Medicare/Anthem (BlueCross BlueShield) Flashcards

1
Q

What is the single largest health care program in the US?

A

Medicare

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Who is responsible for administering medicare?

A

CMS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Medicare A

A

Inpatient hospital

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Medicare B

A

Medical insurance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Medicare C

A

Advantage= alternative plan for Medicare A&B

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

5 star rating system is for which medicare?

A

C

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Medicare D

A

Prescription drug benefits

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Medigap

A

covers cost not reimbursed by normal medicare

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Medicare enrollment

A

65 and older

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Do not pay a premium for Medicare Part A if?

A

They or a spouse paid Medicare taxes while they were working

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Dual Eligible Medicare

A

program that helps w/ people with low income (medicare and medicaid)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Hospice Care

A

$0, no deductible

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Origin of BlueCross

A

Only covered hospitals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Origin of BlueShield

A

Physician services

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

PAR

A

Participating Providers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

PAR is..?

A

Must submit claims for all BCBC subscribers, write off difference or balance btwn the amount charged by the provider and approved fee, Bill patients only the deductible and copay/coinsurance based on BCBS allowed fees