CLAHS California Life, Accident and Health or Sickness Examination - Set 4 - Part 2

Test your knowledge of technical writing concepts with these practice questions. Each question includes detailed explanations to help you understand the correct answers.

Question 21: Which of the following is generally NOT covered by Medicare Part B?

Physician services

Durable medical equipment

Routine dental and vision care

Outpatient diagnostic tests

Question 22: Under Medicare, the income-related monthly adjustment amount has what effect on certain beneficiaries?

It charges higher-income beneficiaries a premium surcharge

It lowers premiums for low-income beneficiaries

It eliminates the Part B premium entirely

It applies only to hospital deductibles

Question 23: An actively working employee age sixty-six is covered by both Medicare and a group plan from an employer with more than twenty employees. Which plan pays first?

Medicare pays first

Neither plan pays

The employee pays everything first

The group health plan pays first

Question 24: An actively working employee age sixty-seven is covered by Medicare and a group plan from an employer with fewer than twenty employees. Which plan generally pays first?

The group plan always pays first

Medicare pays first

The employee chooses each year

Coverage is suspended

Question 25: Under Original Medicare, who usually submits the claim for covered services?

The beneficiary alone

The state insurance department

The provider or supplier

A Medigap insurer

Question 26: The Medicare Summary Notice mailed to a beneficiary in Original Medicare is best described as which of the following?

A periodic summary of services and payments

A bill that must be paid immediately

An application for new coverage

A denial of all benefits

Question 27: A Medicare beneficiary who disagrees with a denied claim has a right to appeal. What is the first level of the Original Medicare appeals process?

A hearing before an administrative law judge

Review by the Medicare Appeals Council

A lawsuit in federal court

A redetermination by the claims contractor

Question 28: A beneficiary who enrolls in a Medicare Advantage plan must continue to do which of the following?

Drop Part A and Part B

Buy a Medigap policy as well

Stay enrolled in Parts A and B

Pay claims directly to providers

Question 29: Compared with Original Medicare, a Medicare Advantage plan must do which of the following?

Cover less than Original Medicare

Cover at least everything Original Medicare covers

Exclude emergency care

Drop prescription drug coverage

Question 30: Which statement about combining a Medigap policy with a Medicare Advantage plan is correct?

Both work together to lower costs

Medigap replaces the Advantage plan automatically

Medigap pays the Advantage plan premium

Medigap cannot be sold with Advantage

Question 31: A dual-eligible special needs plan, a type of Medicare Advantage plan, serves people who are enrolled in which programs?

Both Medicare and Medicaid

Medicare only

Private employer plans only

Medicaid only

Question 32: Medicare Part D provides which type of coverage?

Inpatient hospital coverage

Long-term custodial care

Outpatient prescription drug coverage

Physician office visits

Question 33: A person may delay enrolling in Part D without a late penalty as long as they maintain which of the following?

Any savings account

A Medigap policy

A high credit score

Creditable prescription drug coverage

Question 34: During which annual period may a beneficiary join, switch, or drop a Medicare Advantage or Part D plan, with changes taking effect the following January?

The general enrollment period

The annual enrollment period

The Medigap open enrollment period

The free-look period

Question 35: A Medicare Part D formulary is required to include which of the following?

At least two drugs per category

Every drug available on the market

Only generic drugs

No brand-name drugs at all

Question 36: Which federal program helps low-income Medicare beneficiaries pay their Part D premiums, deductibles, and copayments and waives the late-enrollment penalty?

The income-related adjustment amount

The annual rate guide

Extra Help, the low-income subsidy

The Medicare Summary Notice

Question 37: A Medicare Supplement, or Medigap, policy is designed to do which of the following?

Replace Original Medicare entirely

Provide outpatient drug coverage

Cover only long-term custodial care

Pay the gaps left by Original Medicare

Question 38: Medigap policies are federally standardized. What does that mean for a given lettered plan?

Its benefits are the same everywhere

Its price is fixed by the government

It is sold by only one company

Its benefits change every year

Question 39: Among the standardized Medigap plans, which plan consists of the core benefits only and must be offered by any insurer that sells Medigap?

Plan F

Plan G

Plan A

Plan N

Question 40: Medigap Plans C and F, which cover the Part B deductible, are closed to which beneficiaries?

Everyone, since they were discontinued

Those newly eligible in twenty-twenty or later

People over age seventy

Anyone with Medicare Advantage

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