Soecialized Insurance For Qualified Indivi Flashcards
What is Medicare ?
Federal Med Expense ins program for people age 65 even if they work
How to qualify for Medicare?
65+ years
Entitled to Social Security Coverage 2 years
End stage Renal Failure ESRD
What are the 4 parts of Medicare ?
Part A Hospital Insurance:
Part B Medical Insurance:
Part C Medicare Advantage
Part D Prescription Drugs
Part A Hospital Ins is financed how ?
Federal Govt
Portion of payroll tax FICA
Part B Medical Insurance is funded by?
Monthly premiums paid by insureds
Gen funds of federal govt
Part C financed through who?
Provider organizations
Part D is for ?
Prescription drugs
Original Medicare refers to ? Doesn’t require? Doesn’t cover ?
Part A & B
To have a PCP
Prescription drugs
Ambulatory Surgical Services
Surgical services don’t require inpatient sta, ambulatory center
Names of Part A v Part B
A: Hospital insurance
B: Medical insurance
Part A pays for ?
Inpatient hospital care
Inpatient care in skilled nurse facility
Home health care
Hospice care
Eligibility for Medicare Part A include ?
65+ and social security
Under 65 entitled to social security 24 months
Has End Stage Renal Disease
Has ALS
What’s mean by fully insured? Part A ?
40 quarters 10 years
Medicare Initial enrollment period ?
3 months before 65 , first eligible
When is general enrollment for part A?
Jan 1 - March 31
Part A Special enrollment period ?
Anytime if still employed
If fail to sign up for Part A when first eligible, what is the consequence?
Premium up 10%
Inpatient Hospital Care pays for how long ?
90 Days
First 60 100% after deduct
Next 30 daily copayment
Skilled Nursing Facility Care pays for how long ?
100 Days
Home Health Care is what ?
Care in the house by skilled nurse
Phys therapy
Speech therapy
Hospice Care includes ?
Doctor services
Nursing
Medical appliances
Supplies: outpatient drugs
Which part of Medicare covers Outpatient care ?
Outpatient hospital care
Part B does
Medicare Part B purpose
Pays for doctor services and med services not covered under A