HEALTHCARE IN AMERICA
Healthcare in America is very complex and fragmented. There is no uniform health system and a lot of people still do not have insurance. Health insurance is purchased privately or provided by the government. The United States government funds two kinds of health plans – Medicare and Medicaid both of which began in 1965 and founded for the elderly, disabled, poor and young. The private health plan provides two types of health plans – Health management organization (HMO) and Preferred provider organization (PPO).
Government funded Healthcare Plan
Medicare is a national public health insurance program for people aged 65 and over as well as some disabled individuals. It is the largest health insurer in the country and is
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Part D is provided only through private insurance companies that have contracts with the government.
Medicaid is a program designed for low income and disabled people. By federal law, states must provide coverage for very poor pregnant women, children, elderly and disabled. It is jointly financed by the state and federal government through taxes and administered by each state. Coverage varies because states have established different requirements for eligibility; hence people in certain states receive a more generous benefit package under Medicaid than those in other states. In 2010 Medicaid expanded to allow private health insurance companies to offer affordable health insurance to low income people who would not qualify for Medicaid but do not make enough to pay for private health insurance. This was called the Affordable care Act and intended to provide coverage for free to people with income below the federal poverty level. However some states chose not to expand so eligibility in those states are more strict whereas it’s more lenient in states that opted into the Affordable care Act.
Other public systems
SCHIP – State Children’s Health Program- was founded in 1997 to cover children whose families make too much money to qualify for Medicaid but too little to purchase health insurance. It is administered by the department of health and human services and has similar structure as Medicaid.
Veteran Administration – The veteran’s Administration is a federally
The United States (U.S.) has a multitude of options for health care coverage. People have the option for private or public coverage. One example of public coverage is Medicaid and an example of private coverage is Blue Cross and Blue Shield (HCSC, 2015). There are many differences between each health care option, the biggest difference is the price you are paying. This paper will discuss the differences between private and public health insurances as well as the cost for each.
Medicare is a federally governed insurance program, primarily serving Americans over the age of 65, younger disabled meeting specific disability criteria, and dialysis
Medicare Part D is prescription drug coverage. It’s the newest part in Medicare. It adds prescription drug coverage to original Medicare, some Medicare cost plans, some Medicare PPS plans, and Medicare Medical Savings plans. Beneficiaries choose the drug plan and pay a monthly premium.
Medicare has had many legislative changes to modernize the program since it was first signed into law. Medicare has assisted many retirees from a financial disaster by providing benefits during a healthcare crisis. The prescription drug program has ensured seniors have access to the medications they require. Medicare has also provided care to the disabled that are under age 65. This national social healthcare program has also come under fire politically because of the extremely high cost of the program.
Medicaid is a social health care program that covers nearly 60 million Americans, including children, pregnant women, seniors, parents and individuals suffering with disabilities. Medicaid is the biggest source of funding for health related services and medical needs for the people with low income in the United States. This program is funded jointly by the state and federal level governments, but it is the state’s responsibility to manage this program. The Medicaid program is not a required program that states have to use, but all 50 states have implemented this program. With the introduction of the Affordable Care Act (ACA), and its passing in 2010, the ACA unveiled its plans to expand Medicaid eligibility to nearly all low-income adults as an addition to the other groups that fall into the Medicaid eligibility. The Medicaid program had “many gaps in coverage for adults” because it was only restricted to the low income individuals and other people with needs in their own specific category. In the past, the majority of the states who had adults that did not have children dependent on those parents were not eligible for Medicaid. These low income adults without dependent children would be without medical insurance assistance before the ACA was introduced. Medicaid is now available to all Americans under the age of 65 whose family income is at or below the federal poverty guideline of “133 percent or $14,484 for an individual and $29,726 for a family of four in 2011” (NSCL).
An estimated 5 million uninsured children are eligible for Medicaid or SCHIP but are not enrolled. SCHIP was created in 1997 to provide coverage for children who live in families with incomes that exceed Medicaid eligibility caps but cannot afford private coverage. Like Medicaid, it is financed by a combination of federal and state funds. Because of SCHIP, millions of children can now see a doctor when they are sick and get the health care they need.
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
Medicare D is also provided to you through private companies and are known as prescription drug coverage plans. Medicare D doesn't cover anything other than prescription drugs, and the cost and coverage can vary depending on the company and plan you go with. If you don't need help paying for anything apart from your medications, this is a good option for
Are you aware of the various policies that are being enacted from each state to state regarding the qualification of Medicare? Medicare is funded by the federal government and each state is responsible for operating the
Medicaid is health insurance that covers low income or no income people and families. There are some people that qualify for both Medicare and Medicaid. Due to the Medicaid Expansion (Obamacare), 26 states and the District of Columbia have eased some of the income requirements for Medicaid. Anyone below 138% of the federal poverty level is eligible
| State Children’s Health Insurance Program (SCHIP) was created in 1997 to insure children in families with too much income to qualify for Medicaid and too little to afford private insurance. It emerged from a budget negotiation between a Democratic president and Republican Congress. As such, the program represents a fine balance, designed to maintain equilibrium between states and the federal government, as well as between political conservatives and liberals. States have the option of providing child health assistance in SCHIP through Medicaid, a separate program, or a combination of the two. There is also flexibility in benefits designed; through benefits must meet certain set standards. On average, the federal government pays
Basically, it’s built to replace the original Medicaid, due to the fact it only supports children based on their family income; The lower income family would be on Medicaid and the remainder making slightly above refer to Children’s Insurance Program (CHIP). To dive deeper on the matters, CHIP is slightly similar to Medicaid, but some differences set them apart. In Medicaid’s case “experts say the benefit is generally richer” than Chip. “Medicaid requires that children receive comprehensive services, including physical exams, immunization, laboratory tests and dental, vision, and hearing services. CHIP benefits are not as broad in some states”
Medicare and Medicaid are two types of government insurance assistance that were put into place in order to give those that fall into certain categories receive medical care and have basic insurance. Although they are two separate programs, both managed by the Centers for Medicare and Medicaid Services, which is found under U.S. Department of Health and Human Services.
SCHIP stands for State’s Children Health Insurance Program introduced in January 24, 1997. The bill is part of the Balanced Budget Act of 1997 which was signed by President William Clinton in August 5, 1997 and became a public law1. The bill allows the States to designate the fund given by the federal government to families that qualifies under certain conditions. However, in September 7, 1997 it received a disapproval bill originating from the House. And in 2007, during the 110th Congressional session, the House introduced the State’s Children Health Insurance Program Reauthorization Act of 2007, H.R. 3963. The bill is introduced by the House Representative John D. Dingell and was placed under House Calendar No. 141 with one general
The majority of patients we have are elderly and therefore are on Medicare insurance. Medicare is administered by the federal government and available for Americans over the age of 65. Those of us in the work force under 65 are all paying taxes into the Medicare program.