Part A
You can sign up for Part A at this agency or from their website online.
What is Social Security Administration
Medicare covers routine dental, hearing, & vision at ___%?
What is 0% (Not a covered service through Medicare)
Medicare Advantage Plans are ___ or ___?
What is HMO or PPO
Each Medicare Prescription Drug Plan has its own list of covered drugs called a
What is a Formulary
Providers and Suppliers that bill Medicare for services you did not receive are called?
What is Medicare Fraud
If a Part A premium is due from having between 0-29 quarters, the premium will be set at ______ for 2022?
What is $499
Oxygen supplies are one example of?
What is Durable Medical Equipment
The _____ includes any changes in coverage, costs, provider networks, service area, and more that will be effected in January.
What is (ANOC) Annual Notice of Change
Many Medicare drug plans place drugs into a different _____ on their formularies. Drugs in each _____ have a different cost.
What is a Tier
Name one agency who you can report Medicare Fraud to?
What is Medicare, HICAP, or SMP
How many lifetime days are given to a Medicare beneficiary in a Psychiatric Hospital?
What is 190 days
Medicare Part B Annual deductible amount for 2022 is?
What is $233
The _____ gives you details about what the plan covers, how much you pay, and more.
What is (EOC) Evidence of Coverage
A Medicare program to help people with limited income and resources pay Medicare prescription drug program costs, like premiums, deductibles, and coinsurance.
What is Extra Help Limited Income Subsidy (LIS)
Stop Medicare fraud, abuse and errors. Medicare sends you the following to review for accuracy quarterly.
What is a (MSN) Medicare Summary Notice
In 2022 you pay a $194.50 per day co-payment for days 21-100 while in this location.
What is a Skilled Nursing Facility
Medically necessary physician costs, outpatient hospital care, medical equipment & supplies, mental health services, and some preventive services are all covered through Medicare at ____%?
What is 80%
This MA program is for individuals who have chronic disabling conditions, or are dual eligible, or for people in certain institutions like nursing homes or who still live at home but need the same level of care as someone living in a nursing home.
What is a Special Needs Plan (SNP)
An Appeals process to request lower cost-sharing on Prescriptions.
What is a Tiering Exception
Purposely billing two payers for the same service, or billing for the same service twice.
What is Double Billing
To qualify for _______ ____, a physician must certify that you’re terminally ill, meaning you have a life expectancy of 6 months or less.
What is Hospice Care
Diabetes screenings are one example of?
What are Preventative Services
These plans combine a high-deductible health plan with a bank account. Medicare deposits money into the account (usually less than the deductible). You can use the money to pay for your health care services during the year.
What is a (MSA) Medical Savings Account plan
Medicare Part D Plans very often require ____ _________ to obtain coverage for certain drugs.
What is Prior Authorization
The action a beneficiary can take if they disagree with a coverage or payment decision made by Original Medicare or a Medicare health or drug plan.
What is an Appeal