CCM CCM Financial & Benefits Navigation 3

Question 1

The Social Security Disability Insurance (SSDI) program provides benefits to individuals who:

Accepted Answer

Have a qualifying disability and a sufficient work history of Social Security contributions

Answer

SSDI is an earned benefit for workers who become disabled and have paid sufficient Social Security taxes, with the benefit amount tied to work history.

Question 2

Supplemental Security Income (SSI) differs from SSDI in that SSI is:

Accepted Answer

A needs-based program for disabled or elderly individuals with limited income and resources regardless of work history

Answer

SSI is a means-tested, needs-based program administered by the SSA that does not require a work history, unlike SSDI.

Question 3

A case manager helping a client understand their 'out-of-pocket maximum' should explain that once this limit is reached:

Accepted Answer

The insurance plan pays 100% of covered services for the remainder of the benefit year

Answer

After reaching the out-of-pocket maximum, the insurer covers 100% of covered services for the rest of the plan year, eliminating additional cost-sharing for the enrollee.

Question 4

Which resource connects patients to federally funded community health centers that provide care on a sliding-fee scale?

Accepted Answer

Federally Qualified Health Centers (FQHCs)

Answer

FQHCs receive federal funding and are required to offer services on a sliding-fee scale based on income, making them a key resource for uninsured and underinsured clients.

Question 5

When a client is at risk of losing insurance coverage due to a lapse in premium payment, the case manager should first:

Accepted Answer

Check if the plan has a grace period and connect the client to financial assistance or premium subsidy programs

Answer

Most insurance plans have grace periods during which coverage is not yet terminated; identifying this window and connecting clients to subsidy or assistance programs can prevent a lapse.

(CCM) Certified Care Management Professional Practice Test

(CCM) Certified Care Management Professional Practice Test

CCM CCM Financial & Benefits Navigation 3