Question

Identify three resources that providers can use to determine the scope of Medicare coverage for a particular service?

Answer 1

Ans) Medicare-

Title XVIII amendments to the Social Security Act of 1935, medicare guarantees a minimum level of health insurance benefits to all Americans beginning at age 65 ( and other special needs groups without regard to age).

- Medicare has four parts A, B, C, and D, which cover:

(A) physician and outpatient services,

(B) hospital care,

(C) participation managed care plans, and

(D) prescription drugs.

- Most Medicare parts require beneficiary cost-sharing.

- Medicare funds derive largely from payroll taxes levied on all American workers that are matched by their employers in equal amounts.

- Organization responsible for determining the type, amount and scope services covered by Medicare:

State according to federal quidelines title XIX SS act.

Three groups eligible for Medicare:

• Categorically Needy
• Medically Needy
• Special groups