Essay On Medicare

Part D is financed through general revenues (74%), beneficiary premiums (15%), and state payments for dual eligibles (11%). Similar to Part B, enrollees with higher incomes pay a larger share of the cost of Part D coverage. (Kaiser Family Foundation, 2015)

Since its establishment in 1965 we have seen Medicare change as people’s needs change however being a federal program these changes do have an incredible amount of lag time. One of the first major changes to Medicare occurred in 1972 when President Nixon signed the Social Security Amendments of 1972 which extended coverage to individuals under age 65 with long-term disabilities, expanded benefits to include some chiropractic services and speech and physical therapy. During this time we see the American public growing tired of the Vietnam Conflict and lack of support and care for those returning Marines and soldiers with severe disabilities. As the protests escalate and the peace initiatives fail a key piece of legislation is signed showing government support and a willingness to extend health care benefits to this growing and vocal population of veterans (The Vietnam War, 1999). Also included in this Amendment is the encouragement of the use of Health Maintenance Organizations, President Nixon’s administration caught in the scandal of Watergate and pending hearings appeased the left and proposed the HMO Act, which Congress passed in 1973 (Phillips, 2003).

The Social Security Act of 1965 established Medicare and Medicaid which are health insurance programs for the poor and elderly people of the United States. It is funded by a tax on the earnings of employees and contributions by the employers. “It is now broadly apparent that those who opposed Social Security in 1935 and Medicare in 1965 were wrong in their fears…” (Nicholas Kristof  “The Wrong Side of History”).

Medicare is the federal health insurance program for people with certain disabilities, end stage renal disease, and for those who are over the age of 65. There are four different parts to Medicare, part A, part B, part C, and part D. Medicare Part A, also known as hospital insurance, covers inpatient hospital stays, care in nursing facilities, hospice care, and some in home health care. Part B is often referred to as medical insurance; it covers certain doctors’ services, outpatient care, medical supplies, and preventative care services. Medicare Part C, otherwise known as Medicare advantage plan is offered by a private

Part A is predominantly financed through taxes paid by employees and employers (Facts, 2015). There is a 2.9% tax on earnings, and taxes account for 87% of Part A revenue. The taxes are deposited into the Hospital Insurance Trust Fund (Medicare, 2014). Additionally, the article (2015) states that employers and employees pay a payroll tax of 1.45% each, while higher-income taxpayers pay a higher payroll tax of 2.35% on earnings. Part B is funded by general revenue and premiums paid by beneficiaries. Medicare pays premiums for Part B on the behalf of beneficiaries who qualify for Medicaid based on their low incomes and assets (Medicare, 2014). Alternatively, beneficiaries with higher incomes pay a higher monthly premium based on their incomes (Medicare, 2014). According to data collected in 2014 by the Kaiser Family Foundation (2014), these premiums can range from $146.90 to $335.70 per month. The article (2014) states that the income thresholds for the

Medicare provides access to health insurance coverage for more than 45 million people who qualify due to disability or age. The three components of Medicare are Parts A, B, and D. Part A is hospital insurance and provides coverage for inpatient hospital services, skilled nursing facility services, hospice services, and post-institutional home health care. Covered services under Part B one component of supplementary medical insurance (SMI) include physician services, durable medical equipment, laboratory services, outpatient hospital services, physician-administered drugs, dialysis, and certain other home health care services. The other component of SMI, Part D, mainly provides access to prescription drug coverage through private insurance plans.

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.

Medicare is a federal health insurance program for people over the age of 65. It also covers particular people who may have a disability and people who have End-Stage Renal Disease. There are four different parts to the Medicare program. These parts include hospital insurance, medical insurance, Medicare advantage plans, and prescription drug coverage. The program, since being created, has helped to fix many different problems, as well as help the elderly and other persons to receive health insurance.

Medicare and Medicaid are two of the United States largest broken systems, which must sustain themselves in order to provide care to their beneficiaries. Both Medicare and Medicaid are funding by a joint effort between the federal government and the local state government. If and when these governments choose to cut funding or reduce spending, Medicare and Medicaid take the biggest hit. Most people see these two benefits as one in the same, two benefits the government takes out of their pay check to help fund health care. While the government does deduct a sum from paychecks everywhere, Medicare and Medicaid are very two very different programs.

The Medicaid program is jointly financed by the federal government and states. The federal government pays states for a specific proportion of program expenses, called the Federal Medical Assistance Percentage (FMAP). FMAP varies by state based upon criteria such as per capita income. There are no intermediary like Medicare’s HMO and PPO, so payments are made directly to providers. Medicaid covers health insurance up to 400% of Federal Poverty Line for those who are under age 65 and poor and/or disabled through income and excise taxes. Elderly over age 65 who are poor are dual eligible for Medicare and Medicaid. There is an employer-based insurance (EBI) and cost share is between employees and employers.

Medicare Part B is medical insurance. Part B insurance covers different medical needs than what is covered in Part A. With Part B coverage, a beneficiary will be covered for doctor visits, blood tests, x-rays, diabetic supplies and screenings, and out patient care. Part B has a monthly premium that varies for each person. This is where Medicaid comes in for lower income beneficiaries, if a beneficiary has a higher income the fee for Part B can be higher. Each person is responsible for a small deductible each year before Part B starts to be used and then

Medicare is funded by the Social Security Administration, which means it’s generally financed by taxpayers. Payroll taxes paid by most employers, employees, and people who are self-employed help finance Medicare. There are 4 parts of Medicare, each part is funded differently. Part A, the Hospital Insurance (HI) Trust fund is paid by taxpayers. Employees pay 1.45% of their earning into the Federal Insurance Contributions Act (FICA), which goes into the trust fund. Employers pay an additional 1.45% into FICA. Those who are self-employed pay 2.9% towards FICA. Individuals making $200,000 or more and couples making 250,000 or more pay a higher percentage of 2.35% into the Health Insurance Trust Fund. The

Part A covers the hospital portion and Part B covers the medical portion. If you qualify and have at least one part then you are eligible for Part D coverage as well. Part D helps people on Medicare to be able to cover some of their prescription costs. This is not a free coverage but requires a monthly premium. All prescriptions are based on a formulary where a low tier will cost the patient less versus a high tier costing more. The idea is that low tier medications will be

Medicare Part D was created under the Medicare Prescription Drug, Improvement and Modernization Act of 2003. (Medicare Part D, 2011). It is also known as the prescription Drug Plan. This plan was created to help cover cost of prescription drugs, and people who have the original Medicare or Medicare Advantage are eligible to enroll (Medicare Part D, 2011). Prescription drug coverage is only offered through HMOs, PPOs, and PFFSs and by some private companies who contract with Medicare through individual plans (Medicare Part D, 2011). Private companies are allowed to create their own customized benefit plan as long as the plan is as good as the plan outlined in the 2003 Medicare Act (Medicare Part D, 2011).

“Medicare-for-all” is piece of legislation proposed by Vermont Senator Bernie Sanders that advocates for a single-payer healthcare system and universal coverage for all in the United States (Keith & Jost, 2017). The bill details a national health insurance plan, funded by a government trust, that would cover all services from hospital stays to primary care visits, thus eliminating high out-of-pocket costs, copayments, and deductibles. Comprehensive coverage under Medicare-for-all would also include treatment for substance abuse, mental health counseling and resources, reproductive and maternity services, and even abortion (Keith & Jost, 2017).