# BAS Medicare Terms
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
Help!
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| Medicare | Comprehensive Federal Insurance Program
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| Medicare is intended as financial assistance for only 65 and older. | False.
Certain disabilites qualify for Medicare
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| ESRD stands for: | End Stage Renal Disease
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| Kidney Disorders that require transplant or dialysis qualify for medicare | TRUE
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| Medicare is administered by | The Center for Medicare and Medicaid Services.
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| HCFA is the older acronym for CMS | TRUE
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| CMS is a division of DHHS | TRUE
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| DHHS staNDS FOR | Department of Health and Human Services
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| Medicare is enacted by laws established by Congress | TRUE
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| Medicare A requires no premiums | TRUE
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| Medicare programs are funded by: | * Premiums
* Deductibles
* Coinsurance
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| Medicare Part A is insurance for: | Hospital insurance
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| Medicare part B is insurance for: | Medical Services at clinics, outpatient clinics, doctor offices
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| Medicare Part C is insurance for: | Medical services through a managed care plan.
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| Medicare Part D is insurance for: | Prescription Drugs
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| You are a patient in a SNF facility. This would be covered by: | Medicare Part A
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| 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.
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| Medicare Part A covers: | Inpatient Hospital Care
Inpatient Care in a SNF
Home Healthcare
Hospice Care
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| Medicare reimbursement requires: | The medical service must be medically necessary
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| 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.
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| To be eligible for medicare part A: | Eligible for:
social security benefits
Based on wage deduction if Medicare is withheld
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| 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
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| Medicare Part B requires payment of a premium. | TRUE
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| Medicare Part B helps pay for: | Doctor Services
Outpatient Hospital expenses
DME (if reusable and if used in the home)
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| The Part B premium can be deducted from the person's social security check. | TRUE.
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| When should a person enroll in Medicare | A few month before the age of 65
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| 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.
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| Medicare Part B has an annual deductible | TRUE
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| Medicare Part B pays: | 80% of allowable charges after the deductible is paid.
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| Medicare Part C is also called: | Medicare Advantage (MA) plan.
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| Medicare Part C plans can include: | PPOs
PSOs
PFFS
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| Medicare Part C includes both Part A and Part B coverage and additional services like: | Preventive Care
Prescription Drugs
Eyeglasses
Dental Care
Hearing Aids
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| Medicare Part D covers prescription drugs | TRUE
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| Premiums for Medicare Part D are deducted from the social security check | TRUE
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| There is an initial deductible of $250 for medicare part D | TRUE
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| Medicare part D pays for | 75% of all amounts over $250 and up to $2000 total.
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| Medicare Part D has a gap in coverage beyond $2250 for the next $3600. This is called the: | Donut Hole
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