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.
There are four components to the Medicare program, part A, B, C and D. Part A of Medicare covers in patient hospital services; patients have a financial responsibility to cover a deductible that is equivalent to 1 day of hospitalization, thereafter cost is covered at 100 percent for a maximum of 60 days. This also includes nursing facilities, home and hospice care. Part B covers outpatient surgery and physician office visits. This is an elective component of Medicare in that there is a premium associated with this plan that is paid for directly through social security payments. Part C is know as Medicare Advantage and is a supplemental policy that is purchased directly from employers; one may be denied for health reasons depending one when the plan is acquired. Part D is prescription drug coverage that is eligible to all individuals that qualify for Medicare. Beneficiaries of the Medicare choose which prescription plan they want and pay a corresponding monthly premium.
The increasing number of enrollees, new prescription drug benefit, Part B utilization and availability of enhanced technology has led to a rise in Medicare cost. Out of all the contributing factors of the rise in cost in Medicare, Part B utilizations have been a major cost driver.
Thus far the affordable care act (ACA) has made...
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...ple less than or equal to 133% of the FPL, starting 2014 eligibility will be expanded to people that are 138% or les of the FPL. Also the expansion will cover more parents and expand to adults who are childless. Fore states that choose to accept the expansion this means that they will have to cover more individuals in their Medicaid programs. The government will provide 100% funding for the first 3 years of the Medicaid expansion; thereafter the states will have to figure out how they will fund the program with the absence of federal funding. The stipulation with expanding Medicaid that after the three years are up the state cannot modify the program to not cover the expanding individuals. States that in financial ruins before the ACA, now with the expansion they will need to find alternative ways that will serve the same purpose as Medicaid in order to lower cost.
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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...
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.
(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.
After Medicare covers up to a certain amount, individual will enter what is called a Donut-Hole in their coverage, which means that they will be paying more out-of-pocket for prescription and health needs (Pros and Cons of Medicare Part D Coverage, n.d.). The implementation of the Part D program was a huge undertaking accomplished very quickly. Unlike other benefits available under traditional Medicare, Part D is administered through almost 1,900 stand-alone prescription drug plans (PDPs). Part D coverage is also available through more than 1,000 private Medicare Advantage Part D plans (MA-PDs) that provide Part A (hospital insurance) and Part B (supplementary medical insurance), as well as Part D prescription drug benefits (Oliver, T. R., Lee, P. R., & Lipton, H. L.,
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)
First of all What is Medicare ? Medicare is a federal health insurance both old and young people that needs a cheaper medication and people who are disable. According to Robert Preidt’s Article about medicare he stated that “At least one in four Medicare patients received at least one of these services in 2009, according to the analysis of claims made by more than 1.3 million Medicare patients that year “ his analysis tells us that a bit of americans get their insurance and most of them still pay a lot even though they have insurance provided by the government for example Isadore Cassuto an 88 year old man and a retired tax attorney , broke his pelvis on nov. 12 on a parking lot and spent more than 3 weeks at the rehab hospital . He was stuck with 6,000 bill for his follow up care because of Medicare the federal health plan for people over 65, only pays for inpatient rehabilitation following a serious hospitalization , this analysis is telling us that even an insured retired person who is eligible to pay lesser bill didn't get it instead he payed more . Karen Rowan state...
Medicare has four parts A, B, C, and D. Medicare Part A covers inpatient hospitalization, skilled nursing centers, hospice and some home health services. Medicare Part B covers some services not covered by Part A. Typically there is a premium charged for this coverage. Part B Covers medical supplies and outpatient visits. Medicare Part C, also known as Medicare Advantage plans are offered by private insurance companies which are in contract with Medicare. Medicare Part C provides you benefits from Part A, Part B and usually covers prescription drugs. This plan will cover most services. Last is Medicare Part D, Part D is a prescription drug program offered by private insurance companies. Part D allows drug coverage to the original Medicare plan. (Medicare.gov, 2016)
Medicare fraud occurs when healthcare providers, suppliers, and private companies charge for services or supplies patients never receive. Additionally, abuse of the Medicare program also occurs because physicians and suppliers do not always follow best medical practices which leads to excessive costs through improper payments, or medically unnecessary services, both of which abuse the program. Conservative estimates suggest he...
...while bearing a portion of the costs, and the states’ ability to manipulate the program to obtain federal funds (Weil, 2003). The overwhelming increase in Medicaid costs are born by the states individually and reflect actual costs associated with growing eligible population that requires the services offered by Medicaid.
Managed care is one of the leading form health care in the United States. It has become very popular and many people in the United States have taken advantage of it. There are a few different types of managed care programs: Health Maintenance Organizations or HMOs, Preferred Provider Organizations or PPOs, and Point of Service Plans or POSs. Each one of these types of managed care plans has its pros and cons (Cyrene, 2015). If you would ask a few people what types of insurance they have, they are more than likely going to name off a managed care plan because it is more common to find someone with a managed care plan than not. Managed care has changed the healthcare system in many ways, some for the good and
Medicare has been providing health insurance to people since the signing of the social security act in 1965. Signed by President Lyndon B. Johnson as an amendment to the social security legislature, Medicare became one of the biggest health programs to help people aged 65 and over and to those 65 and under with disabilities. The program has helped these people significantly with their health requirements. Today our economy is under financial stress having a debt accumulation of around 54 trillion dollars, eighty trillion being Medicare liability alone. This debt effects Medicare beneficiaries financial funding, this is bad for many people who have a poverty level income. Now the only way we can accommodate these cuts in Medicare is by paying out of our pockets. The younger generation has a duty to the elderly and our disabled brothers. Although it seems unfair for us to pay for Medicare, it is up to us to keep the program going for these people.
Medicare is a national social insurance program in the United States. It is administered by the federal government. It provides health insurance for citizens aged 65 years and above. These citizens must have initially worked, and paid into trust funds. Moreover, Medicare covers dialysis patients, or those with an end-stage renal disease. This program was established in 1966. Medicaid, on the other hand, is a social health program for both families and individuals, who are low income earners in the United States. It covers citizens of all ages, whose salaries are not enough to cater for healthcare. Those eligible must be U.S. citizens, who are of low income, and also the disabled.
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.
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.