Medicare policy for walk in tubs The statistics reveal that most of the fractures and injuries to elder people are caused as a result of slipping in the bathroom which follows critical hospitalization in many cases. In order to eliminate the cause of slipping the bathroom again, sometimes doctors or the care takers take the decision to install walk in tubs for them. As the cost involved is quite high, many just drop the idea of purchasing it and even those who has a compulsion to buy, tries to get its cost covered via a Medicare claim. The most frequent question asked on this matter is-Does Medicare pay for walk in tubs? We need to find an answer and reason behind it too. As we all know Medicare is a federal run health insurance scheme for elderly people above age of 65. People of this age are very much vulnerable to getting sick or injured, hence Medicare policies are made in such a fashion that they have very strict guidelines for such occasional requests of walk in tubs so the answer to highlight question is that Medicare does not pay for walk in tubs. These tubs do not fall under the category of a durable medical equipment like a wheel chair, nebulizer, oxygen tents, hospital …show more content…
The answer is not as hopeless and one can still try to get it covered by way reimbursement. That means the initial cost has to be borne by you and once you have raised your claim along with doctor’s papers and bill, you let the paper work do the work for you. It has been found that under rare occasions, Medicare agrees to pay for partial reimbursements if not whole, which is still a relief. Medicare does not have an all-inclusive list of such durable medical equipment but only a reference list and walk in tubs do not feature in it. All depends upon how have you presented your case and argued validity of buying a walk in tubs for your senior home member reinforcing it as durable medical
According to Medicare’s WebPage Medicare is a Health Insurance Program for people 65 years of age and older, some disabled people under 65 years of age, and people with End-Stage Renal Disease (permanent kidney failure treated with dialysis or a transplant). Medicare has two parts, Part A which is for basically hospital insurance. Most people do not have to pay for Part A. In addition it has a Part B, which is basically medical insurance. Most people pay a small monthly fee for Part B. Medicare first went into effect in 1966 and was originally administered by the Social Security Administration. In 1977 the control of it was switched over to the newly formed Health Care Financing Administration. Beginning in July 1973 Medicare was extended to persons under the age of 65 with certain disabling conditions. In 1988 Congress passed legislation to expand the program to cover health care costs of catastrophic illnesses.
The IPPS covers patients for 90 days of care per episode of illness, with a 60-day lifetime reserve 2. Episodes begin once the patient is admitted and ends after they have been out of the hospital for 60 days straight 2. During the first 60 days of hospital stay, patients are responsible for a deductible of $1,216 2 while Medicare covers the rest. After day 60, patients must begin copayments, starting at $304, through day 90. After 150 days od care patients are responsible for 100% of costs 2. Comparatively, under the Home Health Prospective payment system (HH PPS), patients are not required to make any copayments for the services provided 4. Home Health care is covered for beneficiaries restricted to their homes and in need of part-time or intermittent skilled care (i.e. nursing, physical, occupational and speech therapy) 4. Instead of 90-day episodes, as in the IPPS, the HH PPS provides care in 60-day episodes 3. Furthermore, after the 60 days ends, a second episode can begin if the patient is still eligible for care as there are no limits to the number of episodes an eligible member can receive
Willy, B. (2013). Gravity assisted seating: Prevention of wheelchair related falls in nursing homes. Gerinotes, 20(2), 8-10.
The prevention of falls in the long term care facility is one of the most important interventions the health care team can do to ensure the safety of loved ones under their care. According to the Summary Data of Sentinel Events Reviewed by the Joint Commission (2016), there were 806 falls between 2004-2015 with 95 of those occurring in 2015 . As health care providers, we have a responsibility to incorporate interventions that will help protect the patient while under our care. Interventions as simple as ensuring the use of a gait belt by any team member that transfers the patient, to making sure all team members are aware of the medications that can make certain patients more of a fall risk, will help in the prevention of falls.
There are several issues concerning the uninsured and underinsured patient population in America. There are many areas of concern the congressional efforts to increase the availability of health insurance, the public image of the insurance industry illustrated by the movie "John Q", the lack of good management tools, and creating health insurance coverage for all low income Americans. Since the number of uninsured Americans has risen to 43 million from 37 million in the flourishing 1990s and could shoot up even more severely if the economy continues to decrease and health care premiums keep increasing (Insurance No Simple Fix, 2001).
