Medicare Part C Flashcards

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.