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18 Cards in this Set
- Front
- Back
Who is eligible for medicare
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65+ regardless of working or not
anyone who has been on S.S. disablility for 2 years or with chronic kidney disease. |
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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 |
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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 |
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Skilled Nursing Care
under part A. of medicare |
-100 days, first 20 paid for w/o copayment
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Part B:
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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. |
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Basic core benefits of Medigap
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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%) |
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Plan B medigap
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core
medicare part a deductible |
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Plan C
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core,
part a deduct, skilled nursing facility coinsurance, part b deduct, foreign travel benefit, |
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Plan D
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Core Benefit,
Part A Deduct, skilled nursing facility coinsurance, foreign travel benefit, at home recovery benefit |
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Plan E
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Part A Deduct,
skilled nursing facility coinsurance, foreign travel benefit, preventive services |
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Plan F
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core,
part a deduct, skilled nursing facility coinsurance, part b deduct, 100% part b excess charges, foreign travel benefit |
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Plan G
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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 |
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Plan H
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core,
part a deduct, skilled nursing facility coinsurance, part b deduct, basic perscription drug benefit, foreign travel benefit |
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Plan I
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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 |
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Plan J
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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 |
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open enrollment period
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medicare supplement cannot be denied ont he basis of an applicant's health status, claims experience, med condition during the first 6 months.
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medicaid
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$90,000
$3000 |
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ADL: 2/7 must be unperformable
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mobility, bathing, dressing, toileting, transferring, continence, eating.
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