A Brief Note On Medicare And Private Plans

The Patient Protection and Affordable Care Act (Obamacare) had mame dramatic changes in the field of the health care system, especially in Medicare, that will seriously take effect in American seniors. Indeed, much of the health law’s new spending is financed by spending reductions in the Medicare program. In addition to the provider payment reductions, Obamacare significantly reduces payments to Medicare Advantage (MA) plans by an estimated $156 billion from 2013 to 2022.( Elmendorf, letter to Speaker Boehner). About 27 percent of all Medicare beneficiaries are enrolled in MA plans, a system of regulated and private plans competing against each other as an alternative to traditional Medicare. MA plans are attractive to beneficiaries because they offer more generous and comprehensive coverage than traditional Medicare by capping out-of-pocket costs and offering drug coverage to a rasonable

Suitable health care would not be possible for the elderly population in America without the assistance of Medicare Part A. Medicare did not come about easily. Currently Medicare spending is more than what is being collected, questioning future solvency. There are many challenges with sustaining Medicare into the future. Medicare’s past struggles, present outcomes, and future challenges confirm that a national health plan is ever evolving to meet the needs of the current population and spending inflation.

Since 1965, Medicare has been attempting to provide low cost, guaranteed access to much needed healthcare for senior citizens over the age of 65 and other age groups that suffer from disabilities and terminal diseases. These people represent some of the most vulnerable population groups in the United States. Most do not work, and rely on Medicare to provide them the access to healthcare they need. Unlike privatized health insurance companies, Medicare is a social insurance program that is paid for through federal mandates and tax payer funds. Billions of dollars are spent annually on over 50 million Americans in need (Alonso-Zaldivar 1). The care structure itself is broken into several main parts: Medicare Part A covers hospital costs, Part B cover most outpatient care costs, and Part C and D cover prescription drug costs through dealing with other private insurance. Yet, the upcoming election in November is threatening to change and alter the structure. Each candidate has his own plan to deal with Medicare; both are trying to reign in the costs of operating Medicare, but with some elements being obviously more beneficial for Medicare recipients than others.

Prior to understanding the PPACA and determining its effects on health care quality, it is important to comprehend its origins and the causes of this vast change in policy. The idea of a national healthcare system, according to the Kaiser Family Foundation, was proposed as early as 1912, but lawmakers were unsuccessful until the 1960’s when Lyndon Johnson amended the Social Security Act to encompass both Medicare and Medicaid. This was the first health care reform allocating federal funding and establishing federal control over health care for primarily senior citizens and low-income families. George W. Bush made the next reform that expanded the scope of Medicare coverage in 2003 when he passed the Medicare Prescription Drug, Improvement, and Modernization Act (MMA). In the years following the MMA’s passage, private health insurance companies began to take advantage over clients,

The historical background of Medicare is explained by answering many different questions. One of the historical problems which led the creation of Medicare was that the health costs for the elderly increased dramatically, while a person’s income is also declining. Many of the elderly were unable to afford health insurance, which led to a large amount of people not being covered by any health insurance. There were also certain companies that decided to terminate health policies for those who were considered to be high risk. The problems historically were very important in the fact that insurance companies were charging the elderly too much, and it didn’t just affect those who were already financially unstable. This problem was handled previously by different Federal-State programs that were set in place for medical assistance, but they were not meeting the needs of the people. Often, people were turned away and many were not eligible for the programs.

The Health Affairs published an article in about a proposed Medicare reform regarding the high levels of use of Medicare although there was little impact on individuals. Though this article dates back to 2002, the issue still remains true to this day. In this article, the authors explain that the high level of Medicare spending was mostly due to the increase number of physician visits, specialist consultations, and hospital stays, especially among those that had chronic illnesses. Although the spending is higher among such Medicare patients, this did not mean better effective care or health care outcomes. On the contrary, according to the article, more than 20% of the total

Medicare currently pays for many preventive services that can detect health problems early when they’re easier to treat, give better access to claims and personal health information, and allow for savings on brand-name and generic when coverage gaps are met. The actual benefits of Medicare will not be changing. There will however be a new plan that is key to the Affordable Care Act that will take place in 2014. This plan is the Health Insurance Marketplace that allows individuals, families, and employees of small businesses to get health insurance. (Services, 2013 ) The Marketplace offers insurance plans through private companies that will provide essential health benefits regardless of gender, preexisting conditions, or preventative

Medicare is a valuable part of health insurance in the United States. Although it is a popular program, it will face a number of financial issues and challenges in the future.

