Medicare Part C Flashcards

Questions and Answers

What is Medicare Part C also referred to as?

Medicare Disability

Medicare Advantage (correct)

Medicare Supplement

Medicare Cost

What is Medicare Part C?

A managed care plan offered by Medicare-approved private insurers.

What may Part C be offered as?

A managed care plan offered by Medicare-approved private insurers.

What is a special needs plan?

Intended for individuals who are insured under Medicare and Medicaid. Signup and view all the answers

When can an individual enroll in Part C?

During the initial enrollment period, open enrollment period, or general enrollment period. Signup and view all the answers

What must an individual do if they move out of the state or out of the plan's service area under a Part C Medicare plan?

They will have to enroll in a new plan during the open enrollment period. Signup and view all the answers

What do Part C plans charge a combined premium for?

Parts A and B, and coverage for Part D may be charged separately if included in the plan. Signup and view all the answers

As of 2012, what can't Part C plans do?

Charge a Medicare beneficiary more than Original Medicare for specific medical services. Signup and view all the answers

Can a person stay enrolled in Part C if they develop ESRD after being enrolled?

True Signup and view all the answers

What must an individual have to enroll in Part C?

Parts A and B, live in the plan's service area, and not have ESRD. Signup and view all the answers

Can someone be enrolled in Part C if they are insured under an employer health plan?

Yes Signup and view all the answers

Study Notes

Medicare Part C Overview

Medicare Part C is also known as Medicare Advantage.
It is a managed care plan provided by private insurers approved by Medicare.

Plan Types

Special Needs Plans (SNP) are designed for individuals eligible for both Medicare and Medicaid.
Medicare Part C may accommodate those with employer health plans.

Enrollment Criteria

Eligibility for enrollment in Part C requires having Medicare Parts A and B, living within the plan's service area, and not having End-Stage Renal Disease (ESRD).
If someone is covered by an employer health plan, they may also enroll in Part C.

Enrollment Periods

Key periods for enrollment, changes, or dropping Part C include:
- Initial Enrollment Period
- Open Enrollment Period
- General Enrollment Period

Moving and Coverage Changes

A beneficiary must enroll in a new plan during the open enrollment period if they move out of their existing plan's service area.

Premiums and Costs

Part C plans charge a combined premium that typically covers both Medicare Parts A and B. Part D coverage may incur a separate charge if included.
As of 2012, Part C plans cannot charge beneficiaries more than Original Medicare for certain medical services, including chemotherapy, dialysis, and skilled nursing facility care.

ESRD and Enrollment

Individuals can maintain their enrollment in a Part C plan even if they develop ESRD after joining, as long as they did not have the condition at the time of enrollment.

Description

Test your knowledge of Medicare Part C with these flashcards! This quiz covers the basics of Medicare Advantage, including definitions and offerings related to this program. Perfect for anyone looking to understand or review Medicare Part C concepts.