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Erstellt von Det Ferraris
vor etwa 11 Jahre
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Medicare
Generally, one must be fully insured (40) to be eligible for Medicare.
People eligible for Medicare
Public Assistance Recipients (Welfare) are NOT eligible for Medicare
Medicare Part A= Hospital Coverage
Medicare Part B= Medical Coverage
I went to A hospital to B seen by a doctor
Medicare Part A: deductibles, copayments and Coinsurance can apply
Part A Cover:
Medicare Part B covers
Medicare Part B:
$135 Annual Deductible
80/20 Coinsurance
Part A is FREE if fully insurable
Part B= monthly premium
You are enrolled in Medicare Part A and B @ 65 if receiving SS benefits.
Enrollment in Part B can be delayed by someone who is covered under a group health plan based on the active employment of...
Initial Enrollment Period (IEP)
General Enrollment Period (GEP)
Special Enrollment Period (SEP)
Part A Funding
Part B
Medicare Advantage Plans (Part C)
Private Fee For Service (PFFS)
Free to choose providers, No restrictive networks, No referrals needed
Demonstrations
Medicare Prescription Drug Coverage (Part D)
Part D can be added for an additional premium to:
Late penalty added to Part D premium if purchased AFTER initial enrollment period for coverage
penalty avoided if NO MORE THAN 63 DAYS pass without CREDITABLE COVERAGE following initial enrollment period.
Creditable Coverage
Con-Creditable Coverage
Annua Enrollment Period (AEP)
Open Enrollment Period (OEP)
Approved Amount
Medicare Assignment
Medicare Assignment
If provider accept ASSIGNMENT they agree to:
Medicare benefits CAN be assigned to an HMO OR PPO
Participating Physician
Non-Participating Physician
Medicare claim is started when medical provider contacts (bills) Medicare
Medical Summary Notice (MSN) AKA Explanation of Benefits
Medicare recipient can appeal ANY claims decision