Out-of-pocket
Emergency care outside the U.S.
True/False
Benefits
Random
100
$1184
What is Medicare's 2013 deductible?
100
80% of the app amt for covered services after the ded is met.
What is the amount BCBSM pays for Er care outside the U.S. for Plan C?
100
Reside in Michigan for at least 4 months of the year.
What is False? (6 months)
100
*Medicare Pays all but very limited copayment/coinsurance for outpatient drugs and inpatient respite care *BCBSM will pay the medicare copayment/coinsurance *The member will not pay anything under A or C.
What is Hospice Care?
100
Medigap coverage, also called medicare supplemental coverage, is a health policy that works in conjunction with original medicare to expand Part A(hospital) and Part B(medical) benefits and lower your out-of-pocket costs.
What is Medigap Coverage?
200
$40.42
What is Medigap Plan A premium + claims tax?
200
All cost for services (no benefits for care)
What is the amount the member pays for Er care outside the U.S. for Plan A?
200
If you are currently enrolled in a MA plan and wish to enroll in Medigap you can coordinate benefits with MA and medigap.
What is False? You must disenroll in writing from MA (only at certain times of the year) before enrolling in Medigap.
200
Medicare pays in full-nothing left for Plan A or C members to pay
What is Clinical Laboratory Services-test for diagnostic services?
200
1st or the 15th of each month
What are Medigap billing cycles?
300
$122.86
What is Medigap Plan C premium + claims tax?
300
No benefits for care outside U.S.
What is the amount that Medicare pays for Er care outside the U.S. for Plan A&C?
300
There are no provider networks or referrals
What is True?
300
In or out of the hospital and outpatient hospital physician's service, inpatient and outpatient medical and surgical services and supplies, physical and speech therapy, diagnostic treatment, such as tests, durable medical equipment, per calender year**
What is Medicare Part B?
300
Higher premiums and higher benefit levels
What is Legacy C?
400
$250
What is the deductible for foreign travel under Plan C?
400
$250 ded + 20% coinsurance
What is the amount the member pays for Er care outside the U.S. for Plan C?
400
I can be enrolled in Part A and Part D only and still purchase a medigap policy?
What is False? (Must be enrolled in Part A & B at age 65)
400
You must meet the medicare requirements, including having been in a hospital for at least 3 days and enter a medicare-approved facility within 30 days after leaving the hospital* First 20 days of care-medicare pays in full (A&C) 21-100-medicare pays all but $148 SNF daily copay Plan A-member pays the $148 daily copay Plan C- member pays nothing-plan pays $148 daily copay
What is Skilled Nursing Facility Care?
400
Medicare pays for the 1st three pints of blood
What is False?
500
$147 annually (Jan 1-Dec 31)
How much is the Medicare Part B deductible? How often does that deductible have to be met?
500
$50,000
What is BCBSM Lifetime Max for Plan C?
500
Can't be eligible for a retiree program or employer-sponsored health care as active or retired employer Can't be eligible for a retiree program through an employer where employer pays a portion of the premium
What is True?
500
Includes semi-private room & board, general nursing care, miscellaneous
What is Medicare Part A?
500
Lower premiums and lower benefit levels
What is Legacy A?
M
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