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Title XIX of the Social Security Act of 1965 established:

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terms list

Medicaid

Title XIX of the Social Security Act of 1965 established:

CMS

Medicaid is administered by:

The Social Security Administration

Supplemental Security Income (SSI) is a cash benefit program controlled by:

Low income families with children, Individuals recieving SSI, Pregnant women, infants, and children with incomes less than a specific percent of the federal poverty level, and Qualified Medicare Beneficiaries (QMBs)

Categorically needy indivduals typically include:

Spend Down

The term used for the process of depleting private or family finances to the point where the individual/family becomes eligible for Medicare assistance is:

Program of All-Inclusive Care for the Elderly (PACE)

The program that provides comprehensive alternative care for noninstitutionalized elderly who otherwise would be in a nursing home is known as:

No less than once a month

Medicaid coverage should be verified:

Duel Eligibles/Medi-Medi

Aged or disabled individuals who are verry poor are covered under the Medicaid and Medicare programs, which are commonly referred to as:

QMBs

Medicare beneficiaries who qualify for certain Medicaid benefits if they have income below the FPL and resources at or below twice the standard allowed under the SSI program are known as:

Reciprocity

When one state allows Medicaid beneficiaries from other states to be treated in its medical facilities, this exchange of privleges is referred to as:

People older than 65

Medicare was established by Congress in 1966 to provide financial assistance with medical expenses to:

Cost sharing

Medicare requires its beneficiaries to pay premiums, deductibles, and coinsurance, which is referred to as:

Taxes withheld from employees' wages/Taxes paid by employers

Medicare Part A, the hospital insurance part of Medicare, is funded through:

Medically necessary

Coverage requirements under Medicare state that for a service to be covered, it must be considered:

Are eligible to recieve Social Security benefits

Part A coverage is available free of charge to eligible Medicare beneficiaries who:

Fiscal Intermediary (FI)

A private organization that contracts with Medicare to pay Part A and some Part B bills and determines payment to Part A facilities is called a:

Medically necessary physician's services

Medicare Part B helps pay for:

Medicare pays _______% of allowable charges after the annual deductible is met.

Benefit period

The __________ is the duration of time during which a Medicare beneficiary is eligible for Part A benefits for services incurred in a hospital or skilled nursing facility (SNF) or both.

Medicare Part C

Managed Healthcare plans that offer regular Part A and Part B Medicare coverage and additional coverage for certain other services are called:

Medicare Part D

The prescription drug coverage plan, which began in January 2006, is called:

Donut hole

The period during which a Medicare beneficiary is responsible for all prescription drug expenses until a total of $3850 (2007 figure) is spent out-of-pocket is referred to as the:

Dual eligible

An individual qualifying for Medicare and Medicaid benefits is referred to as a:

PACE

The program that provides community-based acute and long-term care services to medicare beneficiaries is called:

Supplemental policy

A health insurance plan sold by private insurance companies to help pay for healthcare expenses not covered by Medicare is called:

Medicare Secondary Payer (MSP)

The term used when another insurance policy is primary to Medicare is:

Self-referring

Some Medicare health maintenance organization (HMO) enrollees are allowed to see specialists outside the "network" without going through a primary care physician. This is called:

Provider sponsored organization

A group of medical providers that skips the insurance company middleman and contracts directly with patients is referred to as a:

LCDs

Local medical review policies (LMRPs) were replaced in 2003 by:

ABN

A form that Medicare requires all healthcare providers to use when medicare does not pay for a service is the:

Medicaid

Title XIX of the Social Security Act of 1965 establishe:

CMS

Medicaid is administered by:

The Social Security Administration

Supplemental Security Income (SSI) is a cash benefit program controlled by:

Categorically needy individuals typically include:

Spend Down

The term used for the process of depleting private or family finances to the poin where the individual/family becomes eligible for Medicare assistance is:

Program of All-Inclusive Care for the Elderly (PACE)

The program that provides comprehensive alternitive care for noninstitutionalized elderly who otherwise would be in a nursing home is known as:

No less than once a month

Medicaid coverage should be verified:

Duel Eligibles/Medi-Medi

Aged or disabled individuals who are verry poor are covered under the Medicaid and Medicare programs, which are commonly referred to as:

QMBs

Medicare beneficiaries who qualify for certain Medicaid benefits if they have income below the FPL and resources at or below twice the standard allowed under the SSI program are know as:

Reciprocity

When one state allows Medicaid beneficiaries from other states to be treated in its medical facilities, this exchange of privleges is referred to as:

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