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Ins for Senior Citiz
TN Accident & Health (Insurance For Senior Citizens)
| Term | Definition |
|---|---|
| MEDICARE | A federal health insurance program, administered by the Centers for Medicare & Medicaid Services (CMS), for people age 65 and older and for certain disabled individuals. Signed into law in 1965. |
| 4 | Medicare coverage is divided into how many parts? |
| Parts A,B,C, and D | What are the 4 parts of Medicare coverage? |
| Parts A and B | What parts of Medicare is known as "Original Medicare"? |
| Centers For Medicare & Medicaid Services | What does CMS stand for? |
| Part A (Hospital Insurance) | Covers institutional medicare, including inpatient hospital care, skilled nursing home care, post-hospital home health care, and hospice care. |
| Part B (Medical Insurance) | Covers physicians' services, outpatient hospital care. physical therapy, ambulance trips, medical equipment, and some preventive services. Provides supplemental coverage to Part A. |
| Part C (Medicare Advantage) | A managed care plan alternative to original Medicare. Provided through commercial insurance companies, this all-encompassing plan combines the coverage of Parts A and B in managed care format similar to a PPO. |
| Part D (Prescription Drug Coverage) | Provided through Medicare approved commercial insurers |
| Medicare Savings Program | State run program offered in each state that helps reduce Medicare costs for eligible persons |
| offer atleast Plan A (and either Plan C or Plan F) | If you sell Medigap policies, you MUST... |
| 10 | How many standardized Medicare supplement plans are there? |
| Medicare | Primary Insurer...For the old... |
| Medicaid | Secondary Insurer...For the needy... |
| MEDICAID | Provides healthcare coverage and health related services to people with low incomes and other needy individuals. Jointly funded by the federal and state governments, but it is administered by the states. |
| Financial Need | Eligibility for Medicaid assistance is fundamentally based on... |
| 1.) Disability or Age 2.) Income Limitations 3.) Asset Limitations | Eligibility for Medicaid is determined by state requirements in what 3 areas? |
| 1.) Skilled 2.) Intermediate 3.) Custodial | What are the 3 levels of Long-Term Care? |
| Skilled Nursing Care | Continuous, 24 hour care delivered by licensed medical professionals, under the direct supervision of a doctor or physician. Usually delivered in a nursing home. |
| Intermediate Care | Ongoing care necessary to address a person's condition but but not needed 24 hours a day. Care is delivered by RN's, LPN's, and nurses aides, who are supervised by a doctor. Usually in ones home, assisted living facility, or a community based center. |
| Custodial Care | Care that's provided to help a person meet daily living requirements, like bathing, dressing, or eating. Usually provided by nurse's aides. Delivered in nursing homes, assisted living facilities, adult day-care centers, respite centers, or a person's home |
| 2 or more Activities of Daily Living (ADL) | In order to be eligible for Long Term Care Benefits the insured must be unable to perform.... |
| 1.) Dressing 2.) Eating 3.) Transferring (i,e moving from a bed to a chair) 4.) Bathing 5.) Toileting 6.) Continence (the ability to control urinary and bowel functions) | Long Term Care insurance recognizes 6 basic Activities of Daily Living. Which are: |
| Benefit Amount | The dollar amount that will be paid for qualifying care, typically expressed as a daily amount |
| Benefit Period | The length of time for which benefits will be paid |
| Return of Premium | Returns part of the premium paid for the LTC coverage to the insured's estate or to a named beneficiary when the insured dies. |
| Nonforfeiture Benefit | States that if the policyowner cancels the LTC policy, a minimal amount of paid up LTC benefits will remain in force. |
| Guaranteed Renewable | All Long Term Care policies must be issued as... (as long as the the policyowner pays the premium) |
Created by:
Tiphanie_Dyme
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