Your SlideShare is downloading. ×
Soraya Ghebleh - Basic Medicare Explained
Soraya Ghebleh - Basic Medicare Explained
Soraya Ghebleh - Basic Medicare Explained
Soraya Ghebleh - Basic Medicare Explained
Soraya Ghebleh - Basic Medicare Explained
Soraya Ghebleh - Basic Medicare Explained
Soraya Ghebleh - Basic Medicare Explained
Soraya Ghebleh - Basic Medicare Explained
Soraya Ghebleh - Basic Medicare Explained
Soraya Ghebleh - Basic Medicare Explained
Soraya Ghebleh - Basic Medicare Explained
Soraya Ghebleh - Basic Medicare Explained
Soraya Ghebleh - Basic Medicare Explained
Soraya Ghebleh - Basic Medicare Explained
Soraya Ghebleh - Basic Medicare Explained
Soraya Ghebleh - Basic Medicare Explained
Soraya Ghebleh - Basic Medicare Explained
Soraya Ghebleh - Basic Medicare Explained
Soraya Ghebleh - Basic Medicare Explained
Soraya Ghebleh - Basic Medicare Explained
Soraya Ghebleh - Basic Medicare Explained
Soraya Ghebleh - Basic Medicare Explained
Soraya Ghebleh - Basic Medicare Explained
Soraya Ghebleh - Basic Medicare Explained
Soraya Ghebleh - Basic Medicare Explained
Upcoming SlideShare
Loading in...5
×

Thanks for flagging this SlideShare!

Oops! An error has occurred.

×
Saving this for later? Get the SlideShare app to save on your phone or tablet. Read anywhere, anytime – even offline.
Text the download link to your phone
Standard text messaging rates apply

Soraya Ghebleh - Basic Medicare Explained

88

Published on

This is a presentation by Soraya Ghebleh that explains the major components of Medicare and the associated terms an individual would need to know to navigate the vast amount of information available …

This is a presentation by Soraya Ghebleh that explains the major components of Medicare and the associated terms an individual would need to know to navigate the vast amount of information available on Medicare.

Published in: Business, Economy & Finance
0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total Views
88
On Slideshare
0
From Embeds
0
Number of Embeds
0
Actions
Shares
0
Downloads
5
Comments
0
Likes
0
Embeds 0
No embeds

Report content
Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
No notes for slide

