Medicare parts, supplement plans, and health insurance marketplace concepts tested on health insurance licensing exams.
34 cards · basic cards · AI-written, checked twice. Edit anything.
- What does Medicare Part A cover?
- Hospital inpatient care, skilled nursing facility care, hospice care, and some home health services.
- Is Medicare Part A premium required for someone who paid Medicare taxes for 10+ years?
- No, Part A is typically premium-free for those who meet the work requirement.
- What does Medicare Part B cover?
- Physician services, outpatient hospital care, diagnostic tests, and durable medical equipment.
- What is the typical premium structure for Medicare Part B?
- A monthly premium paid by the enrollee, adjusted based on income level.
- What does Medicare Part C (Medicare Advantage) do?
- Provides an alternative way to receive Part A and B benefits through private insurance plans, typically including prescription drug coverage.
- What is Medicare Part D?
- Coverage for prescription drugs offered by private insurance companies approved by Medicare.
- Can someone enroll in both Original Medicare (Parts A and B) and Medicare Advantage (Part C)?
- No, you must choose either Original Medicare or Medicare Advantage, not both.
- What are Medigap plans (Medicare Supplement)?
- Private insurance policies that help pay for costs not covered by Original Medicare, such as copayments, coinsurance, and deductibles.
- Can you use a Medigap plan with Medicare Advantage?
- No, Medigap supplements Original Medicare only; it cannot be used with Medicare Advantage.
- What is the Medigap open enrollment period?
- Six months starting when you are age 65 or older and enrolled in Medicare Part B, or within 63 days of losing other health coverage.
- What is the Health Insurance Marketplace?
- A system where individuals can compare and purchase qualified health plans (QHP) from multiple insurers, often with access to subsidies.
- What are the four metal levels in the Health Insurance Marketplace?
- Bronze, Silver, Gold, and Platinum, representing different levels of cost-sharing between the plan and the enrollee.
- What percentage of healthcare costs does a Silver plan typically cover?
- Approximately 70 percent; the enrollee is responsible for approximately 30 percent.
- What is a Bronze plan in the marketplace?
- The lowest-cost tier of marketplace plans where the plan covers approximately 60 percent of healthcare costs and the enrollee covers approximately 40 percent.
- What is a Gold plan in the marketplace?
- A marketplace plan where the plan covers approximately 80 percent of healthcare costs and the enrollee covers approximately 20 percent.