Medicare Flashcards
1
Q
Who qualifies for Medicare?
A
- Anyone > 65
- Disabled + ESRD
2
Q
Who qualifies for Medicaid?
A
- low income
- disabled
- individuals in long term care
3
Q
Source of funding for Medicare
A
- Federally-run
- Publicly funded
- Contributions via payroll taxes are made during the years of employment.
4
Q
Source of funding for Medicaid
A
federal/state cost sharing
5
Q
How is short SNF paid for?
A
- Medicare 1st 100 days
6
Q
How is long SNF paid for?
A
- Medicaid (can after spend down)
7
Q
Medicare Part A is?
A
Inpatient service
8
Q
Medicare Part B is?
A
Outpatient service
9
Q
Medicare Part C is?
A
Medicare Advantage
10
Q
Medicare Part D is?
A
Prescription drug coverage
11
Q
How long of inpatient does part A pays for?
A
- first 60 days
- hospital paid a fixed amount regardless of LOS
- Does not pay for long term custodial care
12
Q
T of F? Long-term SNF care is not paid by Medicare
A
T
13
Q
Does part A pays for rehab?
A
- only if hospitalized for 3 midnights
- first 20 days: 100% coverage
- 21-100: co-pay required
- > 100 days: none
14
Q
How does part C work?
A
- government pays an insurance organization to manage Part C
- Combines Part A + Part B with some additional coverage
15
Q
How does part D work?
A
- optional Rx plan
- Average monthly premium $31
- Plans vary in what drugs are covered
