Test 2 Medicare Flashcards
1
Q
Who is medicare for?
A
- those who pay social security and are 65 and older
- some pts with disability under 65, some end stage renal disease patients
2
Q
Part A
A
- Hospital insurance skilled nursing facility - hospice care - some limited home health care - Automatic eligibility - for non-SS people, can buy into the system but has late enrollment policy
3
Q
Part B
A
- Supplemental-physician insurance, voluntary
- income adjusted monthly premium
- late fee of 10% penalty for each 12 months that you don’t apply
- pt pays 20% of coinsurance
4
Q
Part C
A
- Medicare advantage offered by private insurance companies
- aka Medigap
- cost as much as part B premium
- have to sign up for part B to sign up for part C
5
Q
Part D
A
- Prescription drug insurance, voluntary
- eligible if you have part A
- ## must apply within 2 months of eligibility to avoid late fee
6
Q
define benefit period
A
- begins day you go to a hospital or SNF
- ends when have not received any hospital or SNF care for 60 days in a row
- deductibles are for each benefit period
7
Q
Part A Hospital Stay
A
- deductible for first 60 days
- days 61-90, pay $X amount per day
- over 90d, pay $X amount per lifetime reserve day (can have 60 over lifetime)
8
Q
Part A Skilled Nursing Facility
A
- pt doesn’t pay for day 1-20
- 21-100 days pay $164 per day
- day 101 and over, pt pays all costs
9
Q
Low Income Patients
A
_ <= 135% FPL: No premiums, deductible, gap in coverage
- 136-150% FPL: Plan benefits on a sliding scale