Medicare Case Structure

1245 Words 5 Pages
Medicare (Title 18) is a program that provides health care to individuals who are 65 years or older, disabled, or suffer from kidney failure. Medicare has a basic four-part structure: Part A, which is hospital insurance, Part B, which is supplementary medical insurance, Part C, which is Medicare advantage, and Part D, which is prescription drug coverage. Part A and B make up what is known as traditional Medicare. Part A concerns hospital insurance, this is financed by payroll taxed through employers and employees. Part A pays for a portion of inpatient hospitalization, nursing care, home health care, and hospice. Part A includes a benefit period; this means that the insurer will pay for 60 days in the hospital long as a deductible is paid. …show more content…
Part B is financed by tax revenues and also consists of a premium based on income paid by the individual being insured. Services like the doctor, ambulance, outpatient care, x-rays and lab tests, medical equipment needed, and therapy are all covered by Part B. Part C is for individuals who are signed up for Part A and B. Once enrolled in Part C the individual will receive Parts A, B, C, and D). Part D covers prescription Drugs. Part D offers two different plans for coverage of drugs; one is the standalone prescription drug plan (for Medicare fee-for-service program) and the other is named the Medicare Advantage prescription plan (for MCO’s (Managed Care Organization). ) from Part C). Part D helps pay for the cost of prescription drugs. Overall, each part of the structure covers a section of health …show more content…
Discuss the 'take-away ' point of this article, or what the issue could be for older adults who are choosing a Medicare plan.
The overall ‘take-away’ point of the article, “Traditional Medicare…Disadvantage?” was that an individual over 65 needs to set his or her priorities and look through what both traditional Medicare and Medicare Advantage have to offer before choosing one plan or the other. Understanding what each Medicare program has to offer will insure the individual the best option for his or her life. If a person neglects to take the time to look over the plans he or she could end up in Craig’s situation; he was unable to transfer programs due to his pre-existing condition. It is important that and individual sets his priorities before choosing a program. Craig’s priorities changed as he got older. Perhaps, if Craig had taken the time before he picked Medicare Advantage and looked at the doctor’s offered in his network, he may have changed his mind before enrolling in Medicare Advantage. If Craig took this time to analyze his future, he could have solved the problems that occurred later, after enrollment. It is crucial that an individual learns his Medicare inside and out to make a well-informed decision about his

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