Healthcare System Issues for the Elderly: Medicare Decisions
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Healthcare System Issues for the Elderly: Medicare Decisions The Center for Medicare and Medicaid (CMS) was established in 1967 in efforts to increase health coverage. For that matter, Medicare was purposely established to increase health coverage and as well as allow the less fortunate/vulnerable individuals in the society access quality and affordable healthcare (CMS, 2015). Today, Medicare and Medicaid collectively cover about one hundred million Americans. Among the largest group covered by Medicare are the elderly persons. At the old age, the vulnerability to various illness increase. Despite an increasing elderly population in the country, the majority of them cannot afford to pay out of pocket for health care services or pay for a private health insurance. As a result, Medicare aims at providing different coverage plans that are also affordable (CMS, 2015). For that matter, this paper will focus on the various coverage plans offered by Medicare and the ease with which elderly persons can make decisions regarding the coverage plans.
Medicare Health Coverage Plans Medicare is funded and managed by the federal government to offer a broad range of health coverage services. However, there are four major coverage plans. These programs are designated by the letter A, B, C and D (Medicare, 2015). The first health coverage plan is the hospital insurance, and it is typically
Medicare and Medicaid are programs that have been developed to assist Americans in attainment of quality health care. Both programs were established in 1965 and are federally supported to provide health care coverage to vulnerable populations such as the elderly, the disabled, and people with low incomes. Both Medicare and Medicaid are federally mandated and determine coverage under each program; both are run by the Centers for Medicare & Medicaid Services, a federal agency ("What is Medicare? What is Medicaid?” 2008).
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
The purpose of this paper is to give an overview of two federally and/or state funded programs. The programs that will be discussed are Medicare and Medicaid. In this paper will be information about who receives Medicaid/Medicare, the services offered by these programs, and those long term services that are not.
Many proposals to reorganize Medicare could increase the financial and health risks faced by the vulnerable elderly. Turning Medicare into a premium-support system a voucher set randomly at the value of the second-least-expensive insurance plan could shift costs to elderly households. Increasing the Medicare eligibility age from 65 to 67 will leave many Americans ages 65 and 66 without insurance. The basic idea of part A Medicare payment is simple. The patient pays a deductible that approximately equal to the cost of the first day in the hospital;
Medicare and Medicaid information can be overwhelming and confusing to both the consumer and the healthcare professional. The information highway known as the World Wide Web (WWW) can provide the answers to questions about these government benefits, but getting clear, informative and accurate knowledge can be overwhelming. O’Sullivan (2011) identified the WWW as “a primary repository for health information for the medically naïve yet technically savvy healthcare consumer.” One internet website that provides information about Medicare and Medicaid is CMS.gov ("Cms.gov centers for”). The Centers for Medicare & Medicaid Services (CMS) is the United States agency that administers Medicare,
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 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.
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.
Medicare is a social insurance program that is sponsored by the government (1). This was originally made for the long term care for the elderly people that needed health insurance (2). There are four different parts that are provided to the people that are eligible for Medicare. Part A helps pay for the hospitals. As Part B pays for all medical reasons; such as, physician visits, outpatient services, and the need for medical equipment. Part C, for example, deals with the care of people with diabetes, and Part D is to provide people with prescription drugs (1).
Medicaid is a cooperative program administered by federal and provincial government that insures individuals with chronic illness or disabilities who could not have had the means to obtain insurance elsewhere. However, Medicaid’s ability to run efficiently has started to be questioned due to growing budget pressure. This program is need of improvement, so it can benefit both the people and the country. Medicare faces its challenges too, as the population of elderly grows, so does the cost of the program. The coverage of Medicare is also questionable. The government covers about 60% of the medical expenses under Medicare, however 15% of Medicare recipients are so indigent that they would be entitled to Medicaid. Money is also the problem for
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
I must say that I’m very interested in this week’s assignment. I’ve always know that there was a difference in these two programs but I never really took the time to learn about those differences. While both programs are important to the elderly and underprivileged, there are some distinct difference that I will discuss in this essay. In addition, we will take a look at the evolution of Medicare and how it’s frame work has changed over the years to provide care for aging American’s. Furthermore, we will take a look at how the Avoidable Care Act (ACA) initiatives will effect the Medicare and Medicaid programs.
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.
The higher cost of affordable Health care is also eroding the ease with which to afford other insurance that covers about 30 percent of Medicare enrollees ‘expenses. In 2005, about 89 percent of beneficiaries obtained such additional coverage, including through former employers (33 percent), medical policies (25 percent), Medicare advantage plans (13 percent), Medicaid (16 percent), or other programs (1 percent) (MedPAC). These supplemental insurance programs were all very helpful at the onset, but with the passage of time and as health care costs continued to rise, employers are finding it difficult to support these programs and as a consequence, a greater number of these employers are either reducing the benefit or eliminating these benefits especially those that affects their retirees thereby increasing the cost of these supplemental insurances.
After four decades of failure to enact a universal healthcare program, advocates decided to refine their approach in the 1950s, and the strategy that ultimately led to the passage of Medicare and Medicaid was formulated. Wilbur Cohen and I.S. Falk recognized that a health insurance plan focused on Social Security beneficiaries would be much easier to sell than a plan for all Americans. By limiting its benefits to the elderly, Medicare could be portrayed as a program for people who met two important criteria: they had greater need for healthcare coverage and they were especially deserving of public assistance. Because of their age, seniors have relatively high medical costs--when Medicare was passed, average healthcare expenses for people sixty-five or older were twice the average expenses for younger persons. (Orentlicher, D. (2012).