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Medicare Study Guide – Complete With Solutions
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Medicare Study Guide – Complete With Solutions
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Medicare Study Guide – Complete With SolutionsRegulation/factors effects PT services Right Ans - Federal regulations
State regulations and practice act
HIPAA
APTA guidelines/standards
Medicare Right Ans - Federal government program that gives you health
care coverage if you are 65 or older or have a disability, no matter what your
income
Three parts:
-part A(hospital insurance)
-part B(optional medical insurance-outpatient)
-part D(prescription drug insurance)
-to get full Medicare coverage, you need all three parts
Medicare is different from Medicaid, which is a state and federal program
offering health care coverage to people with very low incomes
Part C Right Ans - Most commonly known as Medicare advantage plan
Medicare coverage through a private health plan, such as an HMO or PPO
Provides all your you med A and B coverage along with extras such as vision,
hearing, dental
CMS Right Ans - Centers for Medicare and Medicaid services is the federal
agency that oversees Medicare
Part A Right Ans - Hospital stays(mostly)
Skilled nursing facility care
Home health services
Hospice Care
Part A -Hospital stays Right Ans - -up to 90 days per benefit
-plus 60 lifetime reserve days in a general hospital
-don't pay a premium due to payroll taxes, although a deductible is required
-inpatient mental health care limited to 190 days in a lifetime
-semiprivate room
Part A -SNF Right Ans - -semiprivate room
, -need for skilled nursing 7x/wk or OT/SLP/PT 5-6x/wk
-break in skilled care of more than 30 days, you need 3 day stay in hospital to
require additional care
-break more than 60+ days, end current benefit period and renew your SNF
benefits. Restart your 100 days of SNF
-does not cover long-term care
Part A- Home Health Right Ans - -pt must be home bound
-part-time or intermittent skilled nursing, PT, OT< and speech
-DME, social services, medical supplies
-up to 100 days, to qualify you must be in a the hospital for at least 3 days in
the last 14 days
Part A -Hospice Care Right Ans - Terminal illness(less than 6 months to
live)
Includes drugs for symptom control and pain relief, grief counseling
Usually in home
Part A -blood Right Ans - Most cases, hospital gets blood from a blood bank
at no charge, and you won't have to pay for it or replace it
Hospital has to buy blood for you, you must either pay the hospital costs for
the first 3 units of blood you get in calendar year, or have the blood donated
Part A- monthly premium cost Right Ans - Premium-free at 65 if:
-currently get retirement benefits from SS
-eligible to get SS but haven;t filed for them yet
-you or your spouse had government employment
Purchase:
-up to $422 if you or your spouse paid Medicare taxes for less than 7.5 years
-$232 ifyou or your spouse paid Medicare taxes for 7.5-10years
Part A -inpatient hospital care cost Right Ans - $1350 deductible for each
benefit period. No coin Shurance for days 1-60
$335 daily coinsurance for 61-90 days
$670 daily coinsurance for days 91-150
All costs for each day over 150
Part A -SNF cost Right Ans - Days 1-20 no coinsurance
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