Question 1

The Medicare program that provides expanded benefits through private managed care health plans is:
A)Medicare Part A.
B)Medicare Part B.
C)Medicare Part D.
D)Medicare Advantage (MA).

Accepted Answer

Medicare Advantage (MA) is the program that provides expanded benefits through private managed care health plans. It is also known as Medicare Part C. Medicare Part A covers hospital insurance while Part B covers medical insurance. Part D provides coverage for prescription drugs.

Question 2

The role of the Centers for Medicare and Medicaid Services (CMS) includes all of the following EXCEPT:
A)paying claims for Medicare beneficiaries.
B)establishing policy for provider reimbursement.
C)conducting research of healthcare management and treatment.
D)assessing the quality of healthcare facilities and services.

Accepted Answer

paying claims for Medicare beneficiaries.

Question 3

For each benefit period, a Medicare Part A beneficiary will receive coverage for how many days of skilled nursing care?
A)30 days
B)60 days
C)90 days
D)100 days

Accepted Answer

Medicare Part A will cover up to 100 days of skilled nursing care per benefit period. After the 100 days, the patient will be responsible for all costs.

Question 4

The abbreviation ESRD stands for:
A)ending symptoms of renal disease.
B)early status of respiratory distress.
C)end-stage respiratory distress.
D)end-stage renal disease.

Accepted Answer

ESRD stands for end-stage renal disease, which is the final stage of chronic kidney disease where the kidneys have lost almost all function.

Question 5

Under Medicare Part A, what time limit applies to coverage for home healthcare services?
A)60 days per benefit period
B)90 days per benefit period
C)120 days per benefit period
D)There is no time limit as long as medical necessity has been proven.

Accepted Answer

Medicare Part A does not impose a specific time limit on coverage for home healthcare services as long as the services are medically necessary and meet Medicare's requirements. The key is that the care must be prescribed by a doctor and the patient must be homebound, among other criteria.

Question 6

For each benefit period, a Medicare Part A beneficiary will receive coverage for:
A)30 days of hospital care.
B)60 days of hospital care.
C)90 days of hospital care.
D)unlimited days of hospital care if medically necessary.

Accepted Answer

Medicare Part A covers up to 90 days of hospital care per benefit period, with a deductible and coinsurance applied. A benefit period begins the day you're admitted as an inpatient and ends when you haven't received any inpatient hospital care (or skilled nursing facility care) for 60 days in a row.

Question 7

Medicare prescription drug coverage is offered through:
A)Medicare Part A.
B)Medicare Part B.
C)Medicare Part D.
D)Medicare Advantage (MA).

Accepted Answer

Medicare prescription drug coverage is offered through Medicare Part D.

Question 8

For Medicare Part A, a deductible applies:
A)to each benefit period.
B)to each household.
C)to each hospital admission.
D)only if skilled nursing care is provided.

Accepted Answer

The Medicare Part A deductible applies to each benefit period, which begins when a patient is admitted to a hospital and ends when they have been out of the hospital or a skilled nursing facility for 60 consecutive days. The current deductible amount is $1,484 (as of 2021).

Question 9

Individuals eligible for Medicare may be classified into one or more of the following categories EXCEPT:
A)age 65 or older.
B)disabled.
C)low income.
D)end-stage renal disease (ESRD).

Accepted Answer

The answer of Individuals eligible for Medicare may be classified...

Question 10

Hospice services covered under Medicare Part A may be provided as:
A)short-term hospital care.
B)inpatient respite care.
C)in-home care.
D)all of the above.

Accepted Answer

Hospice services covered under Medicare Part A may be provided as short-term hospital care, inpatient respite care, or in-home care. All options are covered under the Medicare benefit for hospice care.

Question 11

When receiving inpatient hospital care, a Medicare Part A beneficiary has a lifetime reserve of:
A)30 days.
B)60 days.
C)90 days.
D)unlimited days if medically necessary.

