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Exam 14: Medicare

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Question 1

Multiple Choice

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Medicare lifetime reserve days, which total __________ days, are used once during a patient's lifetime and are usually reserved for use during the patient's final, terminal hospital stay.

A) 30
B) 60
C) 90
D) 120

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Question 2

Multiple Choice

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An advance beneficiary notice of noncoverage (ABN) is a written document provided to a Medicare beneficiary by a supplier, physician, or provider, and the ABN must be presented to the patient __________.

A) after Medicare has denied payment for the service
B) at least one month before providing the service
C) on the day the service or treatment is provided
D) prior to providing the service or treatment

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Question 3

Multiple Choice

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Individuals who wait until they turn 65 to apply for Medicare will cause a delay in the start of Part B coverage, because they will have to wait until the next __________ enrollment period, which is held January 1 through March 31 of each year, with Part B coverage starting on July 1 of that year.

Which program added prescription medication coverage to the original Medicare plan, some Medicare cost plans, some Medicare private fee-for-service plans, and Medicare medical Savings Account Plans?

Which insurance claim is submitted to receive reimbursement under Medicare Part A?

Which program helps low-income individuals by requiring states to pay their Medicare Part B premiums?

A Medicare benefit period begins with the first day of hospitalization and ends when the patient has been out of the hospital for __________ consecutive days.

Which program helps individuals whose assets are not low enough to qualify them for Medicaid by requiring states to pay their Medicare Part A and B premiums, deductibles, and coinsurance amounts?

Medicare __________ is a type of Medigap insurance that requires enrollees to use a network of providers to receive full benefits, which may result in lower premiums for enrollees.

Which program helps individuals who received Social Security and Medicare because of disability, but who lost their Social Security benefits and free Medicare Part A because they returned to work and their earnings exceed the limit allowed, by requiring states to pay their Medicare Part A premiums?

A Medicare-Medicaid (Medi-Medi) crossover plan provides both Medicare and Medicaid coverage to __________ beneficiaries with low incomes.

Which insurance claim is submitted to receive reimbursement under Medicare Part B?

An initial enrollment period (IEP) that provides an opportunity for the individual to enroll in Medicare Part A and/or Part B is for a period of __________ months.

Mary Smith is working full time and enrolled in Medicare Part A at age 65. She decided not to enroll in Medicare Part B at that time because her employer group health insurance coverage reimburses for physician and other outpatient encounters. Mary is eligible to enroll in Medicare Part B anytime during a(n) __________ enrollment period, which is a set time when individuals can sign up for Medicare Part B if they did not enroll when they applied for Medicare Part A.

Which program pays for inpatient hospital critical care access, skilled nursing facility stays, hospice care, and some home health care?

Which program pays for physician services, outpatient hospital care, and durable medical equipment?

The Balanced Budget Act of 1997 allows certain health care providers to withdraw from Medicare and enter into private contracts with their Medicare patients, which requires "opting out" of Medicare for at least __________ years for all covered items and services furnished to Medicare beneficiaries.

Which is a combination Medicare and Medicaid option that combines medical, social, and long-term care services for frail people who live and receive health care in the community?

Which is an autonomous, centrally administered program of coordinated inpatient and outpatient palliative (relief of symptoms) services for terminally ill patients and their families?

Which program includes managed care and private fee-for-service plans that provide contracted care to Medicare patients?