Chapter 7 Part 3 Flashcards
Medicare adv is also known as
Medicare part c
Medicare part d
Medicare part a
Medicare part c
All of the following are advantages of an hmo or ppo for a Medicare recipient except
There are no claims forms required
Elective cosmetic procedures are covered
Prescriptions might be covered unlike Medicare
Healthcare costs can be budgeted
Elective cosmetic procedures are covered
Which is NOT correct re Medicare
Medicare a provides hospital care
Medicare b provides physician services
Medicare advantage must be provided through HMO
Medicare advantage must be provided through hmo
To be eligible for Medicare advantage beneficiaries must also be enrolled in
All plans
Consideration plan
Medicare part c
Medicare parts a and b
Medicare part a and b
Health maintenance program aka
PPO preferred provider organization
Medicare adv plan offered by a private insurance company
Medicare private fee for service plan
PPO
Special needs plan
Medicare private fee for service plan
Medicare pays a set amount of money every month to the what to provide health care coverage in a private fee for service plan
Hmo
Ppo
Private ins company
Private ins company
More focused and specialized health care fo specific groups of ppl such as who have both Medicare and medicaid who reside in nursing home or have certain chronic medical conditions
Freedom plan
Catastrophic plan
Special needsplan
Special needs plan
What was passed to add part d prescription drug benefit to standard Medicare coverages
Stand alone plan
Integrated plan
Medicare prescription drug improvement and modernization act of 2003
Medicare prescription drug improvement and modernization act of 2003
Once this amount is reached by beneficiary and their plan combined on drugs (including deductible) beneficiary will pay no more than 25% of cost for prescription drugs until their out of pocket spending is reached
4660
Out of pocket spending for drug benefit plan
7400
Once beneficiary has reached their out of pocket spending on drug benefit program what begins automatically
Primary Medicare
Secondary Medicare
Catastrophic coverage
Catastrophic coverage
Catastrophic =
95%
For individual eligible for Medicare at age 65, who is still employed and covered under employer’s plan, which is true
Plan is primary coverage and Medicare is secondary coverage
Employer plan is secondary coverage and Medicare is primary coverage
Employer plan is discontinued and Medicare is primary coverage
Employer plan is primary coverage and Medicare is secondary coverage
Medicare is part of health insurance market place which is key component of affordable care act that allows qualified individual families and employees of small businesses to obtain health ins
True or false
False
When considered eligible for Medicare part a person will not qualify for marketplace tax credits to help pay for premiums or reductions in
Cost sharing
Premium
Catastrophic
Cost sharing
Which is not covered under medical ins plan a
Medicare part a deductible
First tree pints of blood each year
Approved hospital costs for 365 additional days after Medicare benefits end
Medicare part a deductible
Provides core or basic benefits established by law
Medicare supplement plan a
Omnibus budget reconciliation act of 1990
Globe life
Medicare supplement plan a
