Question

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?

Answer 1

Medicare beneficiary program can be simply described as a program which allows us to get aid (help) from the respective state (which we're a resident of) to pay our medicare premiums, which include the actual medicare premium (both Part A & Part B premiums), deductibles and also coinsurance as well as copayments too.

The following are the 4 major parts of the medicare program:

• Part A - Hospital Coverage
  This makes sure that people are being provided the benefits of medicare plans from the hospitals without any charge (well at least in most of the cases)
  
• Part B - Covering your Doc and Medical Expenses
  This is quite a bit chargeable thing, so the charge is made to your Social Security Check , means the money incurred for such expenses are deducted from you Social Security amount and paid to the respective heads once you sign up for the Part B
  
• Part C - Benefit of Medicare
  This automatically dis-enrolls you from the previous Medicare Coverage and gets you signed up for a new Medicare Coverage under Private Insurance Provider and is normally organized as Health Maintenance Organization or Preferred Provider Organization (HMO/PPO)
  
• Part D - Prescribed Drug Plan
  This part has all the list of drug plans that are prescribed or may be prescribed, in short we can say every drug is covered under Part D. The only thing you've to do is to match your prescription of drugs with the drug plans in Part D

The following are the specific Medicare Eligibility Rules:

For Part A and Part B

• Your age should be either 65 or older than 65, and you automatically get enrolled to medicare
• Or be permanently disabled and get the benefits given under disability for at least two years as prescribed
• Permanent Kidney failure or Transplantation of Kidney
• If you have Lou Gehrig's disease (also know as ALS)

For Part C

• To be eligible you must have been enrolled in any one of the above parts (A or B)
• Or get enrolled in a Medicare Advantage Plan which are available through private insurance providers
• Shouldn't have ESRD (End Stage Renal Disease)

For Part D

• Available through Private providers duly approved and authorized by Medicare
• You must have Medicare Part A and/or Part B as your enrollment
• You should also live in a area where it is serviceable under the prescription drug plan or drug coverage

Application of Rules:
These rules are to applied strictly without fail, for such application and regulations, employees in the selection process shall be perfectly selected and should be suitable for the job and must fit in the job description, so that the rules so framed are checked thoroughly whether everyone is following or not and complied or not.

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