Medicare Part C: A Case Study

Some may ask what Medicare Part D is, it is a fully optional coverage offered by most private insurance companies, and its main priority is to cover the prescription drug cost for Medicare Recipients. For Virginia Medicare Recipients you have many options to choose from when it comes to looking for Medicare Part D plans and it could be very stressful for most people to choose a plan especially when there is so much information about each plan. Cost for prescription drug plans may vary depending on your location most of these plans also require you to pay a monthly premium, annual deductible, and copay. I went to Medicare.gov and clicked on find health and drug plans, then typed in 24091 which happens to be my zip code we only have one pharmacy

Ralph, a 67 year old male, suffers from with degenerative osteoarthritis of the hip. His arthritis progressed so much it’s nearly rendered him immobile and his doctor has recommended a hip replacement. In the United States, the average cost of a hip replacement is $75,399. Fortunately for Ralph, he is a Medicare beneficiary which means that Medicare Part A plan is going to cover about 75% of the total cost of the surgery lowering his out-of-pocket expense to $18,849.

The Medicare Advantage plan is Medicare C. It's offered through a private company. If you know you get your insurance through a private company you know it's not A or B. Medicare Advantage combines all the benefits of A and B plus other things, such as many of your drug prescriptions. This is the most comprehensive of the Medicare plans because it covers the majority of medical expenses you may have.

In a 2017 draft, CMS is introducing new policy changes and rate revisions for Medicare Advantage and Part D. Medicare Advantage rates may increase 1.35% based on predictions where revenues are expected to increase 3.5%. Medicare Advantage plans with a 4, 4.5, and 5-star rating will qualify for an estimated 5% in quality bonus payments. Those with less than 3 stars to 3.5 stars are not qualified. Proposed adjustments in the star rating system include socioeconomic and disability status.

Conclusion: The Obamacare has its very good points it does benefit the economy in ways that are meant to take the economy out of debt. But they do cause side effects that may not have been thought of.

Medicare supplement insurance supplements or completes the Medicare plan. If you are 65 or just about to turn 65 or you find yourself disabled for a period of 24 months, it may be that you qualify for benefits from Medicare. Medicare is the government run health insurance program intended to provide coverage for individuals who have been disabled as well as older citizens. The only trouble with Medicare is it does not pay for the entire cost of your medical expenses. There is always about 20% left over for the individual to pay out of their own pockets. That could be a problem for those on fixed or low incomes.

Part A (Hospital Insurance program) covers inpatient hospital stays, home health service, and skilled nursing facility. In addition to this, Medicare pays for 100 days of care in Medicare-certified skilled nursing facilities as well as for the patients staying in Medicare certified hospice. Some people do not pay any premium for part A due to the taxes paid by them or their spouse during their working years. Moreover, contribution comes to Medicare through payroll taxes paid by individuals which make them eligible for the benefits. In order to become eligible for this premium free Part A program, individuals or their spouse must have forty credits after working at least 10 years. However, people, who do not have forty credits, will pay a monthly

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).

The Affordable Care Act (ACA) caused some of the issues central to the expansion of Medicaid. Some of the major challenges in Affordable Care Act (ACA) the improved access to more individuals. According to Levitt, Claxton, and Damico (2013), the Affordable Care Act expansion increase limitation to families under 65 whose income is at or below 133% of federal poverty guidelines. This leads into significant growth in eligibility of newly coverage populations. Medicaid provide an opportunity to identify successful enrollment and renewal practices, strategies to ensure access to care, effective models of person-centered and coordinated care, and payment systems that align financial incentives with goals for quality and cost. (Paradise, 2015). Especially

Your hospital can be penalized if you are suffering from chronic disease and readmitted within 30 days after the discharge, under the Affordable care act (ACA). ACA has changed the perspective of chronic disease management of hospitals, shifting their focus from treating the conditions to deciding ways to prevent them. Under ACA, hospitals will be penalized or rewarded depending upon their performance on 30-day readmissions, infection control and patient satisfaction levels (1). Are chronic diseases so prevalent and disabling that government has to step in? What could be the impacts of chronic diseases on economy that Government is proposing and enforcing laws to prevent them?

Medicare Part C is Medicare Advantage Plan. This a Medicare health plans that is offered by a private company. It contracts with Medicare and provides all the benefits of Part A and B. Medicare Advantage Plans include: Health Manteca Organizations, Preferred Provider Organizations, Private Fee for Service Plans, Special Needs Plans, and Medicare medical Savings Account Plans. Most plans offer prescription drug coverage

Medicaid and Medicare was created and called the Social Security Act of 1965 to provide coverage for medical treatment for qualified individuals and their families. Medicaid is a program that is jointly funded and managed by the federal and state governments that reimburse hospital and physician for providing care to qualified patients who cannot afford medical expense. To qualify for Medicaid he or she must be a United States or resident citizen which, includes low income adults and their children, people with certain disabilities and senior citizens. “Medicaid and Medicare is overlooked by the Center for Medicare and Medicaid,

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

The major purpose of this work is to completely discuss about the Medicare Part D which will set an influence on the different interest groups and all the entities of government which have been set under the policy changing process. There has been a complete set environment which involved and shape the policy to make efforts as to how all the groups of the stakeholders are influences with the Medical Part D. All the legislation and the specific strategies are made in correspondence to the politics. (Powell et al., 2015). The Medicare Part D is also said to be Medicare prescription drug benefit which directs to setting the United States Federal government programs to work on the subsidizing costs of all the drugs of prescription which insure premiums for the Medicare in US. There is a great enactment which has been based on Medicare Modernization Act of 2003. In December 2003, there are major Medicare Prescriptions which have become into the Improvement and Modernisation Act to become a proper law. There has been a great benefit from the drugs which provides an entire coverage to all the disables and the elderly people who could not have the ability to manage it.

Medicare Part C: Medicare Advantage (MA) offers expanded benefits through private health Insurance programs and usually include Part D coverage.