Chapter 7: Social Security, Medicare, and Other Government Programs – Flashcards
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OASDHI
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The Old Age, Survivor, Disability, and Health Insurance program of the federal government. This program consists of social security and medicare
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Fully Insured
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Insured status under SS. This requires 1. 40 Credits (10 Years) 2. At least as many credits as there are years elapsing after 1059, and the year in which a person dies, becomes disabled, or reaches age 62, whichever comes first.
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Currently Insured
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Insured status under SS that requires a person to have at least 6 credits during the 13 calendar quarters ending with the quarter in which death occurs.
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Disability Insured
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Necessary to receive benefit 1. Fully Insured & 2. Have had a minimum amount of work under SS within a recent period
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Full Retirement Age
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The age at which a worker can retire under SS and receive non-reduced benefits equal to his or her primary insurance amount (PIA). Also Normal Retirement Age
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PIA
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Primary Insurance Amount Amount a worker will receive under SS if he retires at full retirement age or becomes disabled. The amount on which all other SS income benefits are based
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Earnings Test
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Process for determining whether income benefits of SS beneficiaries under the full retirement age should be reduced because of earned income that exceeds a specified amount that is subject o annual indexing
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Social Security Statement
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An annual statement automatically issued by the SSA that enables an employee to verify his or her contributions to the SS and Medicare Programs. The statement also contains an estimate of benefits that will be available because of retirement, disability, or death.
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Medicare Part A (@)
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Provides benefits for expenses incurred in hospitals, skilled nursing facilities, and hospices
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Medicare Part B
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Benefits for most medical expenses not covered under part A
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Original Medicare
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Used to describe the traditional Medicare Parts A & B
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Medicare Advantage
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Part C of Medicare program, previously medicare choice, that allows beneficiaries to select HMOs and other alternative to the traditional Medicare program
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Medicare Part D
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Provides for Prescription Drugs Coverages
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Coverage Gap (Doughnut Hole)
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Medicare prescription drug plans, the range in which the beneficiary must pay the full cost of prescription drugs. Under a standard benefit structure, the gap begins after a beneficiary has incurred a specified dollar amount of expenses and continues until the plan begins paying againafter total drug costs reach a second specified dollar amount. Also called doughnut hole.
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Formulary
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List of preferred medications that a prescription drug plan will cover
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Creditable Prescription Drug Coverage
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Drug Coverage under other plans that is deemed to be equivalent ot or better than the standard benefit plan for medicare prescription drug coverage
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SHIP
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State Health Insurance Assistance Plan UCLA - state program that gets money from the federal government to give free health insurance counseling and assistance to people with Medicare
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Partial Advance Funding
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Taxes are more than sufficient to pay current benefits and thus provide some accumulation of assets for the payment of future benefit
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Unemployment Insurance
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Federal & State programs to provide income benefits to unemployed workers who meet the specific program requirements. There programs are financed entirely by employer contributions
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Temporary Disability Law
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Law in a few states that requires employers to provide short term disability income benefits for non work related disabilities. Often referred to as a nonoccupational disability law
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Workers' Compensation Law
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Employers are required to provide benefits to employees for losses that result from work related accidents or diseases. Benefits include medical care, disability income, income for survivors, and rehabilitative services.
