2022 WellCare ACT Mastery Exam-Tele agent verified 2023

2022 WellCare ACT Mastery Exam-Tele agent verified 2023deductible Amount you must pay before you begin receiving any benefits from your insurance company TERM Medicare DEFINITION A national health insurance program in the United States, begun in 1965 under the Social Security Administration and now administered by the Centers for Medicare and Medicaid Services. + 1 more side Medicare Advantage Medicare plans other than the Original Medicare Plan Medicaid A federal and state assistance program that pays for health care services for people who cannot afford them. Medicare requirements -must be 65 or older, disabled, or have end-stage renal disease -have to be under a licensed physician -home care recipients must also be homebound and in need of skilled nursing or therapy services on an intermittent basis Medigap a private insurance policy that pays the difference between the medical charge and the amount that Medicare pays Medigap Eligibility and Enrollment Unlike Part C which 'disenrolls' an individual from Parts A and Part B, a Medigap plan works with Part A and Part B, requiring recipients to first enroll into the Original Medicare program and then supplement it with a Medigap plan. Individuals who are enrolled in Part C cannot also receive coverage from a Medigap plan and must re-enroll into Parts A and B in order to purchased a Medigap plan. All Medigap insurers are required to offer a one-time, 6-month enrollment period after turning age 65 for individuals who have already enrolled in Medicare Part B that guarantees an enrollee the right to purchase any part of a Medicare supplement insurance policy, regardless of his or her health status. Beyond the initial enrollment period, an insurer can require a paramedical exam or an attending physician's statement if needed to ensure the health of the enrollee. End-stage renal disease the final stage of chronic kidney disease Medicare Coverage Hospital services, some home health, hospice, religiously-associated facilities If a beneficiary requests to discuss other products not originally documented on the SOA, must youdocument a second SOA for the additional product type before the appointment may continue? ... Part A coverage Inpatient hospital care, skilled nursing facility care, home health care and hospice care Medicare Part B The part of the Medicare program that pays for physician services, outpatient hospital services, durable medical equipment, and other services and supplies. Part C coverage (medicare advantage) managed care alternative to original medicare. provided through commercial insurers Part D of Medicare Prescription drug coverage Original Medicare Medicare Parts A and B providing only hospital and medical coverage. Employer Group Health Coverage Employer Group Health Coverage AHIP, MUnder Original Medicare, the inpatient hospital co-payment is a flat per-day amount that remains the same throughout the first 60 days of a beneficiary's stay. After day 60 the amount gradually increases until day 90. After 90 days he would pay the full amount of all costs. ... c. ... Under Original Medicare, if the inpatient hospital service is provided by a participating Medicare provider, the co-payment is waived. Co-payments are only charged when a beneficiary opts to receive care from a non-participating provider. ... Incorrect: Beneficiaries are responsible for a single deductible amount for each benefit period, followed by a per day coinsurance amount through day 90. For day 91 and beyond, there is a charge for each "lifetime reserve day" up to 60 days over a beneficiary's lifetime. After this, he would be responsible for all costs. ...