Which of the following statements is not correct regarding medicare

Medicare

Medicare is an insurance program. Medical bills are paid from trust funds which those covered have paid into. It serves people over 65 primarily, whatever their income; and serves younger disabled people and dialysis patients. Patients pay part of costs through deductibles for hospital and other costs. Small monthly premiums are required for non-hospital coverage. Medicare is a federal program. It is basically the same everywhere in the United States and is run by the Centers for Medicare & Medicaid Services, an agency of the federal government.

For more information regarding Medicare and its components, please go to http://www.medicare.gov.

Medicaid

Medicaid is an assistance program. It serves low-income people of every age. Patients usually pay no part of costs for covered medical expenses. A small co-payment is sometimes required. Medicaid is a federal-state program. It varies from state to state. It is run by state and local governments within federal guidelines. To see if you qualify for your state's Medicaid (or Children's Health Insurance) program, see: https://www.healthcare.gov/medicaid-chip/eligibility/

For more information on Medicaid, please go to http://www.medicaid.gov

Content created by Digital Communications Division (DCD)
Content last reviewed October 2, 2015

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Medicare is the federal health insurance program for:

  • People who are 65 or older
  • Certain younger people with disabilities
  • People with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD)

What are the parts of Medicare?

The different parts of Medicare help cover specific services:

  • Medicare Part A (Hospital Insurance)
    Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.
  • Medicare Part B (Medical Insurance)
    Part B covers certain doctors' services, outpatient care, medical supplies, and preventive services.
  • Medicare Part D (prescription drug coverage)
    Helps cover the cost of prescription drugs (including many recommended shots or vaccines).

Part A & Part B Premiums

Most people don’t pay a monthly premium for Part A.

You usually don't pay a monthly premium for Part A if you or your spouse paid Medicare taxes while working for a certain amount of time. This is sometimes called "premium-free Part A."

Learn more about premium-free Part A.

If you don't qualify for premium-free Part A, you can buy Part A.

If you aren't eligible for premium-free Part A, you may be able to buy Part A. You'll pay up to $499 each month in 2022 ($506 in 2023). If you paid Medicare taxes for less than 30 quarters, the standard Part A premium is $499 ($506 in 2023). If you paid Medicare taxes for 30–39 quarters, the standard Part A premium is $274 ($278 in 2023).

Learn more about Part A premiums.

Everyone pays a monthly premium for Part B.

Most people will pay the standard Part B premium amount. The standard Part B premium amount in 2022 is $170.10 ($164.90 in 2023). If your modified adjusted gross income as reported on your IRS tax return from 2 years ago is above a certain amount, you'll pay the standard premium amount and an Income Related Monthly Adjustment Amount (IRMAA). IRMAA is an extra charge added to your premium.

Learn more about Part B premiums.

How does Medicare work?

With Medicare, you have options in how you get your coverage. Once you enroll, you’ll need to decide how you’ll get your Medicare coverage. There are 2 main ways:

Original Medicare

Original Medicare includes Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance). You pay for services as you get them. When you get services, you’ll pay a

deductible [glossary]

 at the start of each year, and you usually pay 20% of the cost of the Medicare-approved service, called coinsurance. If you want drug coverage, you can add a separate drug plan (Part D).

Original Medicare pays for much, but not all, of the cost for covered health care services and supplies. A Medicare Supplement Insurance (Medigap) policy can help pay some of the remaining health care costs, like copayments, coinsurance, and deductibles. Some Medigap policies also cover services that Original Medicare doesn't cover, like emergency medical care when you travel outside the U.S.

Learn the general rules for how Original Medicare works.

Medicare Advantage

Medicare Advantage is Medicare-approved plan from a private company that offers an alternative to Original Medicare for your health and drug coverage. These “bundled” plans include Part A, Part B, and usually Part D. Plans may offer some extra benefits that Original Medicare doesn’t cover — like vision, hearing, and dental services. Medicare Advantage Plans have yearly contracts with Medicare and must follow Medicare’s coverage rules. The plan must notify you about any changes before the start of the next enrollment year.

Learn about the types of Medicare Advantage Plans.

Each Medicare Advantage Plan can charge different 

out-of-pocket costs

. They can also have different rules for how you get services.

Learn more about how Medicare Advantage Plans work.

Medicare prescription drug coverage (Part D)

Medicare drug coverage helps pay for prescription drugs you need. To get Medicare drug coverage, you must join a Medicare-approved plan that offers drug coverage (this includes Medicare drug plans and Medicare Advantage Plans with drug coverage).

Learn more about how to get Medicare drug coverage.

Each plan can vary in cost and specific drugs covered, but must give at least a standard level of coverage set by Medicare. Medicare drug coverage includes generic and brand-name drugs. Plans can vary the list of prescription drugs they cover (called a formulary) and how they place drugs into different "tiers" on their formularies.

Learn more about Medicare drug coverage.

Plans have different monthly premiums. You’ll also have other costs throughout the year in a Medicare drug plan. How much you pay for each drug depends on which plan you choose.

Learn about your costs for Medicare drug coverage.

How does Medicare work with my other insurance?

When you have other insurance, there's more than one "payer" for your coverage. 

Learn how Medicare works with other insurance.

Which of the following is not covered by Medicare?

does not cover: Routine dental exams, most dental care or dentures. Routine eye exams, eyeglasses or contacts. Hearing aids or related exams or services.

Which of the following statements about Original Medicare is false?

Original Medicare is comprised of Part A and B. In order to receive drug coverage, Medicare beneficiaries must buy a separate Part D prescription drug plan. Answer: False. Original Medicare is different from Medicare Advantage plans.

What is a correct statement about Original Medicare?

Original Medicare is the traditional Medicare program administered directly through the federal government. Under Original Medicare, the government pays directly for the health care services you receive.

What is Medicare all about quizlet?

What is Medicare? Federal program that provides health insurance coverage to people ages 65 and older and younger people with permanent disabilities. The 4 part program covers all those who are eligible regardless of their health status, medical conditions, or incomes.