Transcript

  • 1. Soraya  Ghebleh  
  • 2. ¡  Medicare  is  a  federal  health  insurance   program   ¡  It  covers  people  over  the  age  of  65,  people   with  disabilities,  and  people  with  end  stage   renal  disease   ¡  Medicare  does  not  cover  all  health  care  needs   but  does  cover  most  medically  necessary   services   ¡  Medicare  is  divided  into  four  parts:  Part  A,   Part  B,  Part  C,  and  Part  D  
  • 3. ¡  Part  A  is  for  hospital  insurance,  paying  for   most  inpatient  hospital  care  and  some   inpatient  skilled  nursing  facilities   ¡  Individuals  are  automatically  enrolled  in  Part   A  when  they  join  Medicare   ¡  If  you  automatically  qualify  for  Medicare,  you   do  not  have  to  pay  a  monthly  premium  
  • 4. ¡  Part  B  pays  for  doctors’  services,  outpatient   hospital  care,  outpatient  physical  and  speech   therapy,  some  home  health  care,  ambulance   services,  and  some  medical  equipment  and   supplies   ¡  Part  B  is  voluntary  and  the  monthly  premium   is  automatically  deducted  from  monthly   Social  Security  checks   ¡  If  you  do  not  receive  Social  Security,  you  will   be  billed  for  Part  B  
  • 5. ¡  Part  C  combines  A,  B,  and  D  into  an  HMO  or  a  PPO   with  a  private  insurer   ¡  Part  C  governs  the  way  Medicare  benefits  are   provided  by  companies  that  contract  with  the   Medicare  program   ¡  Individuals  enrolled  in  a  Medicare  Advantage  plan   receive  all  of  their  medical  savings  through  that  plan   ¡  HMOs  and  PPOs  contract  with  Medicare  to  provide   Medicare  benefits  in  a  managed  care  setting   ¡  You  must  pay  the  Part  B  premium  in  order  to  qualify   for  a  Medicare  Advantage  Plan    
  • 6. ¡  Part  D  refers  to  Medicare  prescription  drug   coverage  and  can  often  be  a  stand-­‐alone  plan   with  a  private  insurer   ¡  Part  D  coverage  is  voluntary  and  the  monthly   premium  depends  on  how  much  coverage  an   individual  has  
  • 7. ¡  Medigap  is  also  known  as  supplemental   insurance   ¡  Generally  individuals  who  buy  a  Medigap   policy  also  have  Medicare  Part  A  and  Part  B   and  the  Part  B  premium  must  be  paid     ¡  Medigap  policies  are  health  insurance  sold  by   private  insurance  companies  to  fill  the  “gaps”   in  the  original  Medicare  Plan  coverage   ¡  Costly,  but  often  very  useful    
  • 8. An  agreement  with  a  doctor  to  be  paid  directly   by  Medicare,  accept  the  payment  amount   Medicare  approves  for  the  service,  and  not  bill   you  anything  other  than  the  Medicare   deductible  and  coinsurance.  
  • 9. The  amount  you  have  to  pay  for  medical   services  after  paying  any  deductibles.   Coinsurance  is  usually  a  percentage  of  the   service.  So  if  you  have  a  $10,000  doctor  bill  after   deductibles  and  a  20  percent  coinsurance  rate,   Medicare  would  pay  $8,000  and  you  would  pay   $2,000.  
  • 10. The  amount  you  have  to  pay  for  a  medical   service  or  supply,  for  example,  a  doctor’s  visit  or   a  prescription.  A  co-­‐payment  is  usually  a  set   amount,  such  as  $10  or  $20.  
  • 11. The  amount  you  have  to  pay  for  health  care  or   prescriptions  before  Original  Medicare,  your   prescription  drug  plan,  or  other  insurance  kicks   in.  
  • 12. The  amount  over  the  approved  Medicare   payment  that  some  doctors  and  other  health-­‐ care  providers  can  charge  you  under  Original   Medicare.  
  • 13. Also  called  “Medigap  Protections.”  Means  that   Medigap  plans  can’t  deny  you  a  Medigap  policy,   refuse  to  cover  preexisting  conditions,  or  charge   you  more  for  the  policy  based  on  your  age  or   medical  status  if  you  buy  the  policy  within  six   months  of  signing  on  for  Medicare  Part  B.  
  • 14. Insurance  companies  can’t  cancel  your  Medigap   policy  unless  you  lie  on  your  application,   commit  fraud,  or  don’t  pay  your  premiums.  All   Medigap  policies  issued  since  1992  are   guaranteed  renewable.  
  • 15. A  joint  federal  and  state  health  insurance   program  for  those  who  meet  certain  financial   requirements.  
  • 16. The  maximum  amount  that  doctors  who  accept   a  Medicare  assignment  can  be  paid  for  a  service.   In  other  words,  they  can’t  bill  you  any  extra.  
  • 17. A  Medicare  Advantage  plan  that  combines  a  high   deductible  with  a  medical  savings  account.  The  plan   deposits  money  each  year  into  your  account.  You   do  not  pay  any  taxes  on  the  money  or  the  interest  it   earns  as  long  as  you  use  it  for  health-­‐care  costs,   including  those  that  aren’t  covered  by  Medicare.   Any  money  left  in  the  account  at  the  end  of  the   year  can  still  be  used  for  medical  costs  in  future   years.  Unlike  non-­‐Medicare  medical  savings   accounts,  you  cannot  deposit  any  money  into  this   account.  
  • 18. A  type  of  Medicare  Advantage  (Part  C)  plan  in   which  you  can  see  the  same  doctors  and  use  the   same  hospitals  as  someone  with  Original   Medicare.  However,  because  the  plan   determines  how  much  it  will  pay  doctors  and   hospitals  and  how  much  you  must  pay  when  you   receive  care,  you  may  pay  more  (or  less)  for   Medicare-­‐covered  benefits  than  if  you  had   Original  Medicare.  
  • 19. A  type  of  Medigap  policy  that  may  require  you   to  use  hospitals  and,  in  some  cases,  doctors,   within  its  network  to  be  eligible  for  full  benefits.  
  • 20. A  health  problem  you  had  or  have  before  a  new   insurance  policy  starts.    
  • 21. A  monthly  fee  paid  to  Medicare,  an  insurance   company,  or  a  health-­‐care  plan  to  maintain  your   insurance  coverage.  
  • 22. Health  care  to  prevent  illness  or  detect  illness  at   an  early  stage.  Screening  mammograms,  flu  and   pneumonia  vaccines,  and  Pap  tests  are   examples  of  preventive  services.  
  • 23. Someone  entitled  to  Medicare  Part  A,  whose   income  is  not  higher  than  the  Federal  Poverty   Level,  and  whose  resources  (i.e.,  a  house,  car,   etc.)  do  not  exceed  twice  the  Supplemental   Security  Income  level.  These  people  are  eligible   to  have  their  state  Medicaid  system  pay  their   Medicare  premiums,  deductibles,  coinsurance   and  co-­‐payment  amounts  (except  for  Part  D).  
  • 24. State  programs  that  provide  free  local  health   insurance  counseling  to  people  with  Medicare.   The  federal  government  funds  these  programs.  
  • 25. ¡  http://www.rd.com/health/healthcare/ medicare-­‐alphabet-­‐soup-­‐a-­‐glossary/   ¡  http://www.youtube.com/watch? v=slVO3p83_S0  

×