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Medicare was known as Title ___.
Does Medicare have the same or different benefits in all 50 states?
the same benefits
What form must be used with Medicare?
Who passes the laws for Medicare?
Who turns the laws (passed by Congress) into procedures and policies?
How many Medicare regions are there in the US?
Iowa is in what Medicare region?
Region 7, KC
Who is eligible for Medicare? 5 groups
65+, retired, and collecting SS benefits
65+, railroad retirement, w/ 65 YO spouse
Anyone who has received SS for 2+ years
Anyone blind or disabled, no matter the age
Adults and children w/ end stage renal disease (that requires dialysis)
If you are donating this organ, Medicare will cover the expenses.
What LOCAL administration handles Medicare applicants and provides the necessary information for people needing it?
Social Security Administration
Medicare provides basic protection... what is considered ____________ and _________.
reasonable and necessary
How many physicians are needed for a UR committee?
at least two
Who helps Medicare decide if inpatient care is reasonable and necessary?
This organization is made up of local doctors who review the care prescribed by their fellow doctors.
PROs (Professional Standards Review Organization)
If after review, the __ and the ___s find that the inpatient care is not medically necessary, they will not pay for it.
UR and PROs
The UR looks at something __________ the care, PROs look at it ___________ the care.
Part A is for _______ expenses.
Part B is for _______ expenses.
What would you like to do?
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