Hcs/405 Week 2 Health Care Essay

Medicare Parts A and B. There is a monthly premium for this coverage (Medicare 2013 costs at

This insurance encouraged people that had this basic form of insurance to get a second opinion on their medical issues especially elective surgeries. You had to pay for services that you were receiving right away.

plan, you will typically have no deductible and the co-payments often range from $10 to $20

Part A The central point of this scenario is far more than just healthcare management. Instead, it has elements of medical ethics and the huge amount of bureaucracy often engendered by the American healthcare system. Medicare Part A is hospital insurance that helps cover care in hospitals and skilled nursing facilities. In general, it covers inpatient care and inpatient rehabilitation costs. Medicare Part B covers medically necessary services: doctors', medical equipment, home

However, the coverage Medicare provides comes with premium and cost-sharing requirements as well as gaps in covered benefits, especially for long-term services and supports (LTSS). As a result, Medicare coverage often is supplemented by additional coverage from retiree benefits, Medigap policies separately purchased, and, for low-income beneficiaries, Medicaid (Rowland, 2015). Now, the eligible Medicare beneficiaries can choose between managed care and indemnity plans. Medicare managed care program, Medicare advantage plan, promoted new forms of managed care that were more like traditional insurance policies than like HMOs.

Before a consumer chooses a plan, a good idea would be to evaluate self-health condition and how much money users want to spend in total care costs. For example, if users projected a lot of physician visits per year, hospital stays or need regular prescriptions in this case user need to think about Platinum or Gold plan because the plan covers a higher monthly premium, but covered higher costs of

|Indemnity Plan |Able to choose hospital and doctor, Fee for service, deductible, |Individuals and Families |

Describe differences between Medicare part A and Medicare part B when it comes to group and concurrent treatments?

I had one option where I would essentially pay nothing, but the coverage was different if I had needed to have a major surgery or something of that magnitude. You will have to weigh your options when it comes to your risks of having a large medical cost, but I opted to pick a coverage that was somewhere in the middle, where I still have costs per month, but the overall charges for a long hospital stay would not be massive. So far I have used the plan to see a regular doctor at least six or seven times, have seen several specialist, and picked up medication and I have to say it is the most professional and efficient health insurance company that I have ever dealt

Part C also has drug coverage, alone with other disadvantages it is HMO. Patients are limited to doctors and healthcare providers only unless it’s an emergency. Medigap requires members to have Medicare Part A and B to enroll. Medigap only covers the insured, not their spouse, a separate policy will have to be purchased for the spouse.

Part A – This is the hospital insurance portion of Medicare. It comes at no cost to you once you turn 65.

Whereas indemnity plan designs their benefits based on a percentage assigned to procedures (preventive 100 percent, basic 80 percent, and major services 50 percent) with exclusions and limitations. In direct reimbursement, an employee is reimbursed according to a schedule from a fund established by the employer using employer and employee contributions (Interactive Medical Systems, 2018). Indemnity insurance will determine dental benefits are covered under the policy (not an employer) and reimburse the patients accordinly.

Health plans cover care for members who have different levels of expected cost and utilization due to differences in demographics and diseases.

On average I go to my primary doctor 3 times a year, visit an urgent care facility about 2 times a year, and am prescribed, on average, 3 prescriptions per year. However, in the event that I need emergency and urgent care services, outpatient or inpatient services, prescription drug coverage, preventative care services or to have imaging done, I am covered at no charge after the $500 deductible. Overall, anything could happen in the course of a year that costs more than $500 dollars and if it does happen, any other services after will be covered, as the out of pocket limit is $500; unless there is a fixed indemnity for a specific service.

The main reason behind the Medicare Plan F is so liked is that it will wage for all of the gaps in the Primary Medicare Part A as well as the Part B, comprising both of your hospital as well as the outpatient amount. It even wages the 20% that Medicare Part B does not covert. If you own a Medigap F policy, then though, all of these would be paying for with your insurance. So choosing the best company that fulfill your requirements will be your first step. Then you will be able to get the best plan among all other.