CSS Medicare & Medicaid Benefits Flashcards
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Read the first 6 CSS Medicare & Medicaid Benefits flashcards as text
What are the four parts of Medicare (A, B, C, D) and what does Part A cover?
Answer: Part A covers hospital inpatient care and skilled nursing facility stays
Medicare Part A covers inpatient hospital care, skilled nursing facility care, hospice, and some home health services, and is premium-free for most beneficiaries.
How many days of skilled nursing facility (SNF) care does Medicare Part A cover at 100% with no copay?
Answer: 20 days
Medicare Part A covers the first 20 days of SNF care at 100%, then requires a daily copay for days 21–100, with no coverage after day 100.
Which Medicare part covers outpatient medical services, doctor visits, and preventive care?
Answer: Part B
Medicare Part B covers medically necessary outpatient services, physician fees, preventive care, and some home health services, with a monthly premium.
What is a Medicare Advantage plan (Part C)?
Answer: A private insurance plan that bundles Medicare Part A and B benefits
Medicare Advantage (Part C) plans are offered by private insurers approved by Medicare and must cover all Part A and B services, often including additional benefits.
What is the primary difference between Medicare and Medicaid?
Answer: Medicare is federal health insurance primarily for those 65+; Medicaid is means-tested for low-income individuals
Medicare is a federal insurance program based primarily on age or disability, while Medicaid is a joint federal-state program based on income and asset eligibility.
Which Medicare enrollment period allows beneficiaries to switch or drop Medicare Advantage plans annually?
Answer: Annual Enrollment Period (Oct 15–Dec 7)
The Annual Enrollment Period (AEP) from October 15 to December 7 allows Medicare beneficiaries to switch plans, with changes effective January 1.
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