Exam (elaborations)
MEDICARE SUPPLEMENT LONG-TERM INSURANCE NC QUESTIONS AND ANSWERS
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MEDICARE SUPPLEMENT LONG-TERM INSURANCE NC QUESTIONS AND ANSWERS
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1-47 of 47This coverage includes medically necessary services or supplies or diagnosis or
treatment of a medical condition, as well as preventive services. Mainly physician
services
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Part B Medicare
,Also called Medicare Advantage. This plan must provide the same minimum coverage
as Original Medicare (Parts A and B). Usually offers enhanced coverage and may
charge different co-payments
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Describe Part C Medicare
After the initial enrollment period, individuals may enroll between Jan 1 and March 31
in the yearly enrollment
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General Enrollment Period
visits only doctors that have contracted with health maintenance organizations.
Usually provide drug plans as well. Most plans require the insured choose a primary
care doctor
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Medicare Part C - HMO
- 1-20: no coinsurance or deductible
- 21-100: daily coinsurance requirement
- after 100 days: insured is responsible for all costs
there is a required hospital stay of 3 days as an inpatient
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Medicare Part A - SNF Benefit Period
The method of reimbursement designed under the PPS system to replace cost-based
or contracted monthly payment systems used previously. In DRG terms, each
inpatient admission case at a hospital is categorized and assigned a set fee that can
be billed to Medicare. The goal of the DRGs is to reward hospitals for efficiency and
encourage efficiency in high cost hospitals
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Diagnostic Related Groups
Is also available when covered by a group health plan an dup to 8 months after
employment ends or the group health insurance terminates
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Specialist Enrollment Period
Temporary inpatient care provided by a nursing home, hospice, or hospital care so
that a family member or friend who is the patients caregiving can rest or take some
time off
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