Medicare Parts A, B, C, and D

Correct answer: Inpatient hospital stays, post-hospital skilled nursing facility care, home health services, and hospice care

Part A is the hospital insurance benefit, and it pays for institutional and facility-based care: inpatient hospital stays, post-hospital care in a skilled nursing facility, home health services, and hospice care for the terminally ill. The memory hook is that A is for admissions.

Correct answer: It is voluntary supplementary medical insurance requiring a monthly premium, with a penalty structure for those who enroll late

Part B is supplementary medical insurance and it is voluntary. An eligible person enrolls during a designated enrollment period and pays a monthly premium, and the statute imposes a late-enrollment penalty structure to discourage waiting. Part B generally pays a share of the approved amount after an annual deductible, leaving the beneficiary responsible for coinsurance.

Correct answer: The beneficiary must be entitled to Part A and enrolled in Part B

Part C, the Medicare Advantage program, is the delivery route for Part A and Part B benefits through a private organization under contract with Medicare. To join, the beneficiary must be entitled to Part A and enrolled in Part B.

Correct answer: It is a voluntary benefit delivered only through private plans that contract with Medicare, either as a standalone drug plan or as the drug portion of a Medicare Advantage plan

Part D is the voluntary outpatient prescription drug benefit. It is delivered only through private plans that contract with Medicare — either a standalone prescription drug plan added to Original Medicare, or the drug portion of a Medicare Advantage plan (an MA-PD). Enrollment is elective, involves a premium, and is subject to enrollment periods and a late-enrollment penalty when the person lacks other creditable coverage.

Correct answer: Keep Parts A and B and add a standalone Part D prescription drug plan

Parts A and B are Original Medicare and do not cover outpatient prescription drugs. Part D fills that gap, and one of its two delivery routes is a standalone prescription drug plan added to Original Medicare — which preserves her fee-for-service access to any provider that accepts Medicare.

Correct answer: Under Parts A and B the government pays providers directly on a fee-for-service basis, while Part C routes the same benefits through a private plan

The distinction is delivery, not benefit content. Under Original Medicare the government pays providers directly on a fee-for-service basis. Part C is the Medicare Advantage program, under which a private organization contracting with Medicare delivers the same Part A and Part B benefits, furnishing at least what Original Medicare provides.

Correct answer: People who have received Social Security disability benefits for the required waiting period

Besides people who reach age 65 and are entitled to Social Security or Railroad Retirement benefits, the statute extends Medicare to people who have received Social Security disability benefits for a required waiting period, and to people with end-stage renal disease who need dialysis or a kidney transplant.

Correct answer: He remains a Medicare beneficiary; the plan delivers his Part A and Part B benefits plus his Part D drug coverage and must furnish at least what Original Medicare provides

A person who joins Part C is still a Medicare beneficiary; the private plan simply becomes the route through which Part A and Part B coverage is delivered, and it must furnish at least the benefits available under Original Medicare. An MA-PD also bundles in the Part D prescription drug benefit, so no separate drug plan is needed.

Correct answer: Part A, hospital insurance

Part A is the hospital insurance benefit, and it covers institutional and facility-based care: inpatient hospital stays, post-hospital care in a skilled nursing facility, home health services, and hospice care for the terminally ill. Alma's post-hospital skilled nursing stay falls squarely within Part A.

Correct answer: It is voluntary supplementary medical insurance: the eligible person enrolls during a designated enrollment period, pays a monthly premium, and faces a late-enrollment penalty for waiting.

Part B is supplementary medical insurance and it is voluntary. An eligible person enrolls during a designated enrollment period and pays a monthly premium, and the statute imposes a late-enrollment penalty structure to discourage waiting. Part B typically pays a share of the approved amount after an annual deductible, leaving coinsurance to the beneficiary.

Correct answer: She must be entitled to Part A and enrolled in Part B.

Part C, the Medicare Advantage program, is the route by which private organizations under contract with Medicare deliver the Part A and Part B benefits. Because the plan is delivering those benefits, the beneficiary must be entitled to Part A and enrolled in Part B to join.

Correct answer: Only through private plans that contract with Medicare — either a standalone drug plan added to Original Medicare or the drug portion of a Medicare Advantage plan.

Part D is the voluntary outpatient prescription drug benefit, and it is delivered only through private plans that contract with Medicare: either a standalone prescription drug plan added to Original Medicare, or the drug portion of a Medicare Advantage plan (an MA-PD plan). Enrollment is elective and involves a premium.

Correct answer: Add a standalone Part D prescription drug plan to his Original Medicare coverage.

Ruben wants to keep Original Medicare's fee-for-service access, so a Medicare Advantage plan is not what he asked for. Outpatient prescription drugs are the Part D benefit, and one of the two ways Part D is delivered is a standalone prescription drug plan added to Original Medicare. That combination gives him drug coverage without giving up fee-for-service.

