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CRCE Medicare cover (What does Medicare cover for CRCE) With Complete Solutions
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CRCE Medicare cover (What does Medicare cover for CRCE)With Complete Solutions
Who is elgible for this insurance - ANSWER There are several parts.
-XVII
-reference amendment to SSA that established program
-elderly, 65/older
-permanent disabilities
ESRD
Lou Gehrig's disease
covered=beneficiary
4 parts- each are different
Medicare and you booklet helpful-
https://www.medicare.gov/sites/default/files/2018-09/10050-medicare-and-you.pdf
Medicare Part A - ANSWER Briefly what is covered?
AKA Hospital insurance
MN IP hospitalizations
care in a SNF, following a 3 day stay
home health care
hospice
MN = medical necessary
Part A- premiums - ANSWER most beneficiaries do not pay a premium
if you work enough per SSA requirements you can qualify w/o a premium
If you have not worked enough quarters you may still qualify for coverage but would be
resp. for individual prem.
,Part A deductible - ANSWER Pay this amount once ____________ aka
When does this "period" end?
Once per spell of an illness (aka a benefit period)
this begins when ben is admitted to hosp, and continues for 60 days following d/c from
hospital or SNF
Part A LTR - ANSWER 60 days of IP services for hospital
DAYS 91-150
a beneficiary can ELECT TO USE AFTER using 90 days of IP services in a benefit period.
The reserve has a very high coinsurance 50% of the Part A deductible per day!
682 per day
can only be used ONCE in a benef's lifetime
can be split among multiple stays
If pt chooses not to use LTR days after a 90 day stay, any covered part B services would
be billed.
See chart pg 4-14 of ch 4
Medicare Part A IP hospital stay includes - ANSWER any limits other than the LTR?
covers CAH?
semi private room
meals
general nursing
other hospital services and supplies
, care in critical access hospitals
DOES NOT COVER private duty nursing, TV, telephone if billed seperatley, private
room-unless medically nec
Psych IP in indpendent psych facility is limited to 190 days in a lifetime
Medicare Part A days 1-60 of IP stay Beneficiary Obligation: - ANSWER Beneficiary
Obligation:
Part A current year IP deductible, this IS RENEWABLE during the next benefit period
2020 amount: $1408 per sppell of an illness
Medicare Part A days 61-90 of IP stay Beneficiary Obligation: - ANSWER Beneficiary
Obligation:
Part A coinsurance (25% of current year IP deductible)
Rhttps://quizlet.com/392267825/chapter-4-billing-flash-cards/
352$ per day
That is 1/4 or 25% of current year IP deductible, this is renwable
Medicare part A days 91-150 of IP stay Beneficiary Obligation: - ANSWER Beneficiary
Obligation:
Part A lifetime resever (LTR, 50% of current year IP deductible.
$704 per dau
Nonrenewable- hospitals alert patients when they have 4 days of coinsurance left so
they can use whether to use their LTR days
190 dayu limit ip mental healthcare at independent psych facility
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