UHC Exam 1: Medicare/Medicaid with all
Answers correct
Medicare - ANSWER established based on the need of health insurance for the elderly;
was added as an Amendment to the Social Security Act (Title XVIII)
Medicare Eligibilities - ANSWER Requires that individuals have worked at least 10
years in Medicare-covered employment or have paid taxes into the Medicare system,
are US Citizens or permanent residents, and are at least 65 years old.
People under 65 may qualify for Medicare if they have End-Stage Renal Disease and
require dialysis or a kidney transplat or if they recieve Social Security disability benefits
(and have been for at least 24 months)
Medicare Enrollment and Spending - ANSWER Enrollment: 57 Million
Spending: $680 Billion
Medicare: Part A - ANSWER Hospital Insurance: Covers in-patient hospital care and
other types of institutional care
Medicare Part A Benefit Period - ANSWER A deductible of $1316 is paid at the
beginning of each period, which begins when a person enters the hospital and ends
when a person has not been a patient in a hospital or skilled nursing facility for 60
consequtive days (90 day periods total)
60 day lifetime reserve days are available once the 90 days of the benefit period have
been used
190 day lifetime supply of inpatient psychiatric care is separate from the benefit periods
and reserve days
Individual also receives 100 days per benefit period at a skilled nursing facility care for
short-term skilled care (not custodial care - should be care only provided in nursing
homes) that can only be used if preceded by a hospital stay of at least 3 days
Hospice care (for patients with a life expectancy of less than 6 months that have waived
the right to traditional treatment) is offered with very little patient cost-sharing (Pay 5%
of Rx Drugs, repite care, grief counseling)
Medicare is not applicable if traveling outside of the US
Funding comes from payroll taxes from employees and employers
Answers correct
Medicare - ANSWER established based on the need of health insurance for the elderly;
was added as an Amendment to the Social Security Act (Title XVIII)
Medicare Eligibilities - ANSWER Requires that individuals have worked at least 10
years in Medicare-covered employment or have paid taxes into the Medicare system,
are US Citizens or permanent residents, and are at least 65 years old.
People under 65 may qualify for Medicare if they have End-Stage Renal Disease and
require dialysis or a kidney transplat or if they recieve Social Security disability benefits
(and have been for at least 24 months)
Medicare Enrollment and Spending - ANSWER Enrollment: 57 Million
Spending: $680 Billion
Medicare: Part A - ANSWER Hospital Insurance: Covers in-patient hospital care and
other types of institutional care
Medicare Part A Benefit Period - ANSWER A deductible of $1316 is paid at the
beginning of each period, which begins when a person enters the hospital and ends
when a person has not been a patient in a hospital or skilled nursing facility for 60
consequtive days (90 day periods total)
60 day lifetime reserve days are available once the 90 days of the benefit period have
been used
190 day lifetime supply of inpatient psychiatric care is separate from the benefit periods
and reserve days
Individual also receives 100 days per benefit period at a skilled nursing facility care for
short-term skilled care (not custodial care - should be care only provided in nursing
homes) that can only be used if preceded by a hospital stay of at least 3 days
Hospice care (for patients with a life expectancy of less than 6 months that have waived
the right to traditional treatment) is offered with very little patient cost-sharing (Pay 5%
of Rx Drugs, repite care, grief counseling)
Medicare is not applicable if traveling outside of the US
Funding comes from payroll taxes from employees and employers
