Original Fried
How many pints of blood are covered under Part A/B?
3
A comprehensive list that includes both generic and brand name prescriptions
What is a drug formulary
Copayment per day for hospitalization for days 61-90 under Part A.
What is $371
You must have both of these to enroll
What is Part A & B
Who signed medicare into law and when
Lyndon B Johnson, 1965
Granted to those who are 65 and older, have ALS, ESRD or other qualifying disabilities
What are medicare parts A & B
This phase of Part D is where the beneficiary pays the most for their prescriptions
What is the coverage gap OR donut hole
Anna is hospitalized and under Part A she is responsible for $1484.00 per benefit period
What is her part A deductible
Some MA/MAPD plans offer a portion of your money back paid for Part B, an additional benefit called what?
What is a Part B giveback
The coinsurance beneficiaries are responsible for on Part A and B
What is 20%
This ends when a patient is discharged from hospital or SNF for 60 consecutive days
What is a benefit period
This is required to be submitted by doctor to pharmacy before filling particular prescriptions
What is a prior authorization
In 2021, Part B annual deductible is this
What is $203.00
In 2021, what is the maximum in network out of pocket dollar amount
$7,550
Special care/Facility that cares for people who are terminally ill
Hospice Care
Non-participating doctors can charge up to this amount over Medicare approved services
What is an excess charge OR what is 15%
While receiving this, beneficiaries are exempt from the late enrollment penalty
What is extra help/LIS
I will pay this extra amount per month if I don't enroll into Part A when first eligible
What is a late enrollment penalty OR 10%
I am able to go in and out of the network with this type of MA/MAPD plan
What is a PPO plan
Skilled nursing facility requires this minimum hospital stay
3 days
Services such as outpatient clinic charges, durable medical equipment and lab tests are typically covered under what
What is Part B
The part D deductible in 2021
What is $445
In March 2021, Mr Phillips is admitted to a skilled nursing facility for 23 days, where he paid this cost per day beyond day 20
What is $185.50
Type of medicare plan created for the elderly that provides comprehensive care while in a nursing home.
What is PACE
What is the part D late enrollment penalty
1% of the national average TIMES the number of months you were without coverage