Duyệt tất cả câu hỏi
Mọi câu hỏi kèm đáp án và giải thích — học theo chủ đề hoặc tất cả cùng lúc.
Medicare & Bảo hiểm người cao tuổi
18 câu hỏi1. Which part of Medicare primarily covers inpatient hospital stays, limited skilled-nursing facility care, and hospice?
Part A is hospital insurance. It covers inpatient hospital stays, limited skilled-nursing facility care after a qualifying hospital stay, hospice, and some home health. Part B covers outpatient and physician services.
42 U.S.C. §1395c2. A 67-year-old beneficiary needs durable medical equipment ordered by her doctor. Which part of Medicare pays for it?
Part B is medical insurance and covers outpatient services, physician visits, preventive care, and durable medical equipment. Part A is for inpatient hospital services.
42 U.S.C. §1395j3. Medicare Advantage plans are also known as which part of Medicare?
Part C, called Medicare Advantage, is offered by private insurers that contract with CMS to deliver all Part A and Part B benefits and usually drug coverage as well. Medigap is supplemental, not part of Medicare itself.
42 U.S.C. §1395w-214. Which part of Medicare provides stand-alone prescription drug coverage?
Part D is the prescription drug benefit. It is sold by private insurers and requires the beneficiary to have Part A or Part B to enroll. Medigap policies sold today do not include drug coverage.
42 U.S.C. §1395w-1015. A 50-year-old has been receiving Social Security Disability Insurance (SSDI) for 24 months. He is now eligible for:
Persons under 65 qualify for Medicare after receiving SSDI benefits for 24 months. ALS and end-stage renal disease are exceptions that can qualify a person sooner.
42 U.S.C. §4266. Which condition allows a person to enroll in Medicare without the standard 24-month SSDI waiting period?
ALS qualifies for immediate Medicare enrollment without the 24-month wait. End-stage renal disease also has special rules. Most other chronic conditions still require the 24-month SSDI wait.
42 U.S.C. §4267. How long is the Initial Enrollment Period (IEP) for Medicare?
The IEP is a 7-month window built around the 65th birthday: three months before the birth month, the birth month itself, and three months after.
42 U.S.C. §1395p8. The Annual Election Period (AEP) for Medicare Advantage and Part D plans runs from:
AEP runs October 15 through December 7 each year. During this window beneficiaries can join, switch, or drop a Medicare Advantage or Part D plan for the following calendar year.
42 C.F.R. §422.629. What is the Part B late enrollment penalty for someone who delays signing up by a full 12 months without other creditable coverage?
The Part B late enrollment penalty is 10% of the standard Part B premium for each full 12-month period the beneficiary could have had Part B but did not, and it lasts as long as the person has Part B.
42 U.S.C. §1395r(b)10. The Part D late enrollment penalty is calculated as:
The Part D late enrollment penalty is 1% of the national base beneficiary premium for each month the person went without creditable drug coverage after first becoming eligible, and it lasts for as long as the person has Part D.
42 U.S.C. §1395w-113(b)11. How many standardized Medigap plan letters exist under federal law?
Federal law standardizes Medigap into ten lettered plans: A, B, C, D, F, G, K, L, M, and N. Within a state, the benefits under a given letter must be the same across all carriers.
42 U.S.C. §1395ss12. Which Medigap plan is no longer available to people first eligible for Medicare on or after January 1, 2020?
Plan F (and Plan C) cannot be sold to anyone newly eligible for Medicare on or after January 1, 2020 because those plans cover the Part B deductible, which Congress eliminated for new Medigap purchasers under MACRA. People already enrolled before 2020 may keep them.
MACRA §40113. How long is the federal Medigap Open Enrollment Period during which guaranteed-issue applies?
The federal Medigap Open Enrollment Period is a one-time 6-month window that starts the first month the beneficiary is both age 65 or older and enrolled in Part B. During this window the insurer cannot use medical underwriting.
42 U.S.C. §1395ss(s)14. Under California's Medigap birthday rule, an existing policyholder may switch to:
The California birthday rule lets an existing Medigap policyholder switch each year, in a window beginning on the birthday, to a Medigap plan of equal or lesser benefits from any carrier, with no medical underwriting.
Cal. Ins. Code §10192.1115. Before meeting a 70-year-old prospect in their home to discuss life insurance or annuities, a California agent must:
Insurance Code §789.10 requires a written notice at least 24 hours before an in-home appointment with a senior (65+) to discuss life insurance or annuities. The notice must identify who will attend and what products will be discussed.
Cal. Ins. Code §789.1016. How many days is the free-look period for individual life insurance and annuity contracts sold to a buyer age 65 or older in California?
Insurance Code §10127.10 grants a 30-day free-look period for life insurance and annuity contracts sold to anyone age 65 or older, three times the 10-day period that applies to younger buyers.
Cal. Ins. Code §10127.1017. An agent invites seniors to a free lunch advertised as an educational seminar but plans to deliver a sales pitch for indexed annuities. Under California law this is:
Insurance Code §787 prohibits high-pressure or misleading tactics aimed at seniors. Free-lunch seminars that hide a sales presentation behind educational labeling are not allowed; sales activity must be disclosed in the invitation and on-site.
Cal. Ins. Code §78718. An agent repeatedly persuades an 80-year-old client to replace existing annuity contracts with new ones, generating commissions but no real benefit to the client. This practice is best described as:
Insurance Code §785.10 forbids unnecessary replacement (twisting or churning) of life insurance or annuity products sold to seniors. Replacement must be suitable for the client and properly documented, not driven by the agent's commission.
Cal. Ins. Code §785.10