Supplemental Medical Benefit: Case Study

During 1959, the year before the Amendment of 1960, the Bureau of Census indicated a 35.2% of poverty with those 65+ and 17% with those from the ages of 18-64. Roughly seven years later, in 1966, when Medicare was passed and provided for a year, it was shown that 28.5% of the elderly population lived in poverty whilst 10.5% of people from 18-64 lived in poverty (Excel Files tbl 3). From the seven years prior to Medicare being passed to the actual passing of the program, the rate of poverty in the elderly decreased 6.7%. Sometimes, it is difficult to gauge the progress and effectiveness of a program when looking at the course of a few years, however, one can witness trends over a couple decades. In the fifty years since Medicare has been passed, the rate of poverty in geriatrics has steadily decreased as the rate of poverty in those from 18-64 steadily increases. The data, as reported by the Bureau of Census in 2012, is in agreement with the trend stated above. According to the study, roughly 9.1% of geriatrics live in poverty, whereas 21.8% of 18-64 year olds live in poverty (2012 census figure 5). In the past five decades, the rate of poverty in those 65+ has decreased a massive 26.1%. The favorable consequences of Medicare are undeniable and amidst the concern for the elderly, there was a growing awareness regarding civil rights issues of the

The Department of Veterans Affairs (VA) does not only provide benefits to military veterans. Veterans ' spouses, children, and parents can benefit from the resources that the VA provides.

TRICARE is the health insurance program of the US Armed Forces, National Guard and Reserve members, retirees and their families. Tricare is offered to members of the seven branches of the military and their dependents and offers several options including standard Tricare.

Medicare is a federal government administered healthcare program originally implemented on July 1, 1996. Medicare has four parts (A, B, C and D) that provide different areas and differing levels of coverage. All Medicare programs provide coverage for cover healthcare services to qualifying individuals, known as beneficiaries, which includes Social Security beneficiaries over the age 65, people under 65 with certain disabilities, and people of all ages with end-stage renal disease. Each program provides coverage for medically necessary care and services to covered beneficiaries and has deductibles or copays for covered services. Medicare Part A, Medicare Part B and Medicare Part C all provide coverage for medical services. Medicare Part C and Part D provides prescription drug coverage.

Pharmaceutical representatives, show the physicians the newest drugs on the market, to drum up business for the pharmaceutical companies. The representatives leave samples of the products, In hopes that the doctor will strat prescribing their new name brand products for his patients instead of generic drugs.Also, in some cases, the patients are not financially able to purchase a new drug not knowing if it will help with their disease.The clinic 's management staff will determine whether they will be except the newest medication samples from the representative. If it is a useful product to the physician and their patients that the clinic serves.These pharmaceutical companies offer gifts and meals to the doctors.Such as free services to physicians, like building websites or providing free web pads with the name of the pharmaceutical products on them.

Between 2010 and 2050, the United States population ages 65 and older will nearly double, the population ages 80 and older will nearly triple, and the number of nonagenarians and centenarians—people in their 90s and 100s—will quadruple. (KFF, 2015) Trustees of Medicaid are forecasting that in 2024, Medicaid will start running out of funding. Although there is little evidence in the trustee’s projections it is still something that needs to be looked as more and more people are getting older and are needing benefits vs a number of people putting in. Every day there are 10,000 people turning 65 or older.

Under the Balanced Budget Act (BBA), the Health Care Financing Administration (HCFA) put into effect a nationwide Prospective Payment System (PPS) within Skilled Nursing Facilities to reimburse inpatient service costs for beneficiaries covered under Medicare Part A as of July 1,1998 (Skilled Nursing facility PPS, 2013). Generally, Medicare Part A covers beneficiaries within the following inpatient settings: SNFs, hospitals, nursing homes, hospice, and home health services (What Part A Covers, n.d.). Medicare Part A uses a Prospective Payment System at a per diem rate. In other words, Medicare Part A pays SNFs pre-determined daily rates for patient care, meaning they are dictating the daily allowance of expenses used for services (Skilled Nursing

Sometimes, if the lower income family does have insurance, it does not cover the evaluations and they are very expensive for out of pocket payment. Currently, in some states there are very limited options for people who have Medicaid for their primary insurance. If a psychologist does take Medicaid, the waiting list can be months, even years. It has been established that if a state has better reimbursement schedules, then treatment is more readily available. With the opposite being true with lower reimbursement rates (Thomas, Parish, Rose, & Kilany, 2012).

Every year the United States government has to agree on a federal budget for fiscal policy. The federal budget breaks down how and on what the country’s revenue will be spent. The budget is divided into several parts, including military spending, veteran benefits, health and science, education, transportation, etc. The national government sets aside approximately fifty-four percent of the federal revenue for military expenses such as guns, tanks, ammunition, etc. These expenses do not include the pay of those who serve in the military. Only six percent of national spending is reserved for veteran benefits. Collecting veteran benefits is a lengthy process because of the lack of funding from the federal government, and it is often too late before

the benefits of Medicare, a significant healthcare program, that provides comprehensive benefits to retirees in order to fulfill their healthcare needs cannot be overemphasized enough.

The Patient Protection and Affordable Care Act was signed law March 23rd 2010 by President Obama. The Affordable Care Act is a health care reform that provides Americans with insurance and makes it more affordable as well as giving the recipient more options for places to go. An example of this would be able to choose between four doctors instead of two. The Affordable Care Act also provides people of a wide age range with better options for health insurance. As a results of the Affordable Care Act many uninsured people are receiving medical attention, young adults can stay on their parents insurance plans longer and Medicare and Medicaid have improved plans.

In 2010, the aggregate shortfall of government funding for Medicare and Medicaid beneficiaries was estimated at $28 billion dollars. Currently, Medicare and Medicaid in combined do not cover the complete cost of care for program recipients but their beneficiaries account for about half the care provided by hospitals .

You are a new physician setting up your practice in a new town. You are researching the different MCOs offered in your area and are considering becoming a physician for one of these networks. You have also invited the sales representatives of several healthy plans to speak with you about the benefits of choosing their plans.

The primary reason why the managed care model was created to provide satisfactory and best healthcare to all the enrollees at reduced and controlled cost and its aims to ensure that the healthcare provide a suitable medical condition of the patient and safeguarding such services are provided by appropriate provider. Its emphasis on keeping enrollees healthy to reduce use of services.

Health insurance is one of the main insurances ones can have in life.Without reliable health insurance any small treatment can wipe out a person financially. " health insurance is a type of insurance coverage that pays for medical and surgical expenses that are incurred by the insured" as defined by Investopedia, 2015.