Medicare & Medicaid

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True/False: Medicare Part A is a compulsory hospitalization insurance that provides specified in-hospital and related benefits.
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True
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True/False: Medicare Part B is a voluntary program designed to provide supplementary medical insurance.
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True
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Which part of Medicare covers Physician services, Medical Services and supplies?
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Part B
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How is Medicare Part B financed?
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By montly premiums from those who participate and and by tax revenues.
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True/False: Inpatient hospital services are covered under Part B
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False
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Which part of Medicare covers Posthospital skilled nursing care, in an accredited care facility?
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Part A
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Which part of Medicare covers post hospital home health services, including nursing care, therapy and part time home health aids
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Part A
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Which part of Medicare covers Pysicians and surgeons services
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Part B
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Which part of Medicare covers Hospice benefits for the care of terminally ill patients
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Part A
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Which part of Medicare covers x-rays diagnostic lab tests and ambulance services
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Part B
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Which part of Medicare covers medical supplies and medical equipment rental
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Part B
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Which part of Medicare covers inpatient psychiatric care on a limited basis
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Part A
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Which part of Medicare covers physical and ocupational therapy
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Part B
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Which part of Medicare covers semiprivate room and board and nursing services
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Part A
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Under Medicare how long is a patients lifetime reserve for hospital coverage?
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60 days
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How long does a patient have to be hospitalized inorder to use lifetime reserve benefits?
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Longer than 90 days in a benefit period
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True/False: The lifetime reserve is a one time benefit that does not renew with a new benefit period
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True
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True/False: If a patient is hospitalized and taps into the reserve days, they are required to pay a higher copayment.
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True ($534)
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When does Medicare Part A become available?
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When an individual turns 65 AND is automatically provided when they apply for SSI benefits.
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True/False: No medicare benefits are provided for treatment in a skilled nursing facility beyond 100 days.
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True
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For Medicare Part A how many consecutive days must a patient be hospitalized before the cost of care in a skilled nursing facility can be covered?
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3 days
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True/False: Medicare Part A has a monthly premium
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False
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True/False: Medicare Part B has a premium AND a yearly deductible.
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True
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What year was Medicare established?
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1965
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True/False: The State regulates Medicare
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False
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True/False: The Federal Government regulates Medicade
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False
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True/False: Medicare Advantage specialty plans provide more focused health care for people with specific conditions
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True
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Which part of medicade is known as the Medicare Advantage?
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Part C
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List 4 options (plans) that are available under Part C
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1. Managed Care Plans 2. Preferred provider organizations 3. Private fee-for-service 4. Specialty Plans
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True/False: Medicare advantage options replace the need for long term care insurance.
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False Page 311
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What does a person need in order to be eligible for Medicare Advantage?
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Must be enrolled in both Medicare Part A and B.
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What is the goal of Medicaid?
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To offer medical assistance to those whose income and resources are insufficient to meet the costs of necessary medical care.
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True/False: Medicaid provides for custodial care or assisted care in a nursing home
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True
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What are the 4 qualifications for Medicaid?
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1) Be at least 65, blind or disabled 2) Be a U.S. Citizen or permanent Resident Alien 3) Need the type of care that is provided only in a nursing home. 4) Meet certain asset and income tests.
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Deficit Reduction Act of 2005
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The look-back period has been extended to 5 years the home equity exemption has been limited to $750,000.
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Under Medicaid Reform, what is a Health Opportunity Account (HOA)?
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They give Medicaid beneficiaries a personal account that pays for health care services.
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Direct Service Model
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States give beneficiaries health spending accounts to buy a defined set of health care services.
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Insurance Model
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Medicaid beneficiaries receive a fixed budget to buy a health insurance product of their choice.
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Florida Healthy Kids Corporation
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Established in 1990 Uninsured children can obtain affordable health care coverage.
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For how many days of skilled nursing facility care will Medicare pay benefits?
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100 Days
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True/False: Medicare Part B is a compulsory program.
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False

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