Medicare Flashcards Chapter 15

Medicare Part C

<p>Prescription drug coverage</p> Signup and view all the answers

<p>Seven-month period</p> Signup and view all the answers

<p>January 1 through March 31 of each year</p> Signup and view all the answers

<p>A set time when individuals can sign up if they did not enroll during the IEP.</p> Signup and view all the answers

<p>Helps pay Medicare premiums, deductibles, and coinsurance for eligible low-income individuals.</p> Signup and view all the answers

<p>Covers just the Medicare Part B premium for individuals above the poverty level.</p> Signup and view all the answers

<p>Helps pay Medicare Part B premiums for low-income individuals.</p> Signup and view all the answers

<p>Helps individuals who lost Social Security and free Medicare Part A due to returning to work.</p> Signup and view all the answers

<p>Fee-for-service or traditional pay-per-visit plans.</p> Signup and view all the answers

<p>Begins with hospitalization and ends after 60 consecutive days out of the hospital.</p> Signup and view all the answers

<p>Benefit Period</p> Signup and view all the answers

<p>Days that may be used only once during a patient's lifetime for hospital stays.</p> Signup and view all the answers

<p>Program of coordinated palliative services for terminally ill patients and their families.</p> Signup and view all the answers

<p>Temporary hospitalization to relieve primary caregivers of their duties.</p> Signup and view all the answers

<p>Managed care plans</p> Signup and view all the answers

<p>Healthcare plans offered by private insurance companies, not universally available.</p> Signup and view all the answers

<p>Comprehensive care for those with chronic illnesses or specific needs.</p> Signup and view all the answers

<p>A model for more accurate predictions of medical costs for Medicare Advantage enrollees.</p> Signup and view all the answers

<p>An organization that offers Part D benefits to Medicare beneficiaries.</p> Signup and view all the answers

<p>Medicare Part D 'donut hole'</p> Signup and view all the answers

<p>Verifying that diagnosis codes for payment are supported by patient records.</p> Signup and view all the answers

<p>A type of HMO that covers services from non-network providers under original Medicare.</p> Signup and view all the answers

<p>A special project testing improvements in Medicare coverage and care quality.</p> Signup and view all the answers

<p>To provide community-based care for elderly individuals needing nursing facility levels of care.</p> Signup and view all the answers

<p>To help beneficiaries manage medication use effectively.</p> Signup and view all the answers

<p>Supplemental insurance covering Medicare deductibles and copayments.</p> Signup and view all the answers

<p>A type of Medigap policy requiring beneficiaries to use certain providers.</p> Signup and view all the answers

<p>A provider who does not accept Medicare and is excluded from the program.</p> Signup and view all the answers

<p>An agreement between a beneficiary and a physician who has opted out of Medicare.</p> Signup and view all the answers

<p>Patient responsibility for payment if Medicare denies a claim.</p> Signup and view all the answers

<p>Denial of covered services deemed not 'reasonable and necessary.'</p> Signup and view all the answers

<p>Medicare claim process under specific circumstances where another payer is primarily responsible.</p> Signup and view all the answers

<p>Circumstances where Medicare is not primarily responsible for paying medical expenses.</p> Signup and view all the answers

<p>Larger employers to assume financial risk for providing health benefits.</p> Signup and view all the answers

<p>A combination of Medicare and Medicaid programs for eligible individuals.</p> Signup and view all the answers

<p>A streamlined process for submitting claims for vaccinations for large groups.</p> Signup and view all the answers

<p>A provider who offers vaccinations to a large number of individuals.</p> Signup and view all the answers