Correct answer: She has Parts A and B, under which the government pays providers directly on a fee-for-service basis.

Parts A and B together are commonly called Original Medicare. Under Original Medicare the government pays providers directly on a fee-for-service basis, rather than a private plan delivering the benefits.

Correct answer: People who have received Social Security disability benefits for the required waiting period, and people with end-stage renal disease who need dialysis or a kidney transplant.

Beyond the age-65 pathway, the statute extends Medicare to people who have received Social Security disability benefits for a required waiting period and to people with end-stage renal disease who need dialysis or a kidney transplant.

Correct answer: No — the plan must furnish at least the benefits available under Original Medicare; extras are added on top, and he remains a Medicare beneficiary with the plan simply delivering the coverage.

Under Part C, a private organization contracts with Medicare to deliver the Part A and Part B benefits, and the plan must furnish at least the benefits available under Original Medicare. Extra benefits are additions, not substitutions. The enrollee is still a Medicare beneficiary; the plan is only the route through which coverage is delivered.

Correct answer: Post-hospital care in a skilled nursing facility

Part A is the hospital insurance benefit, covering institutional and facility-based care: inpatient hospital stays, post-hospital skilled nursing facility care, home health services, and hospice care for the terminally ill. Skilled nursing facility care following a hospital stay is squarely a Part A benefit.

Correct answer: It is voluntary supplementary medical insurance covering physician and outpatient services, financed in part by a monthly premium, with a penalty for late enrollment.

Part B is supplementary medical insurance and is voluntary. It covers physician services, outpatient hospital services, diagnostic and laboratory tests, durable medical equipment, and preventive services. An eligible person enrolls during a designated enrollment period and pays a monthly premium, and the statute imposes a late-enrollment penalty structure to discourage waiting.

Correct answer: She must be entitled to Part A and enrolled in Part B.

Part C is the Medicare Advantage program, under which private organizations contract with Medicare to deliver Part A and Part B benefits. Because the plan delivers those benefits, a beneficiary must be entitled to Part A and enrolled in Part B to join.

Correct answer: It is a voluntary outpatient prescription drug benefit delivered only through private plans that contract with Medicare.

Part D is the voluntary prescription drug benefit. It covers outpatient prescription drugs and is delivered only through private plans under contract with Medicare — either a standalone prescription drug plan added to Original Medicare or the drug portion of a Medicare Advantage plan (an MA-PD).

Correct answer: Parts A and B

Parts A and B together are commonly called Original Medicare, the arrangement in which the government pays providers directly on a fee-for-service basis. Part C is the private-plan delivery route for those same A and B benefits, and Part D is the private-plan drug benefit.

Correct answer: It is a Medicare Advantage plan that delivers Part A and Part B benefits and also includes prescription drug coverage.

Medicare Advantage plans must furnish at least the benefits available under Original Medicare, and many bundle in prescription drug coverage. Those combined plans are called MA-PD plans, so an MA-PD delivers Part A and Part B benefits plus the Part D drug benefit through one private plan.

Correct answer: A person who has received Social Security disability benefits for the required waiting period

Most people become entitled to Medicare at age 65 with entitlement to Social Security or Railroad Retirement benefits, but the statute also extends Medicare to people who have received Social Security disability benefits for a required waiting period, and to people with end-stage renal disease who need dialysis or a kidney transplant.

Correct answer: Part A entitlement is generally earned through work in Medicare-taxed employment, while Part B is voluntary supplementary insurance that an enrollee elects and pays a monthly premium for.

Part A is premium-free for most people because entitlement is built on work in Medicare-taxed employment; those who do not qualify that way may be allowed to buy in by paying a premium. Part B, by contrast, is voluntary supplementary medical insurance that the eligible person elects during a designated enrollment period and pays a monthly premium for.

Correct answer: Part A

Part A is the hospital insurance benefit. It pays for institutional and facility-based care: inpatient hospital stays, post-hospital care in a skilled nursing facility, home health services, and hospice care for the terminally ill. An inpatient admission followed by a skilled nursing facility stay falls squarely within Part A.

Correct answer: She must be entitled to Part A and enrolled in Part B

To join a Medicare Advantage plan, a beneficiary must be entitled to Part A and enrolled in Part B. Part C is the delivery route for Part A and Part B benefits through a private organization that contracts with Medicare, so the underlying entitlement and enrollment must both be in place.

Correct answer: It is a voluntary outpatient prescription drug benefit delivered only through private plans that contract with Medicare

Part D is the voluntary prescription drug benefit. It covers outpatient prescription drugs and reaches beneficiaries only through private plans that contract with Medicare — either a standalone prescription drug plan added to Original Medicare or the drug portion of a Medicare Advantage plan (an MA-PD).

