A health insurance program that serves low-income individuals and families who are not able to afford healthcare costs is Medicaid. Parents, children, seniors, and anyone with disabilities are served by Medicaid (NCDHHS, 2014). Medicaid is a federally mandated, state-administered program and is jointly funded by the federal and state governments to give medical care for qualified individuals (Green & Rowell, 2013). The Federal government comes up with guidelines, but each individual state has their own rules. Each state can require someone to pay a part of the cost for some of their services (MedlinePlus, 2014). People have different needs and so there are different types of coverage for them (NCDHHS, 2014). There are certain requirements in order to receive Medicaid. These requirements include, a person’s age, whether they are pregnant, disabled, or blind, their income and resources, and whether or not they are a U.S. citizen (MedlinePlus, 2014).
Eligibility varies among each state. A person who is eligible for Medicaid in one state might not be eligible in another state. Services can be different in each state also and state legislatures can change the requirements of Medicaid eligibility throughout the year (Green & Rowell, 2013). Someone who is automatically eligible for Medicaid is if they receive supplemental security income, work first family assistance, state/county special assistance for the aged or disabled, and special assistance to the blind (NCDHHS, 2014). It is important to understand that Medicaid does not provide medical assistance for all the poor. There are three groups that qualify for Medicaid eligibility. These three groups are the categorically needy, medically needy, and special groups (Green & Rowell, 201...
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...al home strategy to get new Medicaid enrollees into a managed, relationship-based healthcare program (Dickson, 2014).
Works Cited
Dickson, V. (2014, March 17). Oregon offers lessons in serving new Medicaid patients. Retrieved April 18, 2014, from galegroup: http://go.galegroup.com.ezp-02.lirn.net/ps/retrieve.do?sgHitCountType=None&sort=DA-SORT&inPS=true&prodId=PPNU&userGroupName=lirn62668&tabID=T003&searchId=R3&resultListType=RESULT_LIST&contentSegment=&searchType=BasicSearchForm¤tPosition=1&contentSet
Green, M. A., & Rowell, J. C. (2013). Understanding Health Insurance. Clifton Park: Delmar.
MedlinePlus. (2014, February 27). Medicaid. Retrieved April 25, 2014, from Medlineplus: http://www.nlm.nih.gov/medlineplus/medicaid.html
NCDHHS. (2014, April 1). What is Medicaid. Retrieved April 18, 2014, from ncdhhs: http://www.ncdhhs.gov/dma/medicaid/
Eligibility for Medicaid programs in Michigan is based on either income only or income and assets. In addition, many of the programs available have age restrictions and/or require applicants to have certain health conditions (e.g. pregnancy). Eligibility requirements for Medicaid in Indiana are similar to those of Michigan. The two programs, however, do contrast in three substantial ways. Two out of three of these ways indicates that Indiana has the better program.
The health care organization with which I am familiar and involved is Kaiser Permanente where I work as an Emergency Room Registered Nurse and later promoted to management. Kaiser Permanente was founded in 1945, is the nation’s largest not-for-profit health plan, serving 9.1 million members, with headquarters in Oakland, California. At Kaiser Permanente, physicians are responsible for medical decisions, continuously developing and refining medical practices to ensure that care is delivered in the most effective manner possible. Kaiser Permanente combines a nonprofit insurance plan with its own hospitals and clinics, is the kind of holistic health system that President Obama’s health care law encourages. It still operates in a half-dozen states from Maryland to Hawaii and is looking to expand...
Health care inequality has long been customary in the United States. Those in lower classes have higher morbidity, higher mortality, higher infant mortality, and higher disability. Millions of low-income families and individuals have gone with out the care they need simply because they cannot afford it. Denial of benefits due to pre-existing conditions, outrageous deductibles, and unreasonable prescription prices are in large part why the low-income class suffers. In addition, not receiving preventative health care, lack of access to exercise equipment and lack of availability to fresh foods all create health problems that become to expensive to fix. Low-income families need to have better, more affordable access to health care, specifically preventative health care, and be more educated about the benefits of health care in order to narrow the gap of inequality. The new Affordable Care Act under the Obama administration expands heath care coverage to many low income families and individuals by lowering the eligibility requirements for Medicaid, although it is not mandatory for individual states to make this expansion for Medicaid coverage.(CITE) It also requires that preventative health care be included in coverage by insurance companies. So with all the benefits the expansion of Medicaid could offer, why would some states choose not to offer it?
Crowley, Ryan A., and William Golden. "Health Policy Basics: Medicaid Expansion." Annals Of Internal Medicine 160.6 (2014): 423-426. Academic Search Complete. Web. 18 Apr. 2014.
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) .
