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Medicare and Medicaid difference bartleby
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Medicare Paper
Medicare is a health care system that has been around since 1965 and currently covers over 49 million people. Medicare is a major milestone in the history of American health care. However the people that medicare covers have a wide range of opinions about it. I interviewed D.S. she is a 75 year old woman from Saint Louis. She has experienced Medicare in several different ways which will be discussed throughout this interview.
As stated above, D.S. is a 75 year old woman, she has been covered by Medicare since she was eligible at age 65. When asked about how she felt about the care that she was receiving from medicare she responded by saying “The coverage is adequate, but my husband and I are relatively healthy and have not
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had surgeries or cancer treatments, and thus have not used Medicare for any major expenses”. I feel like this has a major implication on her opinion, because by not having major treatments, it decreases the likelihood of a big co-pay for services. Next I asked her if she had health insurance before her Medicare coverage initiated.
D.S. in fact had health insurance before Medicare, it was through Concordia Plan Services, which is for church workers. When asked to compare and/or contrast her coverage between the two plans she said “Concordia Plan Services is now my supplement coverage, both Medicare and Concordia Plan Services do not cover dental or vision because the monthly charge is very high”.
Then I moved on to asking about specifics of her coverage. I asked if she participated in Medicare Part D, and what she thought about it. She was a participant in Medicare part D, which is the prescription drug program. She has not had a good experience with Medicare part D so far. Her husband had to receive a shingles vaccine this year and they were charged $400 for the shot, which means that Medicare did not cover the shot even though they originally claimed they were. She said many phone calls have been made concerning the payment and it has still not been resolved a month
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later. My next question asked if she had any confusing forms to fill out? She said “No, my doctors and pharmacy have copies of my Medicare card and supplement information, and they file our claims with Medicare along with our supplement insurance when charges are incurred”. I also asked my grandma this question as well and it seems that most care providers and pharmacies already have someone's information in their databases. I then inquired about if she ever experienced the “donut hole” in coverage. The “donut hole” in coverage is when someone has spent a certain amount of money and reached a spending ceiling, where they now have to cover all expenses over that ceiling out-of-pocket. 26% of people covered by Medicare part D are in the “donut hole”. However D.S. has never experienced it, she has never hit the deductible ceiling before while being covered by Medicare. The next question I asked was if she was able to select her own doctor?
She replied “I have a free range on a selection of my doctors and clinics”. However she did add that she has to select from a list of pharmacies but all the ones she used in the past were available for use. Both Medicare part A and B gave her and her husband free range on her provider coverage. Next I asked her if she had to pay any premiums for her coverage? She replied “yes, about $105 is deducted from each of our social security benefits every month for Medicare medical insurance”. She also added that she pays a couple hundred a month for additional supplemental
coverage. Finally I asked her what would you like people to know about Medicare and what would you change about the coverage if you could? Her reply was “I would like to have dental coverage and eye examinations/prescription glasses added to Medicare benefits. But I am sure the cost would be prohibitive”. Later she went on to say “So I would rather continue the current coverage rather than the government reducing Medicare benefits to those that need it most”. D.S. had a mixed bag of opinions on Medicare. She thought some of the coverage was beneficial, however Medicare does come with problems, such as no dental coverage. Hopefully Medicare will change over time for the better.
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.
Ranked third by U.S. News and World Report on the list of “Best Health Care Jobs of 2017”, the Physician Assistant career has a 96 percent job-satisfaction rate, and represents one of the fastest growing jobs in the nation. Created as a position to relieve the job shortage of primary care physicians, Physician Assistants first came to be in the mid-1960s. Since then, the number of PAs in practice has just about doubled with every decade helping to improve health care not just nationally, but on a global level as well. Physician Assistants are licensed to practice medicine, prescribe medication, treat chronic illnesses, and assist in surgery in all 50 states under supervision of a physician. Although some medical practitioners perceive the role
(II) The enacting of Medicare Part D in 2006 only helped to fuel America’s hunger for prescription medication. In 2003, President George W. Bush announced and signed the Medicare Prescription Drug, Improvement, and Modernization Act (also known as the Medicare Modernization Act, or MMA) on December 8th. The roughly $400 billion dollar measure was marketed to the American public as something that will provide care for the millions of senior citizens who, at the time, were struggling to afford prescription medication. This was the largest development of Medicare since 1965, which is when the program was initially created, and gave hope to those wishing for positive medical reform. According to title XI of the “Medicare Prescription Drug, Improvement, and Modernization Act of 2003”, the most significant change will be the affordability of prescription drugs by implementing the importation of drugs from Canada, along with necessary safety measures, in order to lessen the cost (United States Congress, 832). For those who were in retirement homes and lacked a steady income, the affordability of drugs was often a deciding factor in the decision to seek medical attention and the idea that those individuals ceased to live simply because they lacked the funds tugged at the heartstrings of many Americans.
