Medicare/Medicaid Flashcards
Is US insurance voluntary
yes
copayment
dollar amount paid per service
coinsurance
ratio of cost sharing
cost sharing reduces…
moral hazard
Program inclusive care for the elderly (PACE)
community-based care for 55 years and older who qualify for nursing home placement
state children’s health insurance program (SCHIP)
covers uninsured children of families that do no qualify for traditional medicaid coverage, however make too little income to purchase traditional marketplace insurance
department of veteran administration insurance
healthcare for active duty and retirees, their dependents and survivors
Tri-care
a civilian health and medical program of the uniform services
indian health service
comprehensive care to native americans living on reservations and in rural areas
T or F: IHS operates its own hospitals, health centers, and health stations
T
there is a “soft” cap of $______ a year for all PT settings. how do you get past it
2150
you check the K-X modifier box if you documentation shows more care is medically needed
medicare is a federal ______ program while medicaid is a federal and state ______ program
insurance
assistance
do pts on medicare or medicaid pay more
medicare
medicare/medicaid was created in what year
1965
What does MedPAC do
advisor committee that analyzes policies
By 2024, medicare is expected to cover how musch of the entire pop
1/5
b/c of baby boomers
medi-gap
selection of 10 plans that cover out of pocket expenses regarding deductibles, copays, coinsurance
the donut hole
medicare part D coverage gap
have to pay you med costs if it is between 2800-4550
medicare does not cover…
vision, dentures, routine foot care, routine physicals
medicare is title ___ of social security act and medicaid is title _____
18
19
charge/rate
set fee for a servicec
charge
price set by provider
rate
price set by third-party payer
fee schedule
an index of charges listing individual fees for each type of service
