Show:
O.M.
Part C
Part D
Supps
Fun Fact
100
Two forms of cost sharing for Medicare are?
What is deductibles and coinsurance/copays
100
Name two plan types available in Rockingham County and describe each
What is PPO and PFFS. PPO- In/out no referrals PFFS- Any dr. or hosp that agrees to except the plans payments, terms and conditions. Can see you visit or visit.
100
What is the TROOP for 2017 and 2018?
What is $4950 and $5000
100
When traveling outside of the United States will Medicare pay for your medical needs?
In general, health care you get while traveling outside the U.S. isn't covered. The 50 states, the District of Columbia, Puerto Rico, the U.S. Virgin Islands, Guam, the Northern Mariana Islands, and American Samoa are considered part of the U.S. Medicare may pay for inpatient hospital, doctor, ambulance services, or dialysis you get in a foreign country in these rare cases: You're in the U.S. when a medical emergency occurs, and the foreign hospital is closer than the nearest U.S. hospital that can treat your medical condition. You're traveling through Canada without unreasonable delay by the most direct route between Alaska and another state when a medical emergency occurs, and the Canadian hospital is closer than the nearest U.S. hospital that can treat the emergency. You live in the U.S. and the foreign hospital is closer to your home than the nearest U.S. hospital that can treat your medical condition, regardless of whether an emergency exists. In some cases, Medicare may cover medically necessary health care services you get on board a ship within the territorial waters adjoining the land areas of the U.S. Medicare won't pay for health care services you get when a ship is more than 6 hours away from a U.S. port.
100
During the Civil War, _______ who the first female practitioner
Florence Nightingale
200
This ends when a patient is discharged from a hospital or SNF for 60 consecutive days.
What is a benefit period
200
People with this type of health condit. usual cant join a Medicare Advantage plan ?
What is ESRD
200
How is the Base National Average Premium applied to the Medicare Prescription Drug Program?
Is it used to calculate the penalty for late enrollment into Medicare Prescription Drug Plan.
200
Name the different types of rating systems and their meaning
What is Issued Age- Rates are based on the enrollment age Attained Aged- Rates increase based on age Community- Rates are the same within a certain area
200
In what year was the Marketplace Agency, ElderCare and Associated established in the Shenandoah Valley.
1977
300
Medicare pays for a "one time" _____ within the first 12 months a person gets Part B Medicare
Welcome to Medicare "physical"
300
If a medicare beneficiary has a MA plan and also have coverage through the VA how will their benefits be coordinated? Who would pay first?
Two Federal agencies cannot bill one another. Their MA plan would be responsible for paying claims because it stands in place of O.M. The VA would pay for services received at a VA facility. However there would be no Coordination of Benefits.
300
Name three ways that an enrollment into Medicare Part D can occur outside of the AEP.
SEP- MOV, LIS, OEPI, 5Star
300
A Medicare beneficiary has to enter a Medicare approved Skilled Nursing facility within how many days after leaving the hospital?
What is 30 days.
300
Who signed the Medicare legislation into law and what year did it occur?
Lyndon B. Johnson - 1965
400
How many months do you have to enroll in your medicare when you first become eligible?
What is 7 months
400
Explain the Trial Right Period with Medicare.
You joined a Medicare Advantage Plan or Programs of All-inclusive Care for the Elderly (PACE) when you were first eligible for Medicare Part A at 65, and within the first year of joining, you decide you want to switch to Original Medicare.
400
Who does the Coverage Gap not affect?
Who are LIS/Extra Help
400
During this time a hosp is prohibited from billing you for the balance based on the difference between the bill charges and the amount Medicare would have paid. Explain whether we are describing hospitalization or medical services.
When your Medicare Part A hospital benefits are exhausted, the insurer stands in the place of Medicare and will pay whatever amount Medicare would have paid for up to 365 days as provided in the policy.
400
Who was the first president to propose national healthcare in the United State?
Teddy Roosevelt
500
If a Medicare beneficiary enrolled in their Medicare A and B two months after their birthday month, when will their Medicare take effect?
What is 3 months
500
How long does a Medicare beneficiary have to enroll in a MA or PDP plan if they are changing their service area?
What is 90 days the month they move and/ or two months after they notify the insurance company/Medicare
500
COBRA allows a Medicare Beneficiary to enroll in either Medicare Advantage and/or Prescription Drug Coverage at the termination of coverage. Which of the two does Medicare allow you to enroll in?
Prescription Drug Coverage- The health portion (B) is not creditable to Medicare
500
Joe, is currently 84 and has recently retired from Walmart. His current group plan is ending 09/01/2017. He currently has both A and B Medicare. He also had a stroke 3 months ago. Is he able to get a Supplement? If so explain why and what plans can he get.
What is Invol. Loss of Coverage Plan Form F
500
This man is the first United States President who enrolled in Medicare
Harry Truman