Accepted Answer

A Medicare Part A beneficiary has a lifetime reserve of 60 days of inpatient hospital care. After exhausting their initial allotment of 90 days of hospitalization coverage, the beneficiary can use these reserve days. Once the lifetime reserve days are used up, the beneficiary is responsible for all hospital costs.

Question 12

Coverage for hospice care is provided by:
A)Medicare Part A.
B)Medicare Part B.
C)Medicare Part D.
D)Medicare Advantage (MA).

Accepted Answer

Hospice care is covered by Medicare Part A. Medicare Part B covers medical services like doctor visits, outpatient care, and preventive services. Medicare Part D covers prescription drugs, and Medicare Advantage (MA) plans provide an alternative way to receive Medicare benefits through private insurance companies.

Question 13

Organizations that are hired by the CMS to carry out day-to-day Medicare program operations are known as:
A)administrators.
B)contractors.
C)intermediaries.
D)carriers.

Accepted Answer

Contractors are organizations hired by CMS to carry out day-to-day Medicare program operations, such as processing claims from healthcare providers and answering beneficiary inquiries. Intermediaries and carriers were previous terms used by CMS for these organizations, but they have since been replaced with the term contractor. While administrators may play a role in managing the Medicare program, they are not specifically designated to carry out day-to-day operations.

Question 14

Medicare Part A provides coverage for all of the following services EXCEPT:
A)inpatient hospital care.
B)inpatient physician services.
C)home health care.
D)hospice care.

Accepted Answer

The answer of Medicare Part A provides coverage for all...

Question 15

To qualify for Medicare, disabled adults must have been receiving Social Security disability benefits for:
A)1 year.
B)more than 1 year.
C)more than 2 years.
D)more than 3 years.

Accepted Answer

Disabled adults must have been receiving Social Security disability benefits for more than 2 years in order to qualify for Medicare coverage.

Question 16

Individuals age 65 and older qualify for Medicare if they have paid FICA taxes for at least:
A)10 calendar quarters.
B)25 calendar quarters.
C)40 calendar quarters.
D)50 calendar quarters.

Accepted Answer

Individuals must have paid FICA taxes for at least 40 calendar quarters (or 10 years) to qualify for Medicare.

Question 17

The organization that enrolls new Medicare beneficiaries into the program is the:
A)Centers for Medicare and Medicaid Services (CMS).
B)Department of Health and Human Services (DHHS).
C)Internal Revenue Service (IRS).
D)Social Security Administration (SSA).

Accepted Answer

The Social Security Administration (SSA) is responsible for enrolling new beneficiaries into the Medicare program, as it is closely tied to Social Security benefits. The other choices, Centers for Medicare and Medicaid Services (CMS), Department of Health and Human Services (DHHS), and Internal Revenue Service (IRS), are involved with Medicare in other capacities, such as administering and overseeing the program, providing funding for it, and collecting taxes to fund it, but they are not responsible for enrolling new beneficiaries into the program.

Question 18

The Medicare coverage that pays for physician services is:
A)Medicare Part A.
B)Medicare Part B.
C)Medicare Part D.
D)Medicare Advantage (MA).

Accepted Answer

Medicare Part B specifically covers physician services, along with other outpatient services such as medical equipment, preventive services, and certain mental health services. Medicare Part A covers inpatient hospital stays, while Medicare Part D covers prescription drugs. Medicare Advantage (MA) plans are provided by private insurance companies approved by Medicare and typically offer a combination of coverage for Parts A, B, and D.

Question 19

The Medicare coverage that consists of hospital insurance is:
A)Medicare Part A.
B)Medicare Part B.
C)Medicare Part D.
D)Medicare Advantage (MA).

Accepted Answer

Medicare Part A is often referred to as hospital insurance as it covers inpatient hospital care, hospice care, skilled nursing facility care, and some home health care services.

