Learn what a Skilled Nursing Facility (SNF) is, and how it provides therapy and nursing care to patients under Medicare.
Explore the Federal Insurance Contributions Act (FICA), a law introduced in 1939, which mandates payroll taxes to fund social security and Medicare benefits. Learn how both employers and employees contribute equally.
Learn about the Utilization and Review Committee in healthcare insurance, which monitors services and supplies provided to Medicare patients to ensure compliance and quality.
Learn about Hospital Tax in Health Insurance, a mandatory social security tax that funds Medicare Part A costs. Discover its purpose and implications.
Explore Hospital Insurance under Part A of Medicare, including coverage for inpatient hospital stays, home health care provided by nurses, and hospice care. Learn about services requiring co-payments or deductibles.
Learn about the customary charge, the average cost of medical procedures used to determine Medicare benefits, and its impact on health insurance.
Learn about the Health Care Financing Administration, a division in the Department of Health and Human Services that oversees Medicare and Medicaid and sets certification guidelines for medical care providers.
Learn about Medicare supplement insurance, an essential adjunct that helps cover deductibles and co-payments not covered by Medicare. Explore how it works, what it covers, and how to choose the right plan for you.
Learn the role and importance of a Participating Provider in Health Insurance, including their approval process in Medicare and how they are compensated.
Explore the concept of Prevailing Charge in Health Insurance, which refers to the standard charge for a service in the insured's geographical area and its role in determining Medicare benefits.
Learn about supplemental medical insurance, a voluntary program that covers physician’s costs and outpatient care, and how it is structured under Medicare Part B.
Learn about reasonable and customary charges in health insurance, what they mean for your healthcare costs, and how they relate to provider charges and Medicare-approved costs.
Discover how the Prospective Payment System (PPS) operates in health insurance, particularly with Part A Medicare, and how reimbursement is determined based on patient condition at hospital admission.
Learn about the role of a third party payor in health insurance, such as Medicare or Blue Cross/Blue Shield, and their importance in healthcare coverage.
Learn about Comprehensive Medicare Supplement policies that cover Medicare deductibles and co-insurance amounts for treatments.
Learn about nonparticipating providers in health insurance, including what it means for a provider to not participate in Medicare or health plans.
Understand the role of Peer Review Organizations (PROs), where physicians hired by the federal government review services provided to Medicare subscribers by Medicare-approved facilities.
Learn about Resource Based Relative Value Scale (RBRVS), a method used by Medicare to determine compensation for doctors, and its implications in the health insurance industry.
Learn about the Explanation of Medicare Benefits, a statement mailed to Medicare participants detailing the payment for their claims. Find out how it informs beneficiaries about covered services and payments.
Explore the concept of legislated coverages in general insurance, covering essential protections like Flood Insurance and Medicare. Understand how laws influence these mandatory insurance policies.
Medicare is a government-run and funded health insurance plan that covers hospital and medical costs for individuals typically older than 65. Learn about Part A and Part B options.
Learn about Qualified Medicare Beneficiary (QMB), who qualifies for Medicare benefits due to income being under the federal poverty guidelines.
Learn about the illegal high-pressure tactics used in selling health insurance policies and how to identify and prevent being a victim. High-pressure tactics often involve threats, intimidation, or coercion, especially in marketing Medicare supplemental policies.
Learn who qualifies as a Medicare beneficiary according to the Social Security Administration and what it means to be eligible for Medicare benefits.
Discover Medicare Select Policy, a specialized Medicare supplement that offers benefits through a specified network of providers. Learn how it can support your healthcare needs.
