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18 Cards in this Set

  • Front
  • Back
Who is eligible for medicare
65+ regardless of working or not
anyone who has been on S.S. disablility for 2 years
or with chronic kidney disease.
four parts of medicare:
A.
B.
C.
D.
A. hospital insurance, portion of payroll tax
B. Medical insurance, monthly premiums + govt. revenue
C. All health care services through available provider
D. perscription drug coverage
Inpatient Hospital care
under part A. of medicare
-90 days, 60 free, next 30 copayment
-all but first 3 pints of blood, and other stuff including preperatory surgery for kidney transplant

-Not include: private duty nursing, tv/telephone, private room unless necessary

190 days in a life time of mental hospital care
Skilled Nursing Care
under part A. of medicare
-100 days, first 20 paid for w/o copayment
Part B:
pays for services from doctors
-annual deductible of $124
-covers out patient services
-does not cover: private duty nursing, skilled nursing home care costs over 100days, intermediate nursing home care, physician charges above medicare's approved amount, most outpatient perscription drungs, care outside U.S., custodial care recieved in home, dental care (non accident), cosmetic surgury, eyeglasses, hearing aids, shoes, acupuncture, expenses during act of war.
Basic core benefits of Medigap
Approved hospital costs for copyments for days 61-90, approved hospital costs for the co-payments for lifetime reserve days 91-150
-approved hospital costs for an additional 365 days after all medicare benefits are used.
-charges for first 3 pints of blood
-part B coinsurance amount (20%)
Plan B medigap
core
medicare part a deductible
Plan C
core,
part a deduct,
skilled nursing facility coinsurance,
part b deduct,
foreign travel benefit,
Plan D
Core Benefit,
Part A Deduct,
skilled nursing facility coinsurance,
foreign travel benefit,
at home recovery benefit
Plan E
Part A Deduct,
skilled nursing facility coinsurance,
foreign travel benefit,
preventive services
Plan F
core,
part a deduct,
skilled nursing facility coinsurance,
part b deduct,
100% part b excess charges,
foreign travel benefit
Plan G
Core,
Part A Deduct,
skilled nursing facility coinsurance,
foreign travel benefit,
80% part B excess charge,
at home recovery benefit,
must pay for activities of daily living (ADL) that medicare doesn't cover
Plan H
core,
part a deduct,
skilled nursing facility coinsurance,
part b deduct,
basic perscription drug benefit,
foreign travel benefit
Plan I
Core benefits,
Part A deductible,
skilled nursing facility coinsurance,
100% medicare part b excess charges,
foreign travel benefit,
at home recovery, basic persription drug benefit
Plan J
Core benefit, Medicare Part A deductible, Skilled nursing facility coinsurance, Medicare Part B deductible, 100% of the medicare Part B excess charges,
foreign travel benefit, at home recovery benefit, extended prescription drug benefit, preventive services
open enrollment period
medicare supplement cannot be denied ont he basis of an applicant's health status, claims experience, med condition during the first 6 months.
medicaid
$90,000
$3000
ADL: 2/7 must be unperformable
mobility, bathing, dressing, toileting, transferring, continence, eating.