Medicare Part A is meant to be a major medical hospitalization plan that is offered to everybody US citizen that has turned 65 years old. It covers inpatient care in hospitals and skilled nursing facilities, hospice care, some home health care services, a semi-...
Medicare was designed as a universal healthcare program for individuals 65 years old and older. This program is funded by Medicare taxes and general federal funding withholding taxes. Medicare is a partnership between federal and state with the goal to provide medical insurance to the elderly that is poor and disabled. Generally all people who are 65 years or older and qualify for social security will automatically qualify for Medicare.
for Medicare, you must meet certain conditions. A person qualifies if they are 65 years of age
Medicare is the nation’s largest health insurance program. Generally, you are eligible for Medicare if you or your spouse worked for at least ten years in Medicare-covered employment and you are 65 years old and a citizen or permanent resident of the United States. Medicare-covered services include hospital insurance, inpatient hospital care, skilled nursing facility care, home health care, hospice care, and medical insurance (Medicare U.S.) With such an encompassing effect on the health insurance field, Medicare provides a haven for older individuals, and end-stage renal disease (ESRD) patients who require the best medical care for whatever possible reason. The only problem with this scenario is that doctors are turning many older patients away because they have Medicare. Why do doctors turn away Medicare patients? Is there a reason why certain doctors turn away certain patients?
When taking steps to analyze and apply intervention strategies for falls, we must examine the factors that cause these occurrences. There are numerous reasons that falls occur, such as intrinsic and or extrinsic risk factors. Intrinsic risk factors for falls may be due to changes that are part of the normal aging process and acute or chronic conditions. According to Zheng, Pan and Hua et al. (2013), about 35-45 percent of individuals who are usually older than 65 years and other 50 percent of the elderly individuals report cases of fall every year. Extrinsic factors are those related to physical environment such as lack of grab bars, poor condition of floor surfaces, inadequate or improper use of assistive devices (Currie). Patient falls is not an easy thing to eliminate. With many clinical challenges, there’s no easy answer to the challenges posed by patient falls; howe...
Medicare and Medicaid are two of the United States largest broken systems, which must sustain themselves in order to provide care to their beneficiaries. Both Medicare and Medicaid are funding by a joint effort between the federal government and the local state government. If and when these governments choose to cut funding or reduce spending, Medicare and Medicaid take the biggest hit. Most people see these two benefits as one in the same, two benefits the government takes out of their pay check to help fund health care. While the government does deduct a sum from paychecks everywhere, Medicare and Medicaid are very two very different programs.
Healthcare plays an important role in almost every person’s life at one point or another. Many times, one can get caught without, or underinsured and it can be detrimental to their livelihood. With the rising cost of healthcare, it is likely that having a national healthcare policy in place, and as an individual, being able to afford and obtain adequate health insurance has not been required until now. With the new national healthcare plan, it is required for all citizens to obtain and maintain some sort of public or private insurance policy. The rising costs can be attributed to many things. A significant reason for the astronomical cost of health care is because of the staggering amount of uninsured or underinsured individuals receiving medical attention and almost many never paying the bill. Those who do have insurance have seen a gradual increase in their premiums and deductibles to make up for this.
One in six Americans and mostly all of the population 65 years and older, are covered by Medicare. In 2012, Medicare provided for 50.7 million people, 42.1 million aged and 8.5 million disabled, with a total cost of $574 billion. This is about 21% of national health spending and 3.6% of Gross Domestic Product (Davis, 2013). Medicare, being a social insurance program, is required to pay for covered services provided to enrollees so long as the specific criteria is met. On av...
Access to health care refers to the ease with which an individual can obtain needed medical services. Many Americans face barriers that make it difficult to obtain basic health care services. These barriers to services include lack of availability, high cost, and lack of insurance coverage. "Limited access to health care impacts people's ability to reach their full potential, negatively affecting their quality of life." (Access to Health Services, 2014) Access to health services encompasses four components that include coverage, services, timeliness, and workforce
Health care has always been an interesting topic all over the world. Voltaire once said, “The art of medicine consists of amusing the patient while nature cures the disease.” It may seem like health care that nothing gets accomplished in different health care systems, but ultimately many trying to cures diseases and improve health care systems.