Medicare is a social policy many of our seniors look to for their stability when they reach 65
Medicare and Medicaid are one of important government programs. According to Medicaid.gov site, there are more than 4.6 million low-income seniors enrolled in Medicare and about 8.3 million people that are enrolled in both Medicare and Medicaid. Anyone that enrolled with Medicare and limited income and resources are eligible to get assistance paying for their premiums and out-of-pocket medical expenses from Medicaid. Not only does Medicaid cover additional services, but, services covered by both programs are first paid by Medicare with Medicaid in the difference up to the state’s payment limit (Medicaid.gov, 2015) .
Medicare is health insurance for people age 65 or older, under age 65 with certain disabilities and people of any age with End-Stage Renal Disease. There are four subcategories of Medicare. Part A is for hospital stays or, with certain restrictions, at-home care for a limited number of days. Part B is more like regular medical insurance. It covers ambulatory care and physician fees. There is a deductible and are sometimes co-pays as well. Part C is presented as an alternative to parts A and B. It is where private insurance companies can contract with the federal government to offer Medicare benefits through their own policies. It can offer benefits not covered under original Medicare, although there might be a premium charged. Part D is the prescription plan for enrollees. (Centers for Medicare and Medicaid Services, 2010)
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.
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...
On December 8, 2003, President Bush signed into law the Medicare Prescription Drug Improvement and Modernization Act of 2003 (Pub. L. 108-173). This landmark legislation provides seniors and individuals with disabilities with a prescription drug benefit, more choices, and better benefits under Medicare. It produced the largest overhaul of Medicare in the public health program's 38-year history. The MMA was signed by President George W. Bush on December 8, 2003, after passing in Congress by a close margin. One month later, the ten-year cost estimate was boosted to $534 billion, up more than $100 billion over the figure presented by the Bush administration during Congressional debate. The inaccurate figure helped secure support from fiscally conservative Republicans. It was reported that an administration official, Thomas A. Scully, had concealed the higher estimate and threatened to fire Medicare Chief Actuary Richard Foster if he revealed it. By early 2005, the White House Budget had increased the 10-year estimate to $1.2 trillion.
for Medicare, you must meet certain conditions. A person qualifies if they are 65 years of age
The two major components of Medicare, the Hospital Insurance Program (Part A of Medicare) and the supplementary Medical Insurance program (Part B) may be exhausted by the year 2025, another sad fact of the Medicare situation at hand (“Medicare’s Future”). The burden brought about by the unfair dealings of HMO’s is having an adverse affect on the Medicare system. With the incredibly large burden brought about by the large amount of patients that Medicare is handed, it is becoming increasingly difficult to fund the system in the way that is necessary for it to function effectively. Most elderly people over the age of 65 are eligible for Medicare, but for a quite disturbing reason they are not able to reap the benefits of the taxes they have paid. Medicare is a national health plan covering 40 mi...
Medicare provides healthcare coverage for individuals over the age of 65, in addition, to others meeting certain criteria. The government funds Medicare through the administration of the federal Centers for Medicare and Medicaid and spends billions annually, on the program. Fraud runs rampantly throughout the healthcare program due to the enormous amount of money spent and the large number of people enrolled in the program. Fighting fraud of this nature necessitates diligence by everyone. Protecting oneself entails understanding what constitutes fraud, identifying it, noting suspicious practices, and taking steps towards prevention.
These requirements overlap between the two and some beneficiaries do qualify for both benefits. This means that Medicaid is sometimes used to help pay for Medicare premiums and those who do quality for both programs are considered to be “dual eligible” and will usually enroll in both programs in order to cut personal costs. Medicare and Medicaid both have their financial woes, each have their burdens, a...
Medicare is a federally governed insurance program, primarily serving Americans over the age of 65, younger disabled meeting specific disability criteria, and dialysis patients having permanent kidney failure. Medicare is linked to Social Security, is not income based, and is available to every American meeting the requirements of the program. Those entitled to Medicare can select Original Medicare Part A (Hospital Insurance) and Part B (Medical Insurance) paying co-insurance and deductibles or opt to add Part C (Medicare Advantage Plans) paying a monthly premium and co-payments normally less than the out-of-pocket expenses for Original Medicare.
Medicare is a national social insurance program, run by the U.S. federal government since 1966 that promises health insurance for Americans aged 65 and older and younger people with disabilities. Being the nation’s single largest health insurance program, covering a large population for a wide range of health services, Medicare's funding is a fundamental part of it sustainability. Medicare is comprised of several different parts, serving different purposes, some of which require separate funding. In general, people at the age of 65 and older who have been legal residents of the United States for at least 5 years are eligible for Medicare. Same is true with people that have disabilities under 65, if they receive Social Security Disability Insurance benefits. Medicare involves four parts: Part A is hospital insurance. Part B is additional medical insurance, that Part A doesn't cover. Part C health plans, also mostly known as Medicare Advantage, are another way for original Medicare beneficiaries to receive their Part A, B and D benefits. Medicare Part D covers many prescription drugs, some of which are covered by Part B. Medicare is a major operation, not only needing adequate administering but the necessary allocated funds to keep this massive system afloat.