC policy, the premiums paid for the policy may be a deductible expense, and the benefits paid are also not considered taxable income. - ANSWER-True.

T/F. Skilled nursing care is primarily custodial care. - ANSWER-False. (It is specialized, acute care that can only be performed by professionals)

Long term care is primarily what type of care? - ANSWER-
Personal/custodial care

Hospice drug benefits for pain relief/symptom control have a copayment of what? - ANSWER-$5

Skilled nursing facility coinsurance is how much per day and starts after how many days of care? - ANSWER$170.50 per day, beginning on after the first 20 days. (100 days of coverage)

What is a qualifying hospital stay? - ANSWER-3 days hospitalization (Provides Medicare coverage after 30 days have elapsed)

Qualified medical expenses paid for from a Medical Savings Account (MSA) are taxed how? - ANSWER-Not taxable. (Funds are used to pay deductibles during the year)
*Only taxable when funds are used for anything other than qualified medical expenses.


LTC provision that provides a guarantee that certain policy benefits will remain available even if the insured stops paying premiums. (Offers option of a paid-up policy
providing the same benefits for a shorter period, etc.) - ANSWER-Nonforfeiture

When must the outline of coverage for a Medigap policy be provided to the insured? - ANSWER-At the time of application.

Home health equipment such as dialysis equipment and supplies are covered under which part of Medicare? - ANSWER-Medicare Part B (Considered an outpatient service)

What is the Medicare Part B enrollment period for an individual who is turning 65? - ANSWER-3 months before the month in which the individual turns 65, as well as the 3 months following that month (7 months).

What is the copayment of the Medicare approved amount? - ANSWER-20% paid by the insured individual.

Prospective review (Precertification provision) - ANSWERPhysician submits claim information prior to providing treatment to know in advance if the procedure is covered and what the rate will be.

What options does an insured person have for prescription drug coverage if they are enrolled in a Medicare Advantage Plan? - ANSWER-1) Receive prescription drug coverage through the Medicare Advantage Plan.
2) Sign up for separate prescription drug plan through Medicare Part D.

Who facilitates processing Medicare applications, collects Medicare premiums, and provides general information about Medicare? - ANSWER-The Social Security Administration

Who administers Medicare? - ANSWER-Centers for
Medicare and Medicaid Services (CMS)

How are LTC benefits triggered? - ANSWER-Insured must be unable to perform at least 2 ADLs without substantial assistance.
(Cannot be triggered solely due to medical necessity)

Home health care covers occasional visits from who? - ANSWER-Registered nurses, licensed practical nurses, community-based professionals (like hospice). **Does NOT cover visits from attending physicians.

Programs that are provided to people who are too poor to qualify for Medicaid. - ANSWER-State-only Medicaid programs

Medicare Part A Coverages and Copayment - ANSWERDays 1-60: All charges covered except for a deductible.
Days 61-90: Copayment of $341 per day
Days 91-150: (Lifetime reserve days) Copayment of $682 per day.

A person who is eligible for Medicare Part B due to endstage renal disease is NOT eligible for what? - ANSWERSpecial enrollment

What types of providers manage Medicare Part A and Part
B, respectively? - ANSWER-Part A- Intermediary
Part B- Carrier