Correct answer: Part B is voluntary supplementary medical insurance, so an eligible person enrolls during a designated enrollment period and pays a monthly premium

Physician services, outpatient hospital services, diagnostic and laboratory tests, durable medical equipment, and preventive services are Part B benefits. Part B is supplementary medical insurance and it is voluntary: an eligible person enrolls during a designated enrollment period and pays a monthly premium. The statute also imposes a late-enrollment penalty structure to discourage waiting, and Part B typically pays a share of the approved amount after an annual deductible.

Correct answer: No — Medicare is a federal program created by Title XVIII of the Social Security Act, so its benefit structure is the same in every state

Medicare is the federal health insurance program created by Title XVIII of the Social Security Act. Because it is a federal program, its benefit structure is the same in every state; states do not write the Medicare benefit package.

Correct answer: A person with end-stage renal disease who needs dialysis or a kidney transplant

In addition to people age 65 who are entitled to Social Security or Railroad Retirement benefits, the statute extends Medicare to people who have received Social Security disability benefits for a required waiting period and to people with end-stage renal disease who need dialysis or a kidney transplant.

Correct answer: He can enroll in a standalone Part D prescription drug plan offered by a private company that contracts with Medicare

Part D coverage comes in two forms: a standalone prescription drug plan added to Original Medicare, or the drug portion of a Medicare Advantage plan (MA-PD). Because this client wants to stay in Original Medicare, the standalone Part D plan from a private company contracting with Medicare is the correct route. Enrollment is elective, involves a premium, and is subject to enrollment periods and a late-enrollment penalty absent other creditable coverage.

Correct answer: Most people receive Part A without a monthly premium because entitlement is built on work in Medicare-taxed employment, and those who do not qualify that way may be allowed to buy in by paying a premium

Part A is the part most people receive without paying a monthly premium, because entitlement is built on work in Medicare-taxed employment. People who do not qualify on that basis may be allowed to buy in by paying a premium. This contrasts with Part B, which is voluntary and carries a monthly premium for everyone who enrolls.

Correct answer: Part A

Part A is the hospital insurance benefit, and it is the part that covers institutional and facility-based care: inpatient hospital stays, post-hospital care in a skilled nursing facility, home health services, and hospice care for the terminally ill. All three services described in the stem fall inside that list.

Correct answer: It is voluntary supplementary medical insurance covering physician and outpatient services, requiring a monthly premium and subject to a late-enrollment penalty structure.

Part B is supplementary medical insurance and it is voluntary. An eligible person enrolls during a designated enrollment period, pays a monthly premium, and faces a statutory late-enrollment penalty structure designed to discourage waiting. It covers physician services, outpatient hospital services, diagnostic and laboratory tests, durable medical equipment, and preventive services, generally paying a share of the approved amount after an annual deductible.

Correct answer: He must be entitled to Part A and enrolled in Part B.

To join a Medicare Advantage plan, a beneficiary must be entitled to Part A and enrolled in Part B. Part C is a delivery route rather than a separate entitlement, so the underlying Part A and Part B status is the prerequisite.

Correct answer: A Part C plan must furnish at least the benefits available under Original Medicare, and many add extra benefits rather than subtract them.

Under the Medicare Advantage program, private organizations contract with Medicare to deliver Part A and Part B benefits, and the plan must furnish at least the benefits available under Original Medicare. Many plans go beyond that floor by adding extra benefits or bundling prescription drug coverage as an MA-PD plan. A plan covering less than Original Medicare would violate that floor.

Correct answer: Enroll in a standalone Part D prescription drug plan offered by a private organization that contracts with Medicare.

Part D is the voluntary outpatient prescription drug benefit, and it is delivered only through private plans that contract with Medicare. For someone remaining in Original Medicare, that means a standalone prescription drug plan; the alternative route, the drug portion of a Medicare Advantage plan, is unavailable to someone who is not in a Part C plan.

Correct answer: He may be entitled to Medicare, because the statute extends the program to people with end-stage renal disease who need dialysis or a kidney transplant.

Although most people become entitled at age 65 through Social Security or Railroad Retirement, the Social Security Act also extends Medicare to people who have received Social Security disability benefits for a required waiting period and to people with end-stage renal disease who need dialysis or a kidney transplant. A 42-year-old dialysis patient therefore may be entitled.

Correct answer: Premium-free Part A rests on entitlement built through work in Medicare-taxed employment; a person who does not qualify that way may be permitted to buy in by paying a premium.

Part A is the part most people receive without paying a monthly premium because entitlement is built on work in Medicare-taxed employment. People who do not qualify on that basis may be allowed to buy in by paying a premium, which explains why one client pays and the other does not.

Correct answer: Medicare is a federal program created under Title XVIII of the Social Security Act, so its benefit structure is the same in every state.

Medicare was created by Title XVIII of the Social Security Act and is a federal program; because of that, its benefit structure is the same in every state. Moving between states does not change the Part A and Part B benefit structure to which she is entitled.