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# BAS Medicare

# BAS Medicare Terms

Medicare Comprehensive Federal Insurance Program
Medicare is intended as financial assistance for only 65 and older. False. Certain disabilites qualify for Medicare
ESRD stands for: End Stage Renal Disease
Kidney Disorders that require transplant or dialysis qualify for medicare TRUE
Medicare is administered by The Center for Medicare and Medicaid Services.
HCFA is the older acronym for CMS TRUE
CMS is a division of DHHS TRUE
DHHS staNDS FOR Department of Health and Human Services
Medicare is enacted by laws established by Congress TRUE
Medicare A requires no premiums TRUE
Medicare programs are funded by: * Premiums * Deductibles * Coinsurance
Medicare Part A is insurance for: Hospital insurance
Medicare part B is insurance for: Medical Services at clinics, outpatient clinics, doctor offices
Medicare Part C is insurance for: Medical services through a managed care plan.
Medicare Part D is insurance for: Prescription Drugs
You are a patient in a SNF facility. This would be covered by: Medicare Part A
SNF is Skilled Nursing Facility Rehabilitation for individuals who have the potential to function independently after a limited period of care. A multidisciplinary team guides health care and rehabilitative services, including skilled nursing care.
Medicare Part A covers: Inpatient Hospital Care Inpatient Care in a SNF Home Healthcare Hospice Care
Medicare reimbursement requires: The medical service must be medically necessary
Medically Necessary means: The medical service is reasonable. The service is necessary for Dx or Tx The service is necessary to improve functioning of a body part.
To be eligible for medicare part A: Eligible for: social security benefits Based on wage deduction if Medicare is withheld
If you do not qualify for Medicare part A you cannot receive it. FALSE: You can still get it but you need to pay a premium
Medicare Part B requires payment of a premium. TRUE
Medicare Part B helps pay for: Doctor Services Outpatient Hospital expenses DME (if reusable and if used in the home)
The Part B premium can be deducted from the person's social security check. TRUE.
When should a person enroll in Medicare A few month before the age of 65
A person that does not sign up for Medicare B at the time they enroll in Medicare A will... 1. Have premiums increased for each 12 months that they don't enroll. 2. Have no penalties if they are working and have a health insurance plan.
Medicare Part B has an annual deductible TRUE
Medicare Part B pays: 80% of allowable charges after the deductible is paid.
Medicare Part C is also called: Medicare Advantage (MA) plan.
Medicare Part C plans can include: PPOs PSOs PFFS
Medicare Part C includes both Part A and Part B coverage and additional services like: Preventive Care Prescription Drugs Eyeglasses Dental Care Hearing Aids
Medicare Part D covers prescription drugs TRUE
Premiums for Medicare Part D are deducted from the social security check TRUE
There is an initial deductible of $250 for medicare part D TRUE
Medicare part D pays for 75% of all amounts over $250 and up to $2000 total.
Medicare Part D has a gap in coverage beyond $2250 for the next $3600. This is called the: Donut Hole
Created by: rjmtoss