What is Medicare insurance? Medicare is a federal health program for an individual between the age 65 and older. Medicare has also helped certain younger people who suffer from some type of disability and also help an individual with kidney failure and need to place on a dialysis machine or need an organ transplant. Medicare insurance was created in the year 1965 it was signed by president Lyndon b, Johnson to help those Americans at the age of 65 who was not covered by health insurance received some types of insurance this insurance will be called Medicare. In the year 1972, Medicare starts to expand their program to people with disability and also patient suffering from kidney failure that required dialysis or needed an organ transplant to save their life. Medicare was designed to give the American people a choice how they want to manage their care that why Medicare insurance created two separate insurance called Type A and Type B. The insurance benefit of Type A generalized coverage, hospital care, skills nurse facility care, nursing home, hospice, home health service. The Medicare insurance of type B coverage service for supplies needed for diagnosis or treating a patient and also coverage preventive & screening for a patient that want to check for potential illness, for example, Mammogram & HIV screening. The insurance benefit of Type B cover ambulance service, inpatient and outpatient service, partial hospitalization, laboratory test and limited outpatient

Medicare is another section that will feel some relieve from practices brought from the Act. As mentioned before, the cost of health care is expensive, therefore making it difficult for those under the Medicare plan to seek preventive services. Before moving forward on the effects of the Act on Medicare, one must first explain some of the benefits of Medicare. Medicare is the nation’s largest health insurance program, it serves more than forty-two million enrollees, and it was originally established to provide access to health services for the elderly (Carroll, 2009). One can grasp the idea that the nation, along with its government, has made constant efforts to support the health of all Americans. This especially true for the ever growing

Medicare is a federal health insurance program for people sixty- five or older, also there can be younger people with disabilities, and people with End-Stage Renal Disease. Medicare splits into two segments. Segment A concerns inpatient hospital, skilled nursing facility care and home health care. Once officially registered in Medicare, you will be given these benefits instantly and won’t have to pay premiums for them, because you’ve already paid for them through your taxes. Segment B concerns majority of your medically necessary doctors’ services, preventive care, durable medical equipment, etc. You will pay a monthly inducement for this coverage. Segment C concerns of Medicare policy that permits private health insurance companies to equip. HMO’s and PPO’s (Medicare private health plans) are acknowledged as Medicare Advantage Plans. You have the choice to choose Medicare Advantage Plan in place of going through Original Medicare. Segment D concerns Medicare that

Due to the upcoming presidential election, the two major political parties, and their candidates, have been focusing on the primary problems that the nation will face. Chief among those problems is the future of Medicare, the national health-insurance plan. Medicare was enacted in 1965, under the administration of Lyndon B. Johnson, in order to provide health insurance for retired citizens and the disabled (Ryan). The Medicare program covers most people aged 65 or older, as well as handicapped people who enroll in the program, and consists of two health plans: a hospital insurance plan (part A) and a medical insurance plan (part B) (Marmor 22). Before Medicare, many Americans didn't have health

How Medicare, Medicaid and private insurance benefits affect how the hospital bills and collects revenue. To begin with, a hospital is funded by numerous fairly distinct systems, depending on who is paying. Medicare program for the aging normally pays hospitals a flat payment per hospital case. With the federal-state Medicaid program the poor, sightless and disabled, hospitals obtain either one case-based expenses or a two set amount of dollars per day of inpatient visit (per-diem payments) or (3) fees for single services and supplies . The levels of the payments are set individually by the state managements. In numerous states payments are greatly lower than the full cost of providing the services. Private insurers

In the news, there are always talks about how Social Security and Medicare are not going to last in the near future. One of the biggest problems these two organizations are facing right now is that people are living longer. This means that more people are retiring early and few people are working, so there are fewer people contributing to the Social Security and Medicare while the number of people receiving benefits is growing. In order to save them, it’s not going to be an easy task because every proposal to find a solution will always make someone very unhappy. Increasing the age of the retired people is a solution which I really don´t like because I´ll be affected but considering we are living longer there is no other choice. Another solution

The growing concern regarding the financial security of Medicare is one of particular interest to the nearly 72 million baby boomers that become eligible for this government-assisted, and tax-payer bolstered, program over the next two decades. According to the U.S. Census Bureau (2010), there will be a rapid increase in baby-boomers between 2010 and 2030, as the entire baby boomer population move into the 65 years and over category (p.3). Political and financial revisions must be made to ensure the security of Medicare as the numbers of individuals paying into this program are soon to be surpassed by the number of individuals drawing-off this program (U.S. Census Bureau, 2010). The elderly are also at a disadvantage with transportation to health care visits, picking up prescriptions, and rehabilitation services. There needs to be an establishment of access not only to primary care providers, hospitals, and rehabilitation services, but access to other aspects of the health care system for the elderly population.