In some states, a spend-down program requires that individuals must spend a portion of their income or resources each month on medical expenses before:
a. Medicare begins paying for services.
b. Medicaid begins paying for services.
c. a deductible is paid

A copayment may NOT be collected from a Medicaid patient for:

Under TRICARE, what does NAS stand for?

The Black Lung Benefits Reform Act provides benefits to current coal mine employees as well as payments to surviving dependents of deceased workers.

Medicare's policy on proper and accurate coding is called the National Correct Coding Initiative (NCCI).

A spouse of a deceased, retired, or disabled individual who was or is eligible for Medicare benefits:
a. is not eligible for Medicare coverage.
b. is also eligible for Medicare coverage.
c. must apply for Medicaid benefits.
d. is eligible for Supplemental

The Medicare coverage that pays for physician services is:

If a beneficiary has both TRICARE Senior Prime/TFL and Medicare, which insurance is primary

Employers can obtain workers' compensation insurance policies through Federal Programs.

A workers' compensation claim will be paid by the carrier even if no case number is assigned.

Medicare prescription drug coverage is offered through:

For a service to be considered medically necessary by Medicare, which of the following criteria must be met?
a. It is delivered at the most appropriate level.
b. It is an elective procedure.
c. It is an investigational procedure.
d. It is performed for th

Under TRICARE, what does MTF stand for?

An injured worker may sue his or her employer after receiving workers' compensation benefits.

Ombudsmen can help present facts and evidence at dispute-resolution proceedings but cannot give legal advice in a workers' compensation case.

An additional health insurance policy sold by a private carrier that provides limited coverage for services that Medicare does NOT cover is known as a:

The Medicare coverage that consists of hospital insurance is:

The TRICARE plan with the lowest out-of-pocket costs is:

If a worker failed to obey safety procedures and was injured on the job, he or she would be eligible for workers' compensation.

If a claim is denied by Medicaid because prior authorization was NOT obtained, the physician can bill the patient for the services.

States may pay for Medicaid services on a fee-for-service basis or:
a. based on the Medicare fee schedule.
b. through contracts with managed care organizations.
c. using a scale based on the beneficiary's annual income.
d. through a per-diem rate.

Services that are NOT covered by Medicare Part A or Part B include:
a. acupuncture.
b. dental care.
c. routine eye care.
d. all of the above.

TRICARE beneficiaries older than age 65 are eligible for TRICARE for Life if they have:

Ombudsmen can provide legal advice to the injured worker.

Providers participating in Medicaid must accept the Medicaid payment rate as payment in full and cannot balance-bill the patient.