A(1). Fee-For-Service or Traditional Indemnity plans are uncommon but still used. Payment is rendered for services provided. Traditional Indemnity plans in general have no provider network and a patient can see a specialist without a referral. If a patient uses an FFS plan, the patient would pay the provider for medical care provided. If the medical care provided is covered by the plan. The insurance company would then reimburse the patient according to the guidelines stated in the policy or the UCR’s “Usual, Customary, and Reasonable Fees.” (“Private-Fee-For-Service Plans,” CMS.gov, 3/16/2012). Key benefits of a Traditional Indemnity or Fee-for-Service plan include no in network physicians or health care providers and the patient may see any physician or seek health care services at any healthcare facility. The patient or client can also seek treatment from a specialist without a physician referral. Fee-for-Service plans are the most flexible plans for choosing a healthcare provider and health care facility. However, Traditional …show more content…
The federal government has established general guidelines for providing and administering State Children’s Health Insurance. Immunizations and well/baby and well/child care is provided at no cost in every state. Eligibility requirements to receive State Children’s Health Insurance benefits, scopes, and services are determined by each individual state following federal government guidelines. Federal guidelines followed by every state that an individual must meet to receive benefits include: 19 years or younger in age, not covered by health insurance, including Medicaid and must be a US Citizen, legal alien, or permanent resident (“Benefits Details,” Benefits.gov,
Another of Michigan's Medicaid programs is called Healthy Kids and is for low-income children under 19 years of age and pregnant women (MDCH, 2014). There is no monthly premium for this and there is only an income test (MDCH, 2014). The benefits of ...
It is generally accepted that the method of payment to physicians affect their professional attitude and behaviour. Consequently, health policy makers manipulate payment system in an attempt to achieve optimal health care for their citizens such as improve accessibility, quality of care, patient’s satisfaction and cost containment. In Ontario, there are a wide range of mechanisms that are used to pay physicians for their services that are funded by both federal and provincial government. According to Canada Health Act annual report (2013), the majority of primary healthcare physicians are funded using the fee for service payment arrangement but of that majority, only less than 30% are compensated exclusively according the fee for service plan. The remaining physicians are funded using one of the following mixed compensation models:
Children in the U.S. may gain healthcare insurance coverage through a parent or guardian, either through an employer or voluntarily obtained private insurance. Voluntary insurance options are available through the Marketplace. The program is run by either state or federal government entities.
What exactly is Medicaid? Medicaid is the largest health insurance in the United States, and it services many low-income families. This government health program is state regulated and varies among states due to having their own guidelines. Medicaid was signed into law on July the 30th, 1965. Medicaid’s guidelines come from the old Welfare law. “Medicaid has never matched that of food stamps, for which eligibility standards are linked to financial need alone. As Smith and Moore explains, the federal government, using its extraordinary demonstration powers under section 1115 of the Social Security Act, has allowed states to experiment with “decategorization” over the years, but Medicaid’s statutory bar against coverage of poor adults remains perhaps its most obvious failure” (Rosenbaum). Regardless of the many faults of this programs design, Medicaid helps close to 60 million low-income families in the United States. The people it helps would include: pregnant women, young children and their parents, the disabled, and the elderly, and other members of society that have low income. Medicaid is involved in many pregnancies and newborn care from a financial standpoint. It allows parents to have medical care for the child while in a low-income household. Medicaid has a huge impact on each states health systems and is used in a wide variety of ways.
Health needs are met due to the program’s emphasis on early detection of medical problems. Each child in Head Start becomes involved in a health program. The health program covers immunizations, medical, dental, and mental services (U.S. Department of Health and Human Services, 2002). Immunizations are ...
Adapted from the novella written by James M. Cain, Double Indemnity is a melodramatic film noir that highlights the conflict its characters face through adultery and murder which develops from the dissatisfaction and alienation that arose in the era of modernity as shown in most noir films. Unlike most noir films, Double Indemnity set the bar in terms of structural themes to follow and elements that eventually came to be considered essential in the noir genre. The film was seen to be a full embodiment of what the genre should be. Double Indemnity is an archetypal noir film, which portrays noir elements through its style, the characters, its writers’ backstory and the history of Los Angeles, the city in which it is set. This essay will examine how Los Angeles is integrated not only into the location but also into the storyline of the characters and their motivations but also the filmmakers’ lives. It does this through characteristic noir motifs like “the urban cultural landscape, the lack of rootedness of the characters, and the self-deceptions that center their world” (p. 437) affect the protagonists in the film. Double Indemnity’s use of Los Angeles as its primary location exposes the innate decadence and decay of the city through film noir stylistic elements. Billy Wilder directed Double Indemnity and the film became the archetypal noir film because it embodied all the characteristics of a typical noir film, which include “claustrophobia, paranoia, despair and nihilism” (Place and Peterson, p. 327) course kit source. Los Angeles, the city used primarily as the location in the film becomes not merely a backdrop but a character in the film through its physical and implied characteristics. The context through the stories of Wild...
