Medicare Supplement Insurance Flashcards

What does Medicare Part A cover for DC beneficiaries?

Answer: Hospital inpatient care, skilled nursing facility care, and hospice

Medicare Part A covers inpatient hospital care, skilled nursing facility (SNF) care following a qualifying hospital stay, hospice, and some home health care.

A DC resident on Medicare incurs a $3,000 hospital bill for a 2-day stay. With only Original Medicare, what does the patient owe?

Answer: The Part A deductible per benefit period (approximately $1,632 in 2024)

Original Medicare Part A requires the beneficiary to pay the Part A deductible (approximately $1,632 for 2024) for each benefit period before Medicare pays.

Which Medigap plan covers 50% of the Medicare Part A deductible for DC policyholders?

Answer: Plan K

Medigap Plan K covers 50% of the Part A deductible and other gaps at 50%, with an annual out-of-pocket maximum, making it a lower-premium option.

In DC, how must Medigap premiums be structured to prevent discriminatory pricing?

Answer: Premiums may be community-rated, issue-age rated, or attained-age rated, but the method must be disclosed

DC allows community-rated, issue-age, and attained-age rating methods for Medigap, but the rating methodology must be clearly disclosed to the applicant.

Under federal and DC Medigap law, what is the 'free-look' period for a newly purchased Medigap policy?

Answer: 30 days

Federal Medigap regulations require a 30-day free-look period, during which the policyholder may return the policy for a full refund.

What does Medicare Part B cover?

Answer: Outpatient medical services, doctor visits, preventive services, and durable medical equipment

Medicare Part B covers outpatient medical services including doctor visits, lab tests, preventive care, and durable medical equipment (DME).