Medicare Flashcards
Medicare Part A
Inpatient hospital care
Skilled nursing care following a covered hospital stay
Home health care
Hospice
Covers meals, operating/recovery room, lab tests, X-ray
Does NOT cover custodial services
Medicare A: Benefits Period?
- Benefits begin 1st day in hospital and end after 60 days of no further skilled care
Medicare A: Deductibles?
$1,600 per benefit period, 1st 60 days
Medicare A: Coinsurance
$400 per day for days 61-90
$800 per day for 91-150
$200 Skilled nursing care days 21-100
- First 20 days following a covered hospital stay are covered 100%
Medicare B: what’s it cover?
- Pays 80% approved charges
- Doc visits, lab test, clinic research, durable medical equipment (wheelchair, hospital bed, walkers, oxygen), mental health, getting 2nd opinion before surgery
Medicare B: Not Cover?
- Dental Care
- Cosmetic surgery
- Hearing aids
- Eye Exams
- Routine physical exams
Medicare B: How do you pay for it?
Deductibles deducted from SS
(standard rate is $164.90, could be higher based on income)
Deductible is $226/year
- after deductible, it covers 80%
Medicare B: How do you enroll?
Automatically enrolled unless you opt out
Medicare C: Who can join?
Must have part A & B and live in plan’s service area to be eligible
Medicare C: How much is cost?
In addition to Part B premium, you usually pay 1 monthly premium for services included
Medicare C: What is it’s other name?
Medicare Advantage or Medicare Managed Care Plan
Medicare C: What’s it cover?
Emergency & Urgent care
(Must offer it outside plan’s service area but not out of US)
Can also offer dental, eyeglasses, wellness programs
Most also include prescription drug coverage (Part D)
Medicare D: What is it and what are payment plans?
Covers prescription drugs
Usually has monthly premium, deductible and coinsurance amount