ACA law allows children to be enclosed under the medical and dental plans until they turn 26. Certain vital benefits covered under this law such as ambulatory patient services, emergency services, hospitalization, maternity and newborn care, mental health and substance use disorder services, prescription drugs, labs, preventive and wellness services, chronic disease management and pediatric services. Anticipatory precaution is covered without any cost-sharing (copayments, coinsurance or deductible).
The state does not pay your entire bill. They subsidize your cost. In general, the assistance is for those that meet low income guidelines and who need help while they are attending job training programs, school or working. Having the availability of these programs helps student parents make better decisions. For example: over 80 percent of students attending Community college said that the availability of on-campus child care was very important in the decision to attend a college. 46 percent of students said that on-campus child care was their first priority when enrolling. 60 percent of students said that they could not have continued college without on-campus child care and 95 percent said that child care allowed them to increase their class load. Federal and state grants for child care for low-income parent’s average $4,600 per
In 1965 President Johnson signed both Medicare and Medicaid programs into law (Nile, 2011). According to Medical news today, “Medicare is a social insurance program that serves more than 44 million enrollees as of 2008” (MediLexicon International Ltd, 2011, para2). It cost about $432 billion or 3.2% of GDP, as of 2007(par2).Medicare is broken down into parts, Part A is hospital Insurance Part B is medical Insurance, and Part D is Medicare prescription drug coverage (medicare.gov). Like we previously stated Medicare is a health insurance for people who are 65 and older, people under 65 with certain disabilities, and people of any age with End- Stage Renal Disease. Medicaid is a joint federal-state program of medical assistance for low income persons (Benefit.gov). It is administered by the Illinois Department of Human Services (DHS) and Illinois Department of Public Aid (IDPA). Medicaid serves about 40 million people as of 2007; it cost $330 billion, or 2.4% of GDP, in 2007.(par.2) “In Illinois you may be eligible for Medicaid if you are a child, pre...
States and localities became the primary authorities in regard to health and welfare benefits. While the states welcome the increase in policy flexibility, the rising costs of healthcare and welfare put constraints on state budgets. As a result, states and localities are being forced to become more creative. Although Medicaid continues to place an enormous fiscal burden on states, programs like Children's Health Insurance Program (CHIP) have proven to be successful in terms of appropriately expanding benefits while reducing caseloads (Longest, 2010, pp. 30-33). States continue to serve as the primary distributors of social service benefits, but decreasing federal support, uncertain state economies, and the increasing need to provide long-term care to healthcare recipients are placing overwhelming burdens on states to maintain and expand existing programs.
Medicaid supports children who are under the age of nineteen, people over the age of sixty five, enrollees who are disabled and those that need permanent nursing home care. Potential beneficiaries can find an application for Medicaid at their State’s Medicaid agency (Medicare.gov, 2008).
President Obama signed the Patient Protection and Affordable Care Act on March 23, of 2010 that changed United States healthcare delivery system by making access to healthcare affordable for all Americans. The PPACA requires Americans to have health insurance coverage with the exception to financial hardship, religious objections and American Indians. The health reform will also expand Medicaid and will include the Children’s Health Insurance program (CHIP), also known as (SCHIP) the State Children’s Insurance Program. In 2009, the number of children without insurance was 7.5 million (Estes, Chapman, Dodd, Hollister & Harrington, 2013).The uninsured children varied by factors such as poverty status, age, race, and the Hispanic origin. The uninsured percentages of children by race were the following: 7.0% for white children, 11.5% for black children, 10.0% for Asian children and 16.8 % for Hispanic children. These percentages show that Hispanic children are most likely to be uninsured due to the lack of knowledge about certain programs available that offer health insurance coverage. The problem is that there are still many children that go without insurance coverage due to several barriers such as the lack of access, lack of education and lack of affordable healthcare for All Americans.
Health reform and health policy has taken over in the United States in recent years. Medicaid is one of the top policies being implemented throughout our nation today. To understand how Medicaid and federalism cross paths with each other one must understand the basic definitions and concepts each one brings. Federalism is “system of government in which the same territory is controlled by two levels of government. Generally, an overarching national government governs issues that affect the entire country, and smaller subdivisions govern issues of local concern.” In short, federalism is a government system that has an overseeing central government over state government. While, “Medicaid is a health insurance program for low-income individuals and families who cannot afford health care costs. Medicaid serves low-income parents, children, seniors, and people with disabilities.” Medicaid is a test based welfare program for United States Citizens. Now the question is how does Medicaid intersect with federalism? These two intersect because Medicaid is a need-based program that is funded by the federal government and the state government and administered at the state level. The issue with Medicaid is that if it expands then a crowding-out effect may occur. Meaning, that the more the government spends on Medicaid then less they would be able to spend on other programs such as: education, transportation, or other state priorities. Medicaid is supposed to provide access to health insurance for approximately half of our nations uninsured citizens. Without Medicaid a vast amount of low-income citizens will go without having a healthcare insurance plan.
retrospect to its governing authority (Shi & Singh, 2012). However, private and public agencies are the controlling constituent in today’s business. Free markets allow patients to choose providers without the prior approval of insurance companies. The current system offers a proposed plan of limited physicians in exchange for payment of services. Because the potential has been given to the payers, they regulate the cost of services rendered through contractual