Kot Task 2

40 days in a SNF. Medicare Part A will cover 100% of the first 60 days of Mrs. Zwick’s hospital

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 Part D Drug Plan was created by Congress in 2003 to aid the elderly, disabled, and sick persons in affording their medication. Coverage for the drug plan went into affect January 1, 2006. This plan was called the Medicare Prescription Drug Improvement and Modernization Act of 2003 (MMA) (Cassel, 2005). The final bill that passed, was influenced by drug-company and health insurance lobbyists and focused mainly on the needs of those industries instead of the seniors it was meant to serve (Slaughter, 2006). These plans are operated by insurance companies and some private companies that have been approved by Medicare. Part D is optional only if a person carries health insurance that includes prescription coverage. If at retirement

D plan will cover her prescriptions that are not covered by part A and B unless they are

Medicare Part D is the prescription drug plan. There are various options under this portion of Medicare and depending on the one that your mother has chosen would base the amount of coverage that she would receive for prescription medications. This does not necessarily cover the full cost of the prescription medications; there are deductibles and copayments that must be met.

The Medicare offers three types of insurance coverage. Medicare part A hospital insurance covers inpatient care in hospitals, and skilled nursing facilities. It also helps cover hospice care and some home health care. This coverage does not cover custodial or long-term care (Center for Medicare and Medicaid Services, 2013). Medicare also offers part B Medical insurance that covers preventative care and outpatient care. Prescription drug

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

Contrary to this, anecdotal reports stated that other clinicians sometimes spend more times in checking and treating patients with severe illnesses or who are in critical conditions, which made the physicians care for a greater number of patients with lower acuity. Whenever a physician and clinician bill for the same service, it is very difficult to tell if the physician saw a more complex patient. Due to these uncertainties in comparing their services, the Commission is reluctant in altering the payment differential. From that discussion, every provider must be familiar with some fundamentals about Medicare. First and foremost, there is Medicare Part A, which actually covers skilled nursing home, hospital, and home health charges; and then there is Medicare Part B, which then envelops most outpatient services, the care that patients in particular obtain from a doctor’s office (Fishman, 2002).

The Outpatient Prospective Payment System pays for services that are designated as outpatient hospital services, partial hospitalization services, hepatitis B vaccines and their administration, casts, splints, and initial preventative physical exams that are received within the first 12 months of the Medicare Part B coverage becoming effective. Other services that are included are x-rays, stitches, hospital charges for an emergency room visit, surgeries that are done on an outpatient basis, observation services due to an illness or injury and the administration of certain drugs that you cannot give

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).

It is basically a Medical Insurance that help you pay for outpatient hospital care, doctors charges and few of the other healthcare care facilities that Part A doesn't cover. It is important to note that beneficiaries are required to pay a monthly premium in most cases to be covered under Medicare Part B

Overview: Medicare – passed into law in 1965 – is the federal health insurance program designed for Americans over the age of 65 and certain people with disabilities. Medicare Part A covers inpatient hospital services. Medicare Part B covers physician and outpatient care. Medicare Part D is the prescription drug benefit. Medigap is a supplemental insurance for individuals with Parts A and B, sold through private insurance.

Medicare Part A hospital insurance is normally provided for free of charge to individuals, whose ages are 65 and older or have a disability. Each benefit period begins the day Medicare beneficiaries are admitted to the hospital and ends when those individuals have not been hospitalized for a period of 60 consecutive days. When Medicare beneficiaries are first admitted to the hospital, they pay an initial deductible of $1316. From the 61st through the 90th day, they are responsible for a copay amount of $329 per day. After the 90th day, they will pay $658 per day for 60 additional lifetime reserve days or can opt to pay the 100percent of charge and continue to reserve the 60 lifetime days. If there are more than 60 days between a discharge and a following readmission, a new benefit period starts with the same $1316 deductible and coinsurance. Moreover, Medicare beneficiaries may be eligible for skilled nursing facility benefits after being hospitalized for more than 3 days and when the skilled nursing facility admission begins within 30 days of the hospital discharge. In that case, the beneficiaries owe nothing for the first 20 days and are responsible for $144.50 per day from day 21st to day 80th. The beneficiaries are obligated to pay all cost after 100 days. Home health services are covered 100percent by Medicare if beneficiaries are confined at home; however, they have a 20percent

Today, Medicare is one of the largest insurance carriers in the U.S. Medicare was instituted in 1965. I do not know what their deductible was at that time, but the part B premium was only $3. Medicare was set up with Part A as insurance coverage for the hospital and Part B as a supplement, to cover physician’s charges for the elderly. In 1975, the patient deductible for Part A was just $44. Since that time, the Part A deductible had risen almost every year, and today, in 2015, the patient pays a little over $1200. The Part B premium is $147, and has not increased in several years. Medicare takes the part B premium out of the recipient’s taxes.

At its initiation in 1965, Medicare expected to provide health insurance to Americans age 65 and older and to younger people with certain disabilities or health conditions. It was a two-part plan. Part A providing payment to the hospital, home health following hospital stays, skilled nursing facility, and hospice care for the aged and disabled. Part A is paid by payroll deductions with no premiums for those who contributed. Part B, is an optional medical insurance program for which enrollees pay a monthly premium. Part B can be used to pay for physician, outpatient hospital, home health, and other services for the aged and disabled. Although it was considered during the 1930’s as a part of president Roosevelt new deal. It was believed that the inclusion of the plan could jeopardize the success of social security and hence was not added at that time. President Truman officially initiated the talks on national health insurance program, but LBJ finally signed it into law and added it to the Social security amendment in 1965. Since 1965 Medicare had changed multiple times with extended eligibility to individuals under age 65 who have long-term disabilities or end-stage renal disease. Addition of Part C (Medicare+Choice), also known as Medicare Advantage, drug benefit inclusion or Medicare Part D, the most recent Patient Protection and Affordable Care Act. The responsibility for overseeing Medicare and it funding lies with the Department of Health and Human Services (HHS).