Medicare and Medicaid

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Table of Contents Executive Summary 2 Summary Statement 2 I. Introduction 3 II. About Medicare 4 III. About Medicaid 5 III. Fraud & Abuse of Medicare 7 IV. Fraud & Abuse of Medicaid 8 V. Prevention Program Methods/Reform for Medicare & Medicaid 9 VI. Conclusion 12 References 13 Executive Summary With the ever-changing difficulties of our health insurance landscape, the government has taken a more active role in the health care and well-being of American citizens. With this shift, programs like Medicare and Medicaid, become polarizing topics in an environment where individual finances are tight, our economy is struggling, and the future is no longer as predictable or financial secure as we once believed it to…show more content…
Most individuals that are covered under Part B pay a monthly premium. Part B of Medicare fills the gaps that the original Medicare coverage does not pay. Medicare Part C, also known as Medicare Advantage Plans, allow individuals to supplement or customize a plan that aligns with their personal medical needs. “These plans enlist private insurance companies to provide some of the coverage, but details vary based on the program and eligibility of the patient. Some Advantage Plans team up with health maintenance organizations (HMOs) or preferred provider organizations (PPOs) to provide preventive health care or specialist services. Others focus on patients with special needs such as diabetes” (Medical News Today, 2013). The last part of Medicare includes a prescription drug plan, known as Part D. Part D adds prescription drug coverage to original Medicare, some Medicare Cost Plans and Medicare Private-Fee-for-Service Plans, and Medicare Medical Savings Account Plans. Insurance companies offer these plans and other private companies approved by Medicare. Medicare Advantage Plans may also offer prescription drug coverage that follows the same rules as Medicare Prescription Drug Plans (Medicare, 2013). III. About Medicaid Medicaid is a health care and long-term care coverage program that is jointly financed by states and the federal

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