Question 20

A spouse of a deceased, retired, or disabled individual who was or is eligible for Medicare benefits:
A)is not eligible for Medicare coverage.
B)is also eligible for Medicare coverage.
C)must apply for Medicaid benefits.
D)is eligible for Supplemental Security Income benefits.

Accepted Answer

A spouse of a deceased, retired, or disabled individual who was or is eligible for Medicare benefits is also eligible for Medicare coverage. This is called the Medicare spousal benefit. The eligibility is based on the deceased, retired, or disabled individual’s eligibility for Medicare. The spouse must be at least 65 years old or have a disability to be eligible.

Quiz 13: Medicare Medical Billing

The Medicare program that provides expanded benefits through private managed care health plans is: A)Medicare Part A. B)Medicare Part B. C)Medicare Part D. D)Medicare Advantage (MA).

For each benefit period, a Medicare Part A beneficiary will receive coverage for how many days of skilled nursing care? A)30 days B)60 days C)90 days D)100 days

The abbreviation ESRD stands for: A)ending symptoms of renal disease. B)early status of respiratory distress. C)end-stage respiratory distress. D)end-stage renal disease.

Under Medicare Part A, what time limit applies to coverage for home healthcare services? A)60 days per benefit period B)90 days per benefit period C)120 days per benefit period D)There is no time limit as long as medical necessity has been proven.

For each benefit period, a Medicare Part A beneficiary will receive coverage for: A)30 days of hospital care. B)60 days of hospital care. C)90 days of hospital care. D)unlimited days of hospital care if medically necessary.

Medicare prescription drug coverage is offered through: A)Medicare Part A. B)Medicare Part B. C)Medicare Part D. D)Medicare Advantage (MA).

For Medicare Part A, a deductible applies: A)to each benefit period. B)to each household. C)to each hospital admission. D)only if skilled nursing care is provided.

Individuals eligible for Medicare may be classified into one or more of the following categories EXCEPT: A)age 65 or older. B)disabled. C)low income. D)end-stage renal disease (ESRD).

Hospice services covered under Medicare Part A may be provided as: A)short-term hospital care. B)inpatient respite care. C)in-home care. D)all of the above.

When receiving inpatient hospital care, a Medicare Part A beneficiary has a lifetime reserve of: A)30 days. B)60 days. C)90 days. D)unlimited days if medically necessary.

Coverage for hospice care is provided by: A)Medicare Part A. B)Medicare Part B. C)Medicare Part D. D)Medicare Advantage (MA).

Organizations that are hired by the CMS to carry out day-to-day Medicare program operations are known as: A)administrators. B)contractors. C)intermediaries. D)carriers.

Medicare Part A provides coverage for all of the following services EXCEPT: A)inpatient hospital care. B)inpatient physician services. C)home health care. D)hospice care.

To qualify for Medicare, disabled adults must have been receiving Social Security disability benefits for: A)1 year. B)more than 1 year. C)more than 2 years. D)more than 3 years.

Individuals age 65 and older qualify for Medicare if they have paid FICA taxes for at least: A)10 calendar quarters. B)25 calendar quarters. C)40 calendar quarters. D)50 calendar quarters.

The organization that enrolls new Medicare beneficiaries into the program is the: A)Centers for Medicare and Medicaid Services (CMS). B)Department of Health and Human Services (DHHS). C)Internal Revenue Service (IRS). D)Social Security Administration (SSA).

The Medicare coverage that pays for physician services is: A)Medicare Part A. B)Medicare Part B. C)Medicare Part D. D)Medicare Advantage (MA).

The Medicare coverage that consists of hospital insurance is: A)Medicare Part A. B)Medicare Part B. C)Medicare Part D. D)Medicare Advantage (MA).

A spouse of a deceased, retired, or disabled individual who was or is eligible for Medicare benefits: A)is not eligible for Medicare coverage. B)is also eligible for Medicare coverage. C)must apply for Medicaid benefits. D)is eligible for Supplemental Security Income benefits.