Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
INSUR {CBCS-CPC}
Medicare
| Term | Definition |
|---|---|
| Medicare | 100 percent federally funded health plan that covers people who are SIXTY-FIVE and over and those who regardless of age have ESRD |
| CMS | agency that runs Medicare, Medicaid, clinical laboratories, and other government health programs |
| Number of Medicare beneficiary categories | SIX |
| Defined benefits program | an item or service must be in a benefit category established by law and not otherwise excluded |
| Medicare beneficiary categories | 1) individuals aged 65 or older 2) disabled adults 3) individuals disabled before age 18 4) spouses of entitled individuals 5) retired federal employees enrolled in the Civil Service Retirement System (CSRS) 6) individuals with end-stage renal disease (ESRD) |
| ESRD | end-stage renal disease |
| Medicare Part A | Hospital Insurance (HI) |
| Medicare Part A | 1) inpatient hospital care 2) skilled nursing 3) facility care 4) skilled home healthcare 5) hospice care |
| Medicare Part A | SSA automatically enrolls anyone who receives SS benefits |
| Medicare Part A | Eligible beneficiaries do not pay premiums |
| Medicare Part A | individuals aged 65 or older who are not eligible for SS benefits may in enroll, but THEY MUST pay premiums for the coverage |
| Medicare Part B | Supplementary Medical Insurance (SMI) |
| Medicare Part B | helps beneficiaries pay for physician services, outpatient hospital services, medical equipment, and other supplies and services |
| Medicare Part B | a voluntary program; eligible persons choose whether to take part in it |
| Medicare Part B | must enroll; coverage is not automatic |
| Medicare Part B | individuals entitled to Part A benefits are automatically qualified to enroll |
| Medicare Part B | US citizens and permanent residents over the age of 65 are also eligible |
| Medicare Part B | Beneficiaries pay a monthly premium that is calculated based on SS benefit rates |
| Medicare Part B two basic types of plans | the Original Medicare Plan and Medicare Advantage Plan |
| Medicare Part C | became available to individuals in 1997 who are eligible for Part A and enrolled in Part B |
| Medicare Part C | originally called Medicare + Choice |
| Medicare Part C | Private health insurance companies contract with CMS to offer Medicare beneficiaries plans that compete with the Original Medicare plan |
| Medicare Part C | under the Medicare Modernization Act, or MMA, certain rules were changed to give enrollees better benefits and lower costs |
Created by:
VA_MedCod3r