3 - Medicare Part B Flashcards
Medicare’s Medical Insurance is a _______ program.
-Voluntary
Medicare Part B has an annual deductible for 2018 of _____ which must be met before Medicare Part B pays.
-$183
Medicare Part B also has a ________ blood deductible coordinated with Medicare Part A.
-3 pint annual
Medicare Part B will generally pay ____ of Medicare “approved charges.”
-80%
Physicians and Suppliers that do not accept assignment are referred to as nonparticipating and may charge an _______ above the Medicare Part B approved amount.
-excess amount of 15%
Any physician who provides services that the physician knows or has reason to believe Medicare will determine to be medically unnecessary and will not pay is required to provide the Medicare Beneficiary with a document called an ______________).
-Advance Beneficiary Notice (ABN)
The typical Medicare Beneficiary participating in Medicare Part B pays _____ of the cost of his or her Medicare Part B premium.
-25%
In 2018, the standard Part B premium amount will be ______.
-$134
Failure to enroll (or continue enrollment) in Medicare Part B during the Initial Enrollment Period will result in an additional ______ of premium for each full ______ delayed enrollment from the end of the individual’s Initial Enrollment Period (IEP)
- 10%
- 12 months
Medicare will pay for mental health services with a _____ coinsurance for outpatient services and _____ coinsurance for inpatient services.
- 40%
- 20%
During the first twelve (12) months that a Medicare Beneficiary has Medicare Part B, he or she can get a ________ preventive care visit.
-“Welcome to Medicare”
Yearly Wellness exams are provided if the Medicare Beneficiary has Medicare Part B for longer than ______. There is no charge for this exam if the physician accepts assignment. This exam is covered once every twelve ______.
- 12 months
- 12 months
Individuals enrolling in Medicare Part B during 2018, not eligible for a special enrollment period, and earning up to ___________ will have a monthly premium of $134.00.
-$85,000
Medicare Part B has an annual deductible of ______ in 2018
-$183
Physicians who accept assignment of a Medicare Part B claim are referred to as:
-Participating Physicians
Typically a Medicare Part B Beneficiary is paying in premiums what percentage of the premium cost of his or her Medicare Part B program with the rest subsidized by the government?
-25%
The Medicare Part B enrollee pays approximately _______ of the cost of his or her Medicare program.
-25%
A Medicare Beneficiary eligible for Medicare Part B will have what penalty assessed if he or she waits 36 months beyond the end of his or her Initial Enrollment Period (IEP)?
-a permanent 30% additional premium over the current monthly rate
The Medicare Part B coinsurance percentage paid by Medicare is generally which of the following:
-80%
A physician that knows that Medicare Part B will not pay for a service must provide the Medicare Beneficiary with a _______________.
-Advance Beneficiary Notice (ABN)
Yearly “Wellness” exams are provided if the Medicare Beneficiary has Medicare Part B for longer than ___.
-12 months
The annual blood “deductible” under Medicare Part B is:
-3 pints
When a Medicare Beneficiary goes to a Physician that does not accept “assignment” or the “limiting charge” for Medicare approved charges, the beneficiary may enter into a ________ with the doctor for his services.
-Private Contract
Nonparticipating physicians may charge _________ of the charges approved by Medicare Part B.
-115%
Medicare Part B uses the term “__________” to determine what items the Medicare Part B program should provide.
-Medically Necessary
The “notice” sent to a Medicare Part B claimant explaining how the claim was settled is called a:
-Medicare Summary Notice
The maximum allowable Medicare Part B “excess charge” by participating physicians is:
-Participating Physicians cannot receive excess charge payments
