According to OBRA, what is the minimum number of employees required to constitute a large group?
100
Regarding Medicare SELECT policies, what are restricted network provisions?
They condition the payment of benefits.
In long term care policies, the term "chronically ill" means an individual who is unable to perform at least 2 activities of daily living - for at least
90 days
When must an insurance company present an outline of coverage to an applicant for a Medicare supplement policy?
At the time of application
Which of the following statements is NOT true concerning Medicaid?
It consists of 3 parts: Part A: hospitalization, Part B: doctor's services, Part C: disability income.
All of the following individuals may qualify for Medicare health insurance benefits EXCEPT
A retired person age 50.
Which of the following is NOT an activity of daily living (ADL)?
Talking
Employer health plans must provide primary coverage for individuals with end-stage renal disease before Medicare becomes primary for how many months?
30 months
A long-term care insurance shopper's guide must be provided in the format developed by which of the following?
NAIC
Which of the following is true regarding optional benefits with long-term care policies?
They are available for an additional premium.
Most LTC plans have which of the following features?
Guaranteed renewability
Which of the following Medicare supplement plans would be available to a reasonably healthy 91-year-old female?
A-N
Which type of care is NOT covered by Medicare?
Long-term care
A long-term care shopper's guide must be presented at what point?
Prior to the time of application
Prior to purchasing a Medigap policy, a person must be enrolled in which of the following?
Parts A and B of Medicare
Medicare Part D provides
Prescription drug benefit.
When a person applies for Medicare supplement insurance, whose responsibility is it to confirm that the applicant does not already have accident or sickness insurance in force?
Insurer
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 limitation, the insured is offered a lower premium. Which type of Medicare policy does the insured own?
Medicare SELECT
Which of the following must the patient pay under Medicare Part B?
20% of covered charges above the deductible
Which of the following is NOT covered under a long-term care policy?
Acute care in a hospital
If one takes Social Security retirement benefits at age 62, what needs to be done at age 65 to qualify for Medicare?
Nothing
Hospice care is intended for
terminally ill
What is the duration of the free-look period for Medicare supplement policies?
30 days
An applicant is discussing his options for Medicare supplement coverage with his agent. The applicant is 65 years old and has just enrolled in Medicare Part A and Part B. What is the insurance company obligated to do?
Offer the supplement policy on a guaranteed issue basis
Guarantee of insurability option in long-term care policies allows the insured to
Increase benefit levels without providing proof of insurability
What type of care is Respite care?
Relief for a major care giver
How many pints of blood will be paid for by Medicare Supplement core benefits?
First 3
Following an injury, a policyowner covered under Medicare Parts A & B was treated by her physician on an outpatient basis. How much of her doctor's bill will she be required to pay out-of-pocket?
20% of covered charges above the deductible
In which of the following locations would skilled care most likely be provided?
In an institutional setting