For example, income often determines one’s access to health-care. Researchers have found that low-income families are less likely to fill prescriptions, have dental coverage, and have preventative care visits (Ives et al., 2015, p. 170). Further, Williamson et al. (2006) declared, “professional treatment services…not covered by provincial health care plans, social services, or Indian and Northern Affairs were most frequently cited by respondents…as services that they choose not to use because of their low-income status” (p. 113). In addition to being unable to afford services, low-income individuals are often unable to afford transportation to appointments (Williamson et al., 2006, p. 116). Clearly, although individuals have the right to health, low-income individuals and families face many barriers in accessing and affording health-care services in
Implemented (along with Medicare) as a part of the Social Security Amendments of 1965, Medicaid’s original purpose was to improve the health of the working poor who might otherwise go without medical care for themselves and their families. Medicaid also assisted low income seniors with cautionary provisions that paid for the costs of nursing facility care and other medical expenses such as premiums and copayments that were not covered through Medicare. Eligibility for Medicaid is usually based on the family’s or individual’s income and assets. When the ACA came into effect in 2010, it began to work with the states to develop a plan to better coordinate the two ...
It involves the mental, physical, emotional, and medical domains of the individual’s life, but due to the fact that many of these services are publicly funded, gaps exist. Cox (2007) reported that “community resources were generally perceived as inadequate. None of our participants had ready access to social workers in the office, so arranging home health care, adult day care, and other community services added to the difficulty of primary care” (p. 82). Not only are the services and programs inadequate, recent economic dilemmas and ‘recession’ has reduced public spending to meager allowances. Another sore problem is Medicare and general health care programs for the less wealthy. This was the sentiment echoed by one physician interviewed: “If you told me I had to run this place on the basis of what I get from Medicare, I would have to tell you I couldn’t do it, which is kind of sad, because they claim that they’re bankrupt and everything. Where in the hell are they spending their money? They sure ain’t giving it to
The author identifies some of the federal and state legislators that are also opposed to the Medicaid expansion in the writer’s district. US Senator John Cornyn says that the Obamacare Medicaid expansion program is formed to be wasteful, fraudulent, and abusive to the nation (Cornyn, 2010). According to US Senator Cornyn, “The $3.4 trillion federal taxpayers spend on the Medicaid program is a target for waste, fraud, and abuse. Instead of fixing these problems, the President’s new health care overhaul includes the largest expansion of the broken Medicaid program since its creation in 1965: it’s only going to get worse from here” (John Cornyn, 2010).
Reese, Philip. Public Agenda Foundation. The Health Care Crisis: Containing Costs, Expanding Coverage. New York: McGraw, 2002.
Medicaid is a broken system that is largely failing to serve its beneficiary’s needs. Despite its chronic failures to deliver quality health care, Medicaid is seemingly running up a gigantic tab for tax payers (Frogue, 2003). Medicaid’s budget woes are secondary to its insignificant structure, leaving its beneficiaries with limited choices, when arranging for their own health care. Instead, regulations are set in order to drive costs down; instead of allowing Medicaid beneficiaries free rein to choose whom they will seek care from (Frogue, 2003)
sponsored programs, such as Medicaid, that try and offset medical problems of the poor youth,
The United States passed bill that health insurance should be mandatory in the year 2014. Under the Patient Protection Affordable Care Act, each person is required to have at least a minimum level of health insurance failure to, the individual will face a penalty. The mandatory health insurance issue has faced reactions from both sides with some people supporting while others opposing. It is mandatory for every individual to purchase a health insurance depending on their earnings. The health care insurance is mandatory for all US citizens, and all legal residents in America. It is considered as an individual responsibility requirement, and those without this insurance are subject to a tax penalty of $750 per year up to a maximum of three times that amount ($2,250) per family. However, there are exemptions for financial hardships, incarcerated persons, religious objections, and undocumented immigrants. Mandatory health insurance is important, and should be applied in all states because, everyone gets ill and at one time, they have to visit a health care facility for medical services. In addition, it protects the health future of families, and protects people from unexpected high medical costs because they are covered.
Health insurance facilitates entry into the health care system. Uninsured people are less likely to receive medical care and more likely to have poor health. Many Americans are foregoing medical care because they cannot afford it, or are struggling to pay their medical bills. “Adults in the US are more likely to go without health care due to cost” (Schoen, Osborn, Squires, Doty, & Pierson, 2010) Many of the currently uninsured or underinsured are forced accept inferior plans with large out-of-pocket costs, or are not be able to afford coverage offered by private health insurers. This lack of adequate coverage makes it difficult for people to get the health care they need and can have a particularly serious impact on a person's health and stability.
Barton, P.L. (2010). Understanding the U.S. health services system. (4th ed). Chicago, IL: Health Administration Press.