Medical Expense Practice Questions — Page 12 of 15

702 free medical expense questions for the California Life & Health insurance license exam. Pick any question — answer it and get the full 3-part explanation, no signup required.

1. 551.A D-SNP (dual-eligible special needs plan) under Medicare Advantage is designed for:
   Difficulty 1/5
2. 552.To enroll in Medicare Part D prescription drug coverage, a beneficiary must:
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3. 553.What is the difference between the Open Enrollment Period (OEP) and a Special Enrollment Period (SEP) in th…
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4. 554.To enroll in a stand-alone Medicare Part D prescription drug plan, an individual must:
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5. 555.When a provider bills Original Medicare for covered services, the beneficiary receives a Medicare Summary N…
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6. 556.A Medicare provider who 'accepts assignment' agrees to:
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7. 557.A Medicare Advantage (Part C) plan must:
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8. 558.The Medicare Summary Notice (MSN) provides a beneficiary with:
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9. 559.If a Medicare beneficiary disagrees with a claim decision shown on the Medicare Summary Notice (MSN), the b…
   Difficulty 2/5
10. 560.Which statement correctly distinguishes a stand-alone Prescription Drug Plan (PDP) from a Medicare Advantag…
    Difficulty 2/5
11. 561.When Original Medicare processes a claim, the beneficiary is notified of the services billed and the amount…
    Difficulty 1/5
12. 562.In Original Medicare, the document sent to beneficiaries summarizing the services billed and the amounts Me…
    Difficulty 1/5
13. 563.Which statement correctly distinguishes Original Medicare from Medicare Advantage (Part C)?
    Difficulty 1/5
14. 564.A physician who does not accept Medicare assignment for a covered Part B service may charge the beneficiary:
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15. 565.To enroll in a Medicare Part D prescription drug plan, an individual must:
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16. 566.To enroll in a Medicare Part D prescription drug plan, a beneficiary must:
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17. 567.A Medicare Summary Notice (MSN) is a:
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18. 568.Under the Affordable Care Act, a Qualified Health Plan (QHP) sold through an exchange must:
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19. 569.Group medical expense coverage may be delivered through which of the following care plan arrangements?
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20. 570.When Medicare denies payment for a service it determines is not covered or not medically necessary, the ben…
    Difficulty 2/5
21. 571.The Medicare Summary Notice (MSN) is:
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22. 572.The Medicare Summary Notice (MSN) is:
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23. 573.A Medicare Part D plan's formulary must include:
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24. 574.In a Medicare Advantage or Part D sales context, the 'scope of appointment' is:
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25. 575.If Medicare denies payment for a covered service, the beneficiary:
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26. 576.Which person is eligible for Medicare coverage?
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27. 577.If a Medicare beneficiary disagrees with a claims decision shown on their Medicare Summary Notice, the firs…
    Difficulty 2/5
28. 578.In Original Medicare, claims for covered physician services are generally:
    Difficulty 2/5
29. 579.A beneficiary who keeps Original Medicare and wants Medicare prescription drug coverage should enroll in:
    Difficulty 1/5
30. 580.Which service is generally NOT covered by Original Medicare?
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31. 581.When a Medicare provider "accepts assignment," the provider agrees to:
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32. 582.If a Medicare claim is denied or a beneficiary disagrees with a payment amount, the beneficiary has the rig…
    Difficulty 2/5
33. 583.A dependent child who loses coverage under a parent's group health plan because of age is permitted under C…
    Difficulty 2/5
34. 584.Under CMS marketing rules, when a Third-Party Marketing Organization (TPMO) contacts a Medicare beneficiary…
    Difficulty 2/5
35. 585.Under CMS marketing rules for agents selling Medicare plans (including TPMO requirements), which practice i…
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36. 586.The Medicare Summary Notice (MSN) is best described as:
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37. 587.When making an unsolicited marketing contact about Medicare Advantage or Part D plans, a Third-Party Market…
    Difficulty 2/5
38. 588.Under Medicare Part A, what is the 'benefit period' (spell of illness), and what role do the lifetime reser…
    Difficulty 3/5
39. 589.When a third-party marketing organization (TPMO) calls a consumer about Medicare Advantage and Part D plans…
    Difficulty 2/5
40. 590.Regarding Medicare Part D enrollment, which statement is correct?
    Difficulty 2/5
41. 591.When Medicare denies payment for a service the beneficiary believes should be covered, the beneficiary:
    Difficulty 2/5
42. 592.Under CMS marketing rules, a TPMO (Third Party Marketing Organization) must include which statement when co…
    Difficulty 2/5
43. 593.A third-party marketing organization (TPMO) that markets Medicare Advantage or Part D plans is required to:
    Difficulty 2/5
44. 594.Under CMS marketing rules, a Third-Party Marketing Organization (TPMO) that markets Medicare Advantage and …
    Difficulty 2/5
45. 595.The statement that Medicare sends to beneficiaries explaining services billed, amounts approved, and what M…
    Difficulty 1/5
46. 596.Which activity is prohibited under CMS marketing rules for Medicare Advantage and Part D plans?
    Difficulty 3/5
47. 597.Under CMS marketing rules, a third-party marketing organization (TPMO) that markets Medicare Advantage and …
    Difficulty 2/5
48. 598.Under CMS marketing rules, when a third-party marketing organization (TPMO) makes a telephone call to marke…
    Difficulty 2/5
49. 599.Within a Medicare Part A benefit period, the beneficiary must pay a daily coinsurance amount for inpatient …
    Difficulty 2/5
50. 600.CMS monitors agent compliance with Medicare marketing rules through 'Secret Shopper' activities, which:
    Difficulty 2/5