IT IS DESIGNED FOR INDIVIDUALS THAT:

•  ARE 65 YEARS OF AGE AND UP
• HAVE PERMANENT KIDNEY FAILURE
• HAVE BEEN ENTITLED TO SOCIAL SECURITY DISABILITY BENEFITS FOR THE PAST 24 MONTHS

HOW IS MEDICARE FINANCED?

IT IS FINANCED THROUGH PAYROLL TAXES WITHDRAWN FROM WORKING AMERICANS' PAYCHECKS

WHAT AGENCY IS MEDICARE ADMINISTERED BY?

 HEALTH CARE FINANCING ADMINISTRATION (HCFA)

WHAT IS MEDICARE PART A?

IT IS THE MANDATORY PART OF MEDICARE THAT COVERS HOSPITAL CARE 

 HOW LONG IS THE BENEFIT PERIOD UNDER MEDICARE PART A?

90 DAYS 

WHAT TYPE OF INPATIENT HOSPITAL CARE IS COVERED BY MEDICARE PART A?

• SEMI-PRIVATE HOSPITAL ROOM
• OPERATING ROOM COSTS
• ANESTHESIA
• X-RAYS WHILE IN HOSPITAL
• DRUGS WHILE IN HOSPITAL
• BLOOD TRANSFUSION WITH A 3-pint DEDUCTIBLE
• SKILLED NURSING FACILITY
• HOME HEALTH CARE
• HOSPICE CARE

FOR HOW MANY DAYS IN A HOSPITAL DOES MEDICARE PART A PAY 100% AFTER AN INITIAL DEDUCTIBLE HAS BEEN SATISFIED?

60 DAYS

AFTER HOW MANY DAYS IN A HOSPITAL A PATIENT HAS TO PAY A DAILY CO-PAYMENT?

61 TO 90 DAYS

HOW MANY LIFETIME RESERVE DAYS ARE AVAILALBLE TO EXTEND THE BENEFIT PERIOD IN A HOSPITAL UNDER MEDICARE PART A.

60 DAYS

HOW MANY DAYS IN A SKILLED NURSING FACILITY DOES MEDICARE PART A COVER?

100 DAYS

WHAT ARE THE CONDITIONS UNDER WHICH A PATIENT CAN BE ADMITTED TO A NURSING HOME IN COMPLIANCE WITH MEDICARE PART A?

• THE PATIENT HAS TO HAVE SPENT 3 DAYS OR MORE IN A HOSPITAL
• HE/SHE MUST BE ADMITTED TO THE NURSING HOME FOR THE SAME REASON AS HOSPITALIZATION.

FOR HOW MANY DAYS IN A SKILLED NURSING FACILITY WILL MEDICARE PART A  PAY 100% ?

FOR THE FIRST 20 DAYS.

MEDICARE PART A DOES NOT PAY ANY BENEFITS TO A NURSING HOME PATIENT BEYOND HOW MANY DAYS?

100 DAYS

WHAT IS MEDICARE PART B?

IT IS AN OPTIONAL MEDICAL INSURANCE THAT PAYS FOR A WIDE VARIETY OF OUTPATIENT DOCTOR AND MEDICAL SERVICES RECEIVED ANYWHERE IN THE U.S.

WHAT DOES MEDICARE PART B COVER?

• DOCTOR VISITS
• AMBULANCE
• PHYSICAL THERAPY
• X-RAYS
• LAB TESTS
• OTHERS

WHAT IS NOT COVERED BY MEDICARE PART B?

• PRESCRIPTION DRUGS
• CARE RECEIVED OUTSIDE THE U.S.
• DENTAL CARE
• FOOT CARE
• ROUTINE PHYSICAL EXAMS
• PRIVATE NURSING CARE
• CUSTODIAL CARE
• EYE/HEARING EXAMS
• GLASSES AND HEARING AIDS 

WHAT REQUIREMENT MUST BE MET FOR AN ACTIVELY WORKING MEDICARE RECIPIENT TO BE ENTITLED TO GROUP BENEFITS?

• THE EMPLOYEE MUST BE 65 YEARS OR OLDER, ELIGIBLE FOR MEDICARE, AND 

• THE EMPLOYER MUST HAVE AT LEAST 20 EMPLOYEES 

HOW ARE PAYMENTS OF BENEFITS CARRIED OUT WHEN A MEDICARE RECIPIENT IS COVERED UNDER A GROUP HEALTH PLAN?

THE GROUP HEALTH PLAN IS PRIMARY

MEDICARE IS SECONDARY 

WHAT IS THE PURPOSE OF MEDICARE SUPPLEMENT POLICIES?

TO FILL IN MANY OF THE "GAPS" LEFT BY MEDICARE

WHO IS ELIGIBLE FOR MEDICARE SUPPLEMENT POLICIES?

MEDICARE RECIPIENTS WHO APPLIED FOR A MEDICARE SUPPLEMENT POLICY WITHIN 6 MONTHS OF ENROLLEMENT IN MEDICARE PART B.

HOW ARE PRE-EXISTING CONDITIONS HANDLED UNDER SUPPLEMENT POLICIES OF MEDICARE?

THEY CAN BE EXCLUDED FOR THE FIRST 6 MONTHS OF COVERAGE, BUT ONLY IF THEY WERE TREATED IN THE 90 DAYS IMMEDIATELY PRECEEDING THE EFFECTIVE DATE OF THE POLICY.