Life and Health California Exam Medicare and Medicaid 2 — Questions and Answers
Question 1: Medicare Supplement (Medigap) policies are primarily designed to:
- Replace Original Medicare with comprehensive private coverage
- Cover gaps in Original Medicare such as deductibles, copayments, and coinsurance (Correct answer)
- Provide prescription drug coverage not included in Medicare Part A or B
- Pay for long-term custodial care in a nursing home
Correct answer: Cover gaps in Original Medicare such as deductibles, copayments, and coinsurance
Medigap policies are sold by private insurers to cover cost-sharing gaps left by Original Medicare, such as deductibles, copays, and coinsurance amounts.
Question 2: How many standardized Medigap plan letters are currently available to most Medicare beneficiaries in most states?
- 5 standardized plans
- 8 standardized plans
- 10 standardized plans (Correct answer)
- 14 standardized plans
Correct answer: 10 standardized plans
There are currently 10 standardized Medigap plans (A, B, C, D, F, G, K, L, M, and N), though Plans C and F are not available to those who became eligible for Medicare after January 1, 2020.
Question 3: Medicare Advantage (Part C) plans are required to cover at minimum:
- Only inpatient hospital services covered under Part A
- All services covered under Original Medicare Part A and Part B (Correct answer)
- Only preventive services and wellness programs
- Prescription drugs and dental services exclusively
Correct answer: All services covered under Original Medicare Part A and Part B
By law, Medicare Advantage plans must provide at least the same level of coverage as Original Medicare Part A and Part B, and many offer additional benefits.
Question 4: Under Medicaid eligibility rules, which population group is typically given the highest priority for coverage?
- Middle-income adults without disabilities or dependent children
- Low-income individuals, families, pregnant women, elderly, and disabled persons (Correct answer)
- Retired federal and state government employees only
- Individuals who have exhausted their Medicare benefits
Correct answer: Low-income individuals, families, pregnant women, elderly, and disabled persons
Medicaid targets vulnerable and low-income populations including children, pregnant women, elderly adults, and people with disabilities, as mandated by federal law.
Question 5: During the annual Medicare Part D Open Enrollment Period, beneficiaries are permitted to:
- Enroll in or change their Part D plan only once every five years
- Add, drop, or switch Part D prescription drug plans for the following year (Correct answer)
- Switch Part D plans only if relocating to a different state
- Enroll in Part D only if they have no existing creditable drug coverage
Correct answer: Add, drop, or switch Part D prescription drug plans for the following year
Each year from October 15 to December 7, Medicare beneficiaries can join, switch, or drop a Medicare drug plan, with changes taking effect January 1.
Question 6: Medicare Part A covers skilled nursing facility (SNF) care only after a qualifying inpatient hospital stay of at least how many consecutive days?
- 1 consecutive day
- 2 consecutive days
- 3 consecutive days (Correct answer)
- 5 consecutive days
Correct answer: 3 consecutive days
Medicare requires a qualifying inpatient hospital stay of at least 3 consecutive days before it will cover skilled nursing facility care.
Question 7: In California, the state's Medicaid program is known by which name?
- CalMed
- Medi-Cal (Correct answer)
- CaliCare
- Golden State Health
Correct answer: Medi-Cal
California's Medicaid program is called Medi-Cal, which provides free or low-cost health coverage to eligible low-income Californians.
Life and Health California Exam Medicare and Medicaid 2
Medicare Supplement (Medigap) policies are primarily designed to: