The PPACA started changing the country’s health care system landscape almost from the moment it was signed into law in March 2010. It has already expanded coverage for young adults, outlawed lifetime limits on what health insurance will cover, lowered the costs of drugs for seniors on Medicare, and expanded access to preventive care for patients of all ages.
The major transformation will be coming in 2014 when almost all Americans will have access to affordable health insurance. Insurers will have to offer policies to anyone who applies, including people with expensive pre-existing medical conditions. Additional changes will be gradually implemented through 2020.
Effective October 1st, 2013, Americans started signing up for health care coverage under the PPACA.
What does this mean for people who receive Medicare? If you or someone you know receives Medicare coverage, the good news is that the PPACA will have no effect on Medicare benefits. Medicare eligible people don’t need to do anything during Open Enrollment period that started October 1st. Medicare is not part of the Health Insurance Marketplace, so if you are a Medicare beneficiary, you don’t need to replace your Medicare coverage with Marketplace coverage. No matter how you get Medicare, whether through original Medicare or a Medicare Advantage plan, you may keep the same benefits you have now.
If you don’t have Medicare and you need health insurance or know someone who does, you can find out more at www.healthcare.gov/marketplace/individual/#state=new-jersey or call toll-free 1-800-318-2596.
The PPACA added certain Medicare preventive services, like mammograms or colonoscopies, without charging people for the Part B coinsurance or deductible. You also can get a free ye...
... middle of paper ...
...te of New Jersey requiring Medicare Part D prescription coverage for all eligible NJREA members.
Appeal process - The PPACA requires all plans to provide an effective process to appeal any decisions and to establish an external review process. If an insurer refuses to pay a claim for a medical service that you think should be covered, you have a right to appeal the denial. You can appeal directly to the provider and ask the plan to reconsider the denial. Other legal options may also be available. If the plan says no, you may be protected by “external review,” which allows you to ask an independent third party expert to help resolve the dispute with your health plan. If the external reviewer says the claim must be paid, your health plan will have to cover it.
Adult dependent coverage - Children can stay or be added to on their parents’ health insurance until age 26.
Due to the Patient Protection and Affordable Care Act signed into law on March 23rd, 2010; health care in the US is presently in a state of much needed transition. As of 2008, 46 Million residents (15% of the population) were uninsured and 60% of residents had coverage from private insurers. 55% of those covered by private insurers received it through their employer and 5% paid for it directly. Federal programs covered 24% of Americans; 13% under Medicare and10% under Medicaid. (Squires, 2010)
What is managed care? According to the Oxford English Dictionary, managed care is “a system of health care in which patients agree to visit only certain doctors and hospitals, and in which the cost of treatment is monitored by a managing company.” Managed care is a variety of techniques designed to reduce the cost of providing health benefits and advance the quality of care. In the United States alone, there are various managed care programs, that are ranged from more restrictive to less restrictive. As stated in the National Institutes of Health, the future of managed care is uncertain. It is enthralling to note that in spite of the advances in healthcare systems, such as our hospital’s ability to provide patients with lower cost, managed
The topic that I am choosing to do is on Obama Care. I chose this topic because the idea of the government forcing people to obtain insurance is wrong in my eyes. I am interested in analyzing the validity for what has been said about this topic in order to increase my understanding about Obama Care. I am not an expert when it comes to Obama Care. I know that this is an insurance that is being provided through the government for the general public. I have read that President Obama never initially read the whole bill itself. I also know that people who cannot afford it, but make too much money to qualify for Medicaid are being heavily encouraged to get this insurance. Some of the common knowledge that I have found that the general public has about this subject is that some people are for Obama Care and think that it is a wonderful idea and that there are some people that are dead set against Obama Care. Younger adults, specifically college age and individuals that are in their twenties tend to be for Obama Care. The insurance is being forced upon individuals that may or may not want it. It also seems as though that the insurance being offered is pretty generic in terms of coverage. Some of the questions that I have that I believe will aide me in writing this paper would be the following: What are the pros and cons of Obama Care? What are the thoughts of Obama Care with the people of the government? As well as what are the basics of Obama Care?
I am terribly ashamed to admit that prior to this class I really did not have a position on the Affordable Care Act (ACA). I simply ignored what was going on because I had insurance through my employer and I didn’t feel like the ACA would have that much bearing on my life. I was aware of some of the positive and negative aspects but had not really given it all a lot of thought. The one thing that did intrigue and interest me was the potential for Medicaid expansion. This was both exciting and troublesome because my job is totally structured around people who qualify for Medicaid. Increasing the rosters would have had a drastic effect on what I do and would have meant tremendous growth for my business but since Tennessee opted not to expand
The Affordable Care Act introduced a plan that would allow Americans with pre-existing conditions to obtain health insurance without the hassle of being turned down or fear of being charged higher premiums. The Pre-Existing Condition Insurance Plan was effective as of July 1, 2010. It allowed patient access to affordable healthcare in which they were previously denied due to their pre-existing condition (Affordable Care Act Summary, n.d.). Patients were required to be uninsured for at least six months before they obtained this form of health insurance. In January 2014, the PCIP plans no longer exist due to funding issues so Amer...
The United States (U.S.) has a health care system that is much different than any other health care system in the world (Nies & McEwen, 2015). It is frequently recognized as one with most recent technological inventions, but at the same time is often criticized for being overly expensive (Nies & McEwen, 2015). In 2010, President Obama signed the Patient Protection and Affordable Care Act (ACA) (U. S. Department of Health & Human Services, n.d.) This plan was implemented in an attempt to make preventative care more affordable and accessible for all uninsured Americans (U.S. Department of Health & Human Services, n.d.). Under the law, the new Patient’s Bill of Rights gives consumers the power to be in charge of their health care choices. (U.S. Department of Health & Human Services, n.d.).
Luckily under the new health care reform law, most people will receive help paying for their healthcare premiums and cost-sharing expenses that people with insurance have to pay out of pocket for doctor visits, and prescription medicine. Families and individuals will be able to receive this assistance with incomes between one hundred and four hundred percent of the federal poverty line. One hundred to four hundred percent makes up at about $23,000 to $94,000 a year assume this is for a family of four.
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
While most countries around the world have some form of universal national health care system, the United States, one of the wealthiest countries in the world, does not. There are much more benefits to the U.S. adopting a dorm of national health care system than to keep its current system, which has proved to be unnecessarily expensive, complicated, and overall inefficient.
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).
Many changes in health care insurance have been made to increase the amount of individuals with health insurance coverage. The Affordable Care Act (ACA) was enacted in 2010 in efforts to help solve some of the biggest issues that Americans faced with health care and its availability (The White House, 2016). As of today, more than 9 out of 10 Americans have health insurance (The White House, 2016). This means that 20 million people have gained health insurance since the ACA was enacted (The White House, 2016).
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?
“Medicare and the New Health Care Law — What it Means for You.” (2010). Medicare Publications, http://www.medicare.gov/Publications/Pubs/pdf/11467.pdf
In March 2010, under the Obama administration, the United States enacted major health-care reform. The Affordable Care Act (ACA) of 2010 expands coverage to the majority of uninsured Americans, through: (a) subsidies aimed at lower-income individuals and families to purchase coverage, (b) a mandate that most Americans obtain insurance or face a penalty,