CSS Medicare & Medicaid Benefits Flashcards
6 cards from real CSS practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 6 CSS Medicare & Medicaid Benefits flashcards as text
Medicaid's 'spend-down' provision allows seniors to qualify for benefits by:
Answer: Reducing countable assets to the state's resource limit
Medicaid spend-down requires seniors to reduce their countable assets to the program's resource limit through allowable expenditures before qualifying for benefits.
What is the 'Medicare donut hole' (coverage gap) in Part D?
Answer: A temporary gap where beneficiaries pay more for prescription drugs after initial coverage
The Part D coverage gap (donut hole) is a phase where beneficiaries historically paid more out-of-pocket for drugs after total drug costs exceeded an initial coverage limit.
What is Medicaid's 'estate recovery' program?
Answer: A state's right to recover Medicaid costs from a beneficiary's estate after death
Medicaid estate recovery allows states to recoup costs paid for nursing home and other long-term care services from the deceased beneficiary's estate.
Which Medicare benefit covers a senior's need for medically necessary part-time skilled nursing care at home?
Answer: Medicare Home Health benefit
The Medicare Home Health benefit covers part-time skilled nursing, physical therapy, and home health aide services for homebound beneficiaries.
What is the Medicare 'Initial Coverage Election Period' (ICEP) for Part D?
Answer: The 7-month window around a person's 65th birthday to enroll in Part D
The ICEP for Part D aligns with the Initial Enrollment Period—three months before, the month of, and three months after turning 65.
Which Medicaid waiver program allows states to provide home and community-based services as an alternative to nursing home placement?
Answer: 1915(c) Home and Community-Based Services Waiver
Section 1915(c) HCBS waivers allow states to offer community-based long-term services and supports to individuals who would otherwise require nursing facility level of care.