Who is eligible for Medicare?
Did you know that all Americans who have attained the age of 65 and above are entitled to a health insurance that is offered by the Federal government? Young people who have disabilities or kidney failure complications can also be eligible to benefit from this insurance. This type of federal health cover assists in reducing the cost of health care, but cannot entirely cover all the costs in case long-term care is required. People are given an option to choose how to obtain Medicare coverage. If you decide to the original Medicare policy, then you can purchase a Medicare supplement plan (often referred as Medigap) from a private insurer to cater for other costs that the original Medicare is unable to pay. What is
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Part B
This caters for outpatient care, preventive services and doctor’s services
Part C
This is a type of care that is offered by a private insurer in collaboration with Medicare to offer services given under part A and B
Part D
This covers the cost of the prescribed drugs that are not covered under the original cover.
The key benefits of Medigap includes the following:
Medicare Part A- It can cater for hospital and coinsurance costs when the original Medicare has been exhausted(members can access this benefits for a period of one year after the exhaustion)
Medicare part B-it covers for copayments
It can also cater for the first three pints of blood
It can also pay for hospice care offered.
Deductibles can also be paid using medigap.
Medigap Plan F
This is a high-deductible cover where you may be forced to pay the balance out of your pocket But the plan has lower premiums compared to others. Medigap Plan G
This offers almost the same advantages as plan F, only that users will be required to pay an annual deductible of $166. They are used to cater part B excess charges of the initial Medicare.
Medigap Plan
After an annual $100 deductible per person, the Fund will cover 80% of the cost for covered items provided the expense is reasonable and customary. There is a maximum payment of $5,000 per person in any calendar year. The following items are covered under this benefit: Emergency ambulance/nonemergency ambulance or ambulette if medically necessary ($2,500
In typical bundled payment models, providers and payers share in savings and/or losses. When actual health care costs fall below the lump-sum payment, both parties keep a portion of the difference as additional profit. Conversely, the provider must provide extra services at a loss when health care costs exceed the lump-sum payment, though payers mitigate some of this loss. The potential for savings for payers lies in upfront discounted payments for episodes of care, as well
Lastly, I will discuss if Medicare Part D being passed corresponds with my understanding of the policy and politics. Medicare Part D is a prescription drug benefit program that was designed to subsidize the cots of prescription drugs and prescription drug insurance premiums for Medicare beneficiaries. Medicare Part D offers prescription drug coverage to everyone with Medicare coverage. Medicare Part D was passed in 2003 in a political climate that used it as a tool to ensure the re-election of a President facing huge deficit (Medicare Part D Policy: The Cost to the Republican Party. (2015).
Medicare is our country’s health insurance program for people ages 65 and older. Certain people younger than 65 can still qualify for Medicare, including those who have disabilities. In 2006 there were over 38 million people receiving Medicare benefits in the United States. Blue shield is a form of Medicare. Blue shield is a health care that is in the U.S. and Canada.
It is a system which all Canadians are proud of. “Medicare’s basic principles embody how Canadians wish to both see themselves and distinguish their nation from a powerful, and at times overwhelming, continental neighbor ”(Shevell,2012,p.35). They did it. Nowadays, in the United States, there are only 48 million American who are able to enjoy medical treatment(Celeste& Roxanne, 2013). Furthermore, Medicare also brought benefits not only to local people but also immigrants.
There are aspects of Medicaid, especially for low-income populations, where it is really almost better to have instead of private coverage. In Medicaid, there are very low copays and no deductibles, but Medicaid recipients are more likely to report having difficulty finding a provider or delaying care because their health care coverage is not widely accepted.
Although the Plan D is optional, any delay in signing up for the coverage will being late penalty charges for the beneficiary adding up to the premiums except in case of below conditions- Beneficiary is enrolled with other prescription drug coverage Beneficiary is eligible to get Extra Help which means that if in case of meeting a specific income and resource criteria, beneficiary might qualify to get Extra Help from Medicare to get the prescription drug
Some variability differs with the capability of providing out-of-network health providers and the services in which can be provided. By having a broad range of choices that can be provided, will cause a higher the cost for the individual that is paying. Most Medicare patients have received the managed care plans due to promises of a lower copayment amount and often medication benefits. Medicare post-acute spending has grown rapidly with the number of users between 1999 and 2007. The growth in Medicare short-term post-acute service use, in part, reflects short hospital stays and a growing demand for rehabilitation services.
Previously, medical costs were largely paid for by individual patients through out-of-pocket expenses or private insurance premiums. While the Affordable Care
AARP also operates and effects our society. AARP has generated over 458 million dollars in royalty fees from plan called “medigap”. “Medigap plans are private insurance plans that seniors buy to cover things that traditional, government-run Medicare does not, like catastrophic coverage. " It has also brought in 266 million dollars for lobbyist that they receive in membership dues. AARP aggressively, and successfully, lobbied to keep Medigap reforms out of Obamacare.
The Effects of Regulations on Managed Care and IDS Managed Care is a health care delivery system organized to manage cost. The legal and business imperatives of managed care pervade our national healthcare system, the regulation of managed care depends on who contributes to the plan and who bears the risk for paying for the insured services. More than 170 million Americans receive health care coverage or benefits through some type of "managed care" setting.1 By 2007 about 20 percent of these services are directly provided by a health maintenance organization (HMO), while the majority are served through other managed arrangements, 60 percent in Preferred Provider Organizations (PPO) and 13 percent in Point of Service (POS) plans. Beginning
Examples include programs to reduce unnecessary hospital readmissions by coordinating care and services for patients when they leave the hospital. Other provisions provide for the development of Accountable Care Organizations, bundled payments, and medical homes all of which are intended to provider higher-quality, coordinated care for beneficiaries. The Affordable Care Act also covers seniors on preventative services and annual wellness visits. Medicare beneficiaries are eligible to receive many preventive services with no out-of-pocket costs. These include flu shots, tobacco cessation counseling, as well as no-cost screenings for cancer, diabetes, and other chronic diseases.
Medicare is funded by taxpayers, with money coming out of each paycheck, social security benefits. I believe this is effective as of right now, but I do not believe that by the time I turn 65 medicare will be running effectively. Medicaid is funded by state and federal governments. With states covering over half the cost. I believe funding programs and organizations that help provide care and inform our citizens is a great resource it will lead to less costs of healthcare for care that could have been avoided.
It be treated in the public hospitals and clinics that is supplied by public insurance since it lacks the least facilities that can treat any patient, consequently low, middle, and high income families shift to private insurance since it can provide the least facilities. Adding to that, private insurance can provide a plan of payment according to the patient’s salary, but each plan has its benefits and coverage. Some other private insurance have special enrollment periods. For instance, according to HealthCare.gov (2015)“ special enrollment period such as having a baby, getting married or moving to a new