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Medicare Part A - D
Medicare Part A - D pharm tech
| Medicare Part A - D | Medicare Part A - D |
|---|---|
| Medicare Part A | Inpatient care (hospital stay, skilled nursing facilities, hospice, and some home health care) |
| Medicare Part A | patients who are eligible for Social Securtiy benefits are automatically enrolled in Medicare Part A |
| Medicare Part B | Pays for doctor visits, certain injections, diabetes testing, durable medical equipment, chemotherapy, physical and occupational therapists, and diabetes supplies (not insulin); coverage is optional and most people pay a monthly premium |
| Medicare Part B | Part B will cover drug costs essential to the use of DME like albuterol for nebulizers |
| Medicare Part B | covers blood glucose testing strips, heparin for home dialysis, lancets |
| tech note | if a patient has Medicare Part B, the technician should ask the patient for the most current card at each visit. Some states require Part B to be renewed monthly, so it is important to verify that it is not expired |
| Medicare Part C | Also called a Medicare Advantage Plan, offered by a private company that contracts with Medicare to provide all of Part A and Part B benefits; is is a private plan that uses Medicare and must be equivalent to coverage provided by Parts A and B. Some Part C plans cover certain prescription drugs. A person should have either Part C or Medigap because the two are not cumulative in coverage |
| Medicare Part D | Pays for prescription drug coverage; covers outpatient prescription drugs exclusively through private plans or through Medicare Advantage plans that offer prescription drugs; patient pays a monthly premium and may have an annual deductible. After maximum benefit has been reached, there is a gap in the coverage of drug costs and the patient must pay for prescriptions out of pocket |
| Medicare Part D | covers medications, insulin, vaccines, and certain medical supplies |
| donut hole | most Medicare prescription plans have a coverage gap known as the donut hole meaning there is a limit to how much a particular plan covers for drugs |
| Medigap | supplemental insurance provided by private insurance companies to help cover costs not reimbursed by the Medicare plan such as copays, deductibles, or coinsurance; regulated by federal government |
| Medigap | intended to fill the gap in the Medicare program coverage of Medicare Parts A, B, and D; twelve different Medigap policies labeled A - L; can't use Medigap with Medicare Part C; Medicare is primary payer and Medigap is secondary |
| Medigap | some states offer Medicare SELECT which require participants to use specific hospitals and providers for full coverage; works similar to a HMO |
Created by:
DbaileyC
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