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, Medicare Federal health insurance program
CMS ( Centers for medicare and medicaid services)
Medicare is administered by
whom?
federal health insurance program referred to as original medicare
Parts A & B of medicare are
Part A? Hospital insurance
Part B? Medical insurance
routine dental, eye care hearing exam,deductibles, coinsurance
What doesnt medicare cover? and copayments
Part C? Medicare Advantage Plans
MA covers? Part A &B coverage, and some part D coverage
MA plans are not? Medicare supplement insurance plans
MADP
What offers lower monthly
premiums MADP or supplement?
YES
do MAP's have a annual
maximum OOP maximum that
limits the amount of money a
member must spend every year
for covered services?
MA plans integrate what type of part D prescription drug coverage
additonal coverage?
MA-only PFFS plan
If a customer wants to keep their
stand alone prescription drug
plan, what may the customer
want to enroll in?
PDP
What is a stand alone drug plan
called?
Private Fee for Service (PFFS) - Plans that allow you to go to any
WHat is PFFS? doctor or hospital that accepts their terms
PFFS plan
If a customer lives in a rural area,
what type of plan may they want
because it gives them freedom to
access doctors that may not be in
their network?
Do HMO's require referals? Yes
Do PPO's require a referal? No