Ch 9: Review Test (Part 1) Flashcards
Conquering Medicare's Challenges
Medicare provides financial assistance with medical expenses to what three groups?
- People older than 65
- People with ESRD
- People younger than 65 with certain disabilities
Medicare requires its beneficiaries to pay premiums, deductibles, and coinsurance, which is referred to as ____?
Cost sharing
Medicare Part A, the hospital insurance part of Medicare, if funded through ____?
- Taxes withheld from employees’ wages
- Contributions paid by employers
Coverage requirements under Medicare state that for a service to be covered, it must be considered ____?
Medically necessary
Part A coverage is available free of charge to Medicare beneficiaries age 65 or older who ____?
Are eligible to receive monthly Social Security benefits
Private insurance companies that serve as the federal government’s agents in the administration of the Medicare program, including the payment of claims, are called ____?
Medicare Administrative Contractors (MACs)
Medicare Part B helps pay for what?
Medically necessary physicians’ services
Medicare pays ____% of allowable charges after the annual deductible is met
80%
The ____ is the duration of time during which a Medicare beneficiary is eligible for Part A benefits for services incurred in a hospital and/or skilled nursing facility (SNF)
Benefit period
Managed healthcare plans that offer regular Part A and Part B Medicare coverage and additional coverage for certain other services are called ____?
Medicare Part C
The Medicare prescription drug coverage plan is called ____?
Medicare Part D
In Medicare Part D, individual plans (such as group health insurance plans that offer varying benefits) must offer no less than the standard Medicare benefit, referred to as _____?
Credible coverage
An individual qualifying for both Medicare and Medicaid benefits is referred to as a ____?
Dual eligible
