This does not include those covered by PART A or PART B Part D and the DONUT HOLE 2018 1) First plan you pay *$405 out of pocket* Beneficiares pay an additional premium! Part D Cost Sharing -Part D will cover *most FDA approved RX drugs* = However *IT DOES NOT TELL YOU HOW MUCH IT COSTS*. What is Voluntary Enrollment for Medicare Part D? In PART D, this is voluntary coverage. They know the plans to choose based on patients circumstance.Ģ) PCP's and Pharmacists are Essential to teaching patients on the best plan.ģ) Military lady's mom has Part C = Medicare Advantage. ![]() Covers your prescriptions Eglibility for PART D? 1) Again = MUST HAVE PART Aģ) Part D is optional The rIGHT PLAN DOES MATTER.how do you get patients to get the right plan? 1) Having a relationship with the doctor. What is Medicare Part D? Medicare Part D = Drug plan Soooo what does Medicare Advantage cover? = TEST QUESTION! 1) Part C is like a combo of *Part A + B*ģ) Part C has *ADDITIONAL BENEFITS* that depends on the plan. If the *plan is cheap, they must pass on savings to benficiary* OR *return it to medicare*. Plans for Part C must *provide minimum of a traditional medicare benefit*. Part C has Increased options for medicare. Cost Sharing on Medicare Advantage *Part C Cost Sharing* *Part C may have PHARMACY BENEFITS, but some DO NOT*. *Some Part C plans cover prescriptions* PART C Coverage = Medicare Advantage Coverage 1) Must have Part A to get Part Cģ) Part C members may need to pay *additional premium*. Part C expanded the ability to participate in HMO's and PPO's If Physician *DOES NOT ACCEPT ASSIGNEMNT* patient can be billed for the difference.ĮX) If my bill is for 100 and medicare only pays 50, if my *physician ACCEPTS ASSIGNMENT* = I pay NOTHING! What is Medicare Part C? Medicare Part C = *Medicare Advantage* Medicare participating physicians agree to accept only what medicare pays. Dental Care Cost Sharing for Part B Medicare 1) Part B has a monthly premium Taste, Sight, Smell, Hearing *NOT COVERED BY PART B* Comes from *PREMIUMS + Cost Sharing* What services are Covered on Part B? 1) Physician ServicesĢ) Outpatient service = X-rays, MRI's, Labs,Dialysisģ) Preventive services = Vaccines + Cancer screenings Part B Does not Cover your 5 senses Financing for Part B? *Financing for Part B* Anything not covered on Medicare Part A might be covered on *medicare Part B* Eligibility for Part B? 1) you must have PART Aģ) Social Security may have premium deducted from checks Covers *Lab tests, Medical equipment, Orhotics/prostetihics, Mental Health Care, wheelchairs + hospital beds*. Provides coverage for *physician services, OUTPATIENT HOSPITAL* (n.d.).-This is OPTIONAL.not required Medicare Part B
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