Week 2 Assignment (B): The Payment Process: Government Payment Programs 1. List three ways a person becomes eligible for Medicare benefits. A person can become eligible for Medicare at the age of 65 years of age, or you can be younger with disabilities and or End Stage Renal Disease. You can qualify for part A Medicare benefits. If you are a U.S citizen or legal resident of the United States for at least 5 years. You have or your spouse has worked long enough to qualify for Social Security or railroad retirement benefits. Lastly If you or your spouse had Medicare-covered government employment. 2. What is the difference in coverage between Part A and Part B of Medicare? Medicare Part A: Covers inpatient hospital care, most people that qualify for free Part A coverage if you meet one of those three criteria listed above. Part A coverage covers your hospital room and hospital meals, general nursing, prescription drugs received in the hospital, skilled nursing facility care, hospice care and home health care. Medicare Part B: Covers outpatient medical care, you will typically pay a premium for part B coverage. In most cases you will be required to pay 20% of the Medicare allowable. In an article I read it states that,” in 2018 the average Part B premium is $130.Your Part B premium may be the “standard” amount, $134 in 2018”. So the main difference between Medicare Part A and Medicare Part B is that part A is usually premium Free, but part be usually requires a monthly premium, even if you’re have a Medicare Advantage plan that provides your Part A and Part B benefits, you still have to pay your Part B premium. Medicare Part D: Is prescription drug coverage, if you have Medicare you do not automatically get Part D coverage. This is completely optional but can be very valuable to someone that takes medication regularly like most of the aging population. Part D drug coverage, you will pay a co-pay for your medications based on the drug, the medications are divided in to tiers Each tiers has a co-pay amount that you will pay for the drug. If the drug is considered a tier one medication this would be one that is usually a generic medication. Your co-pay would be lower than if the drug was a tier three which is usually name brand. For Medicare Part D you will also pay a monthly premium to the insurance company to have Part D coverage.
- Fall '17
- Susan Heybourne