Medi-Cal/Medicare Flashcards
what is medicare?
health insurance for people age 65+
Other than 65+, how can a person be elgible?
people with certain disabilities or permanent kidney failure also qualify;
What does medicare do and not do?
helps with cost of health care does not cover all medical expenses or the cost of most long-term care
what is Medigap
supplemental policy that can be bought froma prvate insurance company to cover some costs that medicare doesn’t.
How is medicare financed?
by a portion of payroll taxes paid by workers and their employers;; also finance in part by monthly premiums usually deducted from social security checks
what are the four parts of medicare
Hospital insurance (Part A) for inpatient care or skilled nursing facility following a hospital stay; Medical Insurance (part B) helps pay for services from doctors and other heath care provider, outpatient, home health care; Medicare Advantage (part C) having parts A and B administered through one of the provider organizations under Part C; Part D Prescription drug coverage.
Medicaid versus Medicare
Medicaid is state run that provides hospital and medical coverage for people with low income;
Medicare Part A
Most people 65+ who are citizens or permanent residents are eligible for free part A (Hospital); You’re eligible at 65 if: you are eligible for SS benefits; spouse receives or can receive ss or railroad benies; you or spouse (living or deceased) worked long enough in a government job where medicare taxes were paid; you are dependent parent of a fully insure deceased child. If you don’t meet requirements you may be able to benies by paying a monthly premium.
when can you sign up for medicare
a few months before you turn 65
before 65, you can be elig for Medicare if:
entitled to ss disability for 24 mos.; receive a disability pension from railroad retirment board; ss disability for Lou Gerhrig’s disease; worked long enough in government job where medicare taxes were paid and entitled to ss benies for 24 mos.; you are the child or widow age 50 or older of someone who worked long enough to satisfy previous point; permanent kidney failure;
Part B
anyone elig. for part a can enroll in part B (medical ins) by paying monthly premiuma; some wirth higher incomes will pay higher premium; if not elig for part a, then can buy medical ins without having to buy hosp ins. as long as; u.s. citizen or lawfully admitted noncitizen in US for 5 yrs.
Part C
Parts A and B directly from govt. are ‘orginal’ medicare. If you receive from a Medicare Advantage organization or other company approved by Medicare, you have an Advantage plan. If you have A and B, you can join an Advantage plan– provied by private companies approved by Medicare– CAN’T have Medigap with these.
what is enrollment period for part B
when you become eligible for A, hyou have 7 mos. period to sign up for medical ins.f
What is Ticket to Work? (TTW)
helps you get vocational, rehabilitation, training, job referrals and other employment support services free of charge
requirements for Ticket to Work (TTW)
voluntary; age 18-64 and get disability benies;
how TTW works
employment networks including private organizations and govt. agencies have agreed to work with the SSA. They provide employment services and other support to beneficiaries with disabilities.
what is an Employment network
organizations that an help you find and keep a job and also other employment support services. An EN can be a single organization or it can be a group of providers.
