Medicaid and Medicare Overview

Income assistance for work-related injury is not covered under Medicaid.

Medicare Part B covers 80% of the charges above the deductible for outpatient physician services, so the policyholder would pay 20%.

Insurance companies are legally required to offer Medicare supplement policies on a guaranteed issue basis to individuals who enroll in Medicare Part A and Part B within 6 months of turning 65.

Social Security Disability benefits will not cease if the individual's son gets a part-time job to help support the family. The benefits are based on the individual's disability, not the family's income.

The individual's disability must be expected to last for at least 1 year. While the other options are part of the Social Security disability definition, the duration requirement is crucial.

An individual needs 12 work credits to qualify for Social Security disability benefits. Regardless of age, a person needs enough work credits to demonstrate they contributed to the system.

Automatic enrollment is not an enrollment period for Medicare Part A applicants. People have other options like initial enrollment period and general enrollment period to enroll.

Restricted network provisions condition the payment of benefits, meaning you must use the network or face higher costs. This helps control costs.

The individual must be at least 65 years old is not a qualification for Social Security disability benefits. Age is not a factor for disability benefits.

After reaching the initial benefit limit, the insured is responsible for paying 25% of the prescription drug cost. It's a sliding scale, with higher costs as you reach higher limits.

The primary eligibility requirement for Medicaid benefits is based upon need, meaning low income. The program helps those who can't cover their healthcare costs.

The open enrollment period for Medicare supplement policies lasts for 6 months. This is a crucial time for people to compare options after their initial enrollment.

The insured must have first been hospitalized for 3 consecutive days. This requirement links skilled nursing facility coverage to prior hospitalization, providing a level of protection.

Individuals must first be enrolled in Medicare Part A to be eligible for a Medicare prescription drug plan. It's a stepping stone to accessing prescriptions.

Medicaid consists of a variety of programs designed to provide medical assistance for low-income individuals. It's not a three-part program like traditional Medicare.

Long-term care is not covered by Medicare. While it covers some short-term skilled nursing, long-term care needs require different types of insurance.

Cosmetic surgery is not covered by Medicare. It's considered elective and not medically necessary.

Worker's occupation is not a factor. Social Security disability benefits are determined solely by the individual's ability to work, regardless of their occupation.

Plan A in Medigap insurance covers the Medicare Part A deductible. This is a core benefit that helps bridge coverage gaps.

Medicare Part B is funded by a combination of general tax revenues and monthly premiums paid by beneficiaries. It's not solely funded by social security taxes.

A retired person age 50 does not qualify for Medicare health insurance benefits. Individuals must be age 65 or older, or meet other specific disability requirements.

Medicare will pay full benefits for 100 days of skilled nursing facility care. However, there are conditions and limitations on coverage.

Core benefits are found in all Medigap supplemental policies. These are fundamental benefits to fill coverage gaps in traditional Medicare.

Individuals must be enrolled in Parts A and B of Medicare prior to purchasing a Medigap policy. It's a prerequisite for supplemental coverage.

Part A of Medicare helps pay for inpatient hospital care, including inpatient care in a skilled nursing facility, home health care, and hospice care. It's the foundation of Medicare's hospital coverage.

Medicaid is program that expands individual public assistance programs for people with insufficient income and resources to pay for health care.

Routine dental care is not covered by Medicare Part B. It primarily focuses on physician and preventive services, leaving dental care separate.

All Medicare supplement plans must have at least a guaranteed renewable provision. This means the policy cannot be cancelled by the insurer, providing stability for policyholders.

A 63 year old man will be eligible for Medicare at age 65, regardless of his employment status. Age is the primary qualification, not employment.

HMOs, under Medicare Advantage, may pay for services not covered by traditional Medicare. They offer expanded benefits for a fee.

The waiting period for Social Security disability benefits is 5 months. This is a period of time to ensure the disability is enduring.

The insured must have accumulated 6 work credits in the past 3 years to receive Social Security disability benefits. It shows recent participation in the workforce.

Medicare SELECT policies do not prohibit payment for regularly covered services if provided by non-network providers. While they encourage network use, they still cover some services outside the network.

Medicare SELECT requires insureds to use specific healthcare providers and hospitals (network providers), EXCEPT in emergency situations. It's a network-based plan designed to control costs.

Physician's and surgeon's services are covered by Medicare Part B, which includes many types of medical services.

Medicare Part B coverage is not free of charge. Individuals pay monthly premiums for access to various medical services.

Medicare Advantage (formerly Medicare + Choice) is not solely provided through HMOs. They can be provided through HMOs, PPOs, and other private health insurance models.

Medicare Part A provides hospital care, covering things like inpatient hospital stays, skilled nursing facility care, and some home health services.

Medicare Part B provides coverage for doctor's services, outpatient care, and preventive services, such as routine checkups and screenings.

Medicare Advantage offers expanded health benefits for a fee by providing a range of private health insurance options, including HMOs and PPOs, that go beyond traditional Medicare.

Medicare Supplement core benefits cover the first 3 pints of blood. They are a crucial component of Medigap plans.

Medicare supplement policies do not cover the cost of extended nursing home care. It's typically not a core benefit, and long-term care needs require specialized insurance.

Anyone who is willing to pay a premium does not qualify for Medicare Part A. Age or eligibility through disability are the primary requirements.

Medicare will pay full benefits for 20 days in a skilled nursing facility after hospitalization. It's a limited benefit, so they need to be aware of coverage limitations.

Outpatient hospital treatment is covered by Medicare Part B, not Part A. Part A primarily focuses on inpatient hospitalization.

Hospice care is intended for the terminally ill individuals. It provides a level of comfort and support in the final stage of life.

Part B of Medicare pays for physicians services, diagnostic tests, and physical therapy. It's a broad benefit package designed to cover a wide range of medical services.

Medicaid is not solely a federally administered program. States manage the program, with funding shared by the federal and state governments. It's collaborative program.

Medicaid is a program providing medical assistance for individuals with insufficient income or resources to pay for health care costs. It's a safety net program for those struggling financially.

To be eligible for Social Security, individuals must meet certain requirements, including age, work history, and disability criteria. It's not a universal program.

Plan A is a required core benefit in all Medicare supplement plans. It provides important protections and helps bridge coverage gaps.

HMOs and PPOs, while offering expanded benefits, do not cover elective cosmetic procedures under Medicare Advantage. Those services are generally considered non-essential.

Medicare Part B is not a compulsory program. It is elective, so individuals can choose to enroll, and pay premiums, or decline participation.

Medicare Part B is an elective program. Individuals become eligible for Part B at the same time they become eligible for Part A, but they must actively choose to enroll and pay a monthly premium. It's not automatic.

None.