Medicare

We’ll finish the TPL discussion with Medicare.

EPM Definition: A federal health insurance program for people who are age 65 or older, disabled, blind, or have permanent kidney failure.

Always verify the amount a client is paying for Medicare premiums. Premiums vary based on what Part of Medicare the client is enrolled, when the client enrolls, and if services/prescriptions are being received through a health care plan, which plan is chosen.

There are four types (or parts) of coverage

Medicare consists of the following:
Part A – Hospitalization Insurance.

Part B – Medical Insurance.

Part C – Medicare Advantage.

Part D - Prescription Drug Coverage.

in the Medicare program. Clients can be enrolled in all, some or one of the coverage parts at a given time. Each of the coverage parts may have premiums, co-insurance and deductibles which are subject to annual increases on January 1 of each year.

You are probably most familiar with Medicare Part A and Part B, and the premiums associated with them, from your experiences working with basic MA.

To Do: Take a minute to refresh you Medicare knowledge by reviewing the chart found on the Medicare (PDF) handout. This chart will be utilized both in the MA-LTC online courses and in the MA-LTC Systems classroom course.

You will learn more about how to apply Medicare Part A, B, C and D premiums as a deduction in the LTC income calculation in the Income and MA-LTC course and how to use them to meet a medical spenddown in the MA-LTC Spenddowns and Waiver Obligations course.

Page 6

Third Party Liability

«Back | Next»

Skip to content subnavigation Questions? | Policy Manual | Training Information

Skip to content subnavigation
Questions? | Policy Manual | Training Information