Medicare & Medicaid Rules Flashcards
Medicare Part A
Is part of title 18, and cover inpatient services- Hospital stays, Skilled care, 80% of HHC.
People age 65+ automatically get _____
Medicare Part A at no premium
First ____ are co-pay free.
Days ___ to ___ have a ____ percent copay
20 days, 21-100, 20%
____ Days to be eligible for another 100 days.
60 days
Medicare Part B
Outpatient Services. Has monthly premium, covers HHC at 100%
Medicare Part B doesn’t cover ______ Care
Custodial
Medicare Part D
Prescription drugs
Medicaid Title 19
Income limit $1,860, Asset limit of $2,000, 5 Year look back period.
Bed Certification
Beds are either medicaid or medicare certified or dully certified for either medicaid or medicare.
How many times a year can you change your bed certification?
2 times a year.
When are cost reports due to medicaid?
within 90 days of the end of the facility fiscal or calendar year.
What is the cost reports used for by medicaid?
Used to determine your medicaid rate.
PASSR
Pre-admission and Pre-Screening
Why is a PASSR done?
To evaluate new admissions. it checks mental illness/ mental retardation, and he need for 24 hour care. This qualifies patients for LTC paid for by medicaid
CUSTODIAL CARE OR INTERMEDIATE
care involves observing an individual and monitoring nutritional intake and hydration, assist with activities of daily living and administer medications
