Ans) Medicare eligibility – Part A and Part B:
- To be eligible for Medicare Part A and Part B, you must be a U.S. citizen or a permanent legal resident for at least five continuous years.
- You must also meet at least one of the following criteria for Medicare eligibility:
Most individuals don’t have to pay a premium for Medicare Part A if they or their spouse paid Medicare taxes while working for at least 10 years (or 40 quarters). If you’re not eligible for premium-free Part A, you will have to pay a monthly premium of up to $437 in 2019.
In addition, you must also pay the Part B premium each month. The standard premium is $135.50 in 2019.
Also, keep in mind that individuals with a higher income may have to pay more for their Part B premium. Be aware that if you don’t sign up for Medicare Part B when you first become eligible, you may have to pay a 10% penalty (added to your monthly premium) for each full 12-month period you could have had it but didn’t sign up (some exceptions apply).
Medicare Part C eligibility:
- Medicare Part C (also called Medicare Advantage ) is an alternative way to your Medicare Part A and Part B benefits. Medicare Advantage plans are available through private insurers. To be eligible for Medicare Part C, you must already be enrolled in Medicare Part A and Part B, and you must reside within the service area of the Medicare Advantage plan you want. You can get more information about and enroll in a Medicare Advantage plan by contacting one of the following:
- The Medicare Advantage plan (Part C) Initial Coverage Election Period is generally the same as the Initial Enrollment Period for Medicare Part A and Part B (the seven-month period that starts 3 months before the month you turn 65, includes the month you turn 65, and ends 3 months after the month you turn 65). Or, you can sign up during the Annual Election Period (AEP) from October 15 to December 7 for coverage effective January 1 of the following year. You can also enroll during a Special Election Period (SEP), if you qualify.
- If you have end-stage renal disease (ESRD), you might not qualify for a Medicare Advantage plan in most cases. But there’s one type of Medicare Advantage plan that’s specifically meant for people with ESRD. Read about Medicare Special Needs Plans.
- Medicare Part C is optional, and there is no penalty for not signing up. But you must have Medicare Part A and Part B to get Part C, and live in the service area of a Medicare Advantage plan. You also generally can’t have end-stage renal disease (with some exceptions).
- If you have Medicare Part C, you must continue paying your Part B premium even if you enroll in a Medicare Advantage plan. Monthly rates and plan coverage for Medicare Advantage plans vary by the insurance company you choose and your specific plan details.
Medicare Part D eligibility:
- Medicare Part D covers prescription drugs and, like Medicare Part C, is available through private insurers that are approved by Medicare. To be eligible to enroll in a Medicare prescription drug plan (PDP), you must have Medicare Part A and/or Part B and you must live in the service area for the prescription drug plan in which you want to enroll. To be eligible to enroll in a Medicare Advantage plan with prescription drug coverage (MAPD), you must have Medicare Part A and Part B, and you must live in the service area for the MAPD plan while considering.
Describe the types of medicare coverage ehich should include eligibilty requirements, coverage, and bebefit periods.
Describe the eligibility requirements and costs, if any, for each of these types of subsidized care. Coverage for acute care, including hospitalization Coverage for preventive care Outpatient services Specialty services, such as mental health, rehabilitation, etc.
Medicare has expanded to include medicatios for seniors under the Medicare Part D ppl and. is this an important part of healthcare coverage or another plan the nationa cannot afford?
Describe how Medicare reimburses the major types of providers, and discuss the implications of these methods for an organization’s resource management.
Describe the type of medical insurance coverage you have. If you are not insured, describe the policy held by someone you know, or access the website of the Medicare program (Medicare.gov) and click the tab "What Medicare Covers" before answering the following questions. According to the plan’s policy information (often printed in a pamphlet that accompanies the policy itself or available online at the plan’s website), what benefits does the policy cover? Are some services excluded from coverage? Are any...
evaluate and describe the Medicare beneficiary program. Include a brief discussion about the 4 "Parts" of the Medicare Program. What are the specific general Medicare eligibility rules? How can you apply what you have learned about Medicare in your current and/or future profession?
What are the current time periods for the meaningful use program under Medicare and Medicaid, respectively? How do providers avoid payment penalties for failing to satisfy meaningful use requirements?
Beatrice Hampton is a Medicare patient who has Part A and Part B coverage. Will Medicare cover her office visit with the endocrinologist? What percent of the bill will she be financially responsible for?
Discuss Medicare eligibility, including the five categories of people eligible for Medicare coverage. Do you think all 5 categories are appropriate, would you add or remove any? Explain.
Describe Medicare Part A Hospital Insurance. Describe Medicare Part B Voluntary medical insurance. Describe Medicare Part C Medicare Advantage Plans.
Medicare coverage of which of the following is relatively limited? Select one: a. Somatic acute care services b. Hospital care coverage c. Physician care coverage d. Mental health and long-term care