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15 Cards in this Set
- Front
- Back
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Who is medicare provided to?
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Americans 65+, disabled or suffering end-stage renal disease
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What does medicare cover?
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~80%; coinsurance 20%
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What are the 3 options for physicians to choose from in the FFS medicare program?
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Participation
Non-participation Private contracting |
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What does medicare part A cover?
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hospital insurance
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When are people eligible for medicare part A?
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If they have payed the Medicare tax for at least 10 years, others can pay monthly premium that is dependent on how long taxes were paid
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What does medicare part B cover?
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medical insurance
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When are people eligible for medicare part B?
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age 65 if they are entitled to part A
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What does medicare part D cover?
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prescription drugs
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How much of prescriptions are covered by medicare part D?
Also know as the "donut hole" |
75% of drug costs up to a specified amount ($2930 in 2012)
No coverage for drug costs exceeding this amount After a specified maximum ($4700 in 2012) medicare covers 95% |
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What is medicare part C?
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advantage plans:
HMO- health maintenance organizations PPO- preferred provider organizations PSO- provider sponsored organizations Private FFS plans |
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What is medicaid?
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health insurance to people of all ages who have low incomes and limited savings (vary considerably from state to state)
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What is Medigap?
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supplemental insurance plans that cover medicare A and B deductibles and co-insurance costs
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What are long-term care insurance?
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these policies pay for less than 2% of all nursing home care
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What specifically does Medicare Part A cover?
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hospital, skilled nursing home, home-health and hospice
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What specifically does Medicare B cover?
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physicians, PAs, NPs, social workers, psychologists, therapists, lab tests and durable medical equipment
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