Insurance Planning (2024) Flashcards
Medicare Part A
Part A is paid for by a portion of the Social Security tax.
• Services covered include: hospital, skilled nursing, home health care, and hospice.
• A benefit period begins on the first day a patient receives services and ends after 60 consecutive days of no further hospital stays, skilled nursing care or rehabilitation services. There is no limit to number of benefit periods per individual.
• Deductible of $1,632 (2024) / benefit period.
• Coinsurance (insured pays).
• $408 (2024) / day for days 61 - 90 / benefit period
• $816 (2024) / day for days 91 - 150
(lifetime reserve days)
• Skilled nursing facility coinsurance.
• $204 (2024) / day for days 21 - 100 / benefit period
• Medical equipment coinsurance of 20%.
• Services not covered are custodial care services. Custodial care services include a nursing care facility that provides assistance with activities of daily living, such as eating, bathing and dressing.
Medicare Part B
Persons with Part A coverage can elect Part B coverage as well.
Premiums are paid by the insured ($174.70 (2024) / month or more depending on income).
• Services include:
• Doctor’s services
• Ambulance transportation
• Diagnostic tests
• Outpatient therapy
• Home health care
• Clinical research
• Durable medical equipment (wheel chairs, hospital beds, walkers, oxygen)
• Mental health (inpatient, outpatient, partial hospitalization)
• The deductible is $240 (2024) / year with a coinsurance of 20%.
• Part B does not cover: dental care, cosmetic surgery, hearing aids, and eye exams.
• Note: There’s a high probability of a question coming from what is not covered.
Common disaster clause
Provides for policy disposition in the event of a common death of the insured and primary beneficiary
Collateral source rule
The person who commits the tort will not benefit or be relieved, obligation, and responsibility just because the victim has insurance
Conditional receipt
Gives an insurance company window of time and which they can ultimately issue or refuse to approve the policy.
During this time, the applicant relief insurance contract dies, the company will pay a death benefit.if the policy would’ve been issued.
