Medicare Impact On Health And Social Care

Improved Essays
What is Medicare? Medicare is federal health insurance for people 65 and older individuals 65 and under with certain disabilities, and any person with End Stage Renal Disease (ESRD) and Lou Gehrig’s disease also known as Amyotrophic Lateral Sclerosis (ALS) (Medicare Matters, n.d.). Medicare is one of the largest federal government programs that provide health care benefits to the elderly. The Centers for Medicare & Medicaid Services is the organization in control of the Medicare program. Three parts of Medicare discussed is how Medicare is financed, those who are eligible for Medicare and the benefits such as differences in premiums and covered services.

Medicare Financed Medicare is paid through two trust funds that are held by the
…show more content…
The eligibility criteria include the following: a U.S. citizen or legal resident, lived in the U.S. for a minimum of five years, and worked at a minimum of 10 years in Medicare-covered employment (Towers Watson, 2014). Individuals may have to apply for Medicare benefits if the member has not applied for Social Security or Railroad Retirement benefits, employed by the government, or have kidney disease (Towers Watson, 2014). Those individuals under 65 may qualify for Medicare if the person has End Stage Renal Disease (ESRD) or has received Social Security Disability Income (SSDI) for 24 months or in the first month of disability for Lou Gehrig Disease also known as ALS (Towers Watson, 2014). In addition, a person has the option to purchase additional insurance coverage to cover the gaps of …show more content…
Medicare is paid by two trust funds that are held by the U.S. Treasury, Hospital Insurance (HI) Trust Fund and Supplementary Medical Insurance (SMI) Trust Fund. A portion of payroll taxes and the employer covers most of the Medicare expenses. Medicare is one of the largest federal government programs that provide health care benefits to the elderly. Most individuals qualify for Medicare around 65 and over. Some individuals under 65 may qualify for Medicare if the person has End Stage Renal Disease (ESRD) or has received Social Security Disability Income (SSDI) for 24 months or in the first month of disability for Lou Gehrig Disease also known as ALS (Towers Watson, 2014). Medicare has four different parts: Hospital Insurance, Part A; Medical Insurance, Part B; Medicare Advantage, Part C; and Prescription Drug coverage, Part D. In addition, the program assists with the expenses of health care, but it does not cover all medical expenses or the price of most long-term care. Medigap coverage can be used to purchase from a private insurance company to cover the additional expenses that Medicare does not

Related Documents

  • Improved Essays

    Health Policy Case Study

    • 754 Words
    • 4 Pages

    1) From the case study, provide one example of each of the forms that public policies can take: laws, rules or regulations, other implementation decisions, and judicial decisions. Law: Social Security Amendment of 1965 is a public law 89-96. It was created to aid senior citizens with health insurance (Medicare) and to provide health care to indigent population and disabled (Medicaid). Rules/Regulations:…

    • 754 Words
    • 4 Pages
    Improved Essays
  • Great Essays

    Medicare Part A Case Study

    • 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.…

    • 1245 Words
    • 5 Pages
    Great Essays
  • Improved Essays

    As the population ages in the U.S., there is need for medical care among our elderly citizens. Most elderly citizens over the age of 65 have Medicare for their insurance coverage. Citizens can also be approved for Medicare benefits should they be disabled or have end-stage renal disease. So, the question becomes, how is Medicare making an impact on our healthcare ecosystem of today?…

    • 1093 Words
    • 4 Pages
    Improved Essays
  • Improved Essays

    Long Term Care Benefits

    • 1821 Words
    • 8 Pages

    Based off of deeper research, three different parts to the types of coverages that Medicare provides are; Part A, Part B, and Part D (Original Medicare np). When Medicare first existed, there were only two original coverages, including Part A, impatient/hospital coverage, and Part B, outpatient/medical coverage, while Part D, prescription drug coverage, was later added, but rarely used by most (Original Medicare np). Even though most Americans believe that Medicare is a single health insurance program, that is not exactly true. In fact, multiple different plan options are provided today, based off of an individual's needs, costs, rules of the plan, and time limit on care. Two different options become available when applying for Medicare, including; Original Medicare and Medicare Advantage Plan (Original Medicare np).…

    • 1821 Words
    • 8 Pages
    Improved Essays
  • Improved Essays

    Medicare Vs Medicaid

    • 200 Words
    • 1 Pages

    Medicare and Medicaid are two different government programs in response to the low-income Americans to buy health insurance. Medicare is the federal health insurance program for people who are 65 or older or have any type of disability no matter what the persons imcome. There are different kinds of services that Medicare offers. This Services are Hospital Insurance, Medical Insurance, Medicare Advantage Plans and Prescription Drug Coverages. Once of the benefits of Medicare is Nursing home and home services but limited.…

    • 200 Words
    • 1 Pages
    Improved Essays
  • Improved Essays

    Medicare is a federally program founded in 1965 as Title XVIII of the Social Security Act. It is considered the nation’s largest health care coverage program. The purpose of Medicare is to provide the same type of health care as a private party insurance plan. Medicare provides healthcare coverage and services to elderly seniors age 65 and over, regardless of their income or medical history. It also covers those individuals under the age of 65 who are permanently disabled, as well as those with end stage renal disease known as kidney failure requiring dialysis or a transplant.…

    • 391 Words
    • 2 Pages
    Improved Essays
  • Improved Essays

    Medicaid Vs Medicare

    • 313 Words
    • 2 Pages

    According to the videos, Medicare A covers hospitalization, B is medical insurance, C is purchasing private insurance through Medicare which sounds better out of the four because with this policy they…

    • 313 Words
    • 2 Pages
    Improved Essays
  • Improved Essays

    Recent Changes in Medicare Medicare is federal health insurance program that helps 65 and older patients or younger adults with disabilities and anyone with certain diseases. Medicare is always changing and sometimes those changes can affect you with more severe changes to the program. If you are eligible for Medicare your enrollment period will begin 3 months before your 65th birthday and applying online will save you time and money so it is best to apply online. There are different types of Medicare plans there is part A, B, and D. Every year Medicare cost can go up and also the coverage options can change as well, which those are the important parts of having healthcare insurance. In this year of 2017 costs for the max premium of part A…

    • 339 Words
    • 2 Pages
    Improved Essays
  • Improved Essays

    Medicare Benefits

    • 1287 Words
    • 6 Pages

    Another emerging provisions was the 75% prescription drug coverage when Medicare beneficiaries met their total out-of-pocket expense but it was capped at $2,250. The Medicare Modernization Act gave the beneficiaries a choice of at least 2 qualifying plans in their area under HMO or PPO under Medicare Advantage plan. These multiple individual plans were responsible for negotiating prices with drug manufactures on an individual…

    • 1287 Words
    • 6 Pages
    Improved Essays
  • Improved Essays

    Medicare was established after World War I and added stability to the nation. It was put into place to support the nation, not cripple it. The establishment of Medicare helped many citizens receive jobs, find houses, and receive better educations. The elderly, who could no longer work, can receive help from individuals who are able to do what the elderly can no longer do. The retired individuals of America receive a safety net provided by the government through the taxes paid by citizens; by doing so the federal government can give all people the same opportunity to receive a stable life without the hardships of stressing payments.…

    • 576 Words
    • 3 Pages
    Improved Essays
  • Improved Essays

    Don't Ignore the Formulary Medicare offers several different prescription drug plans, and each covers different medications. These medications are listed in the plan's formulary. If you take maintenance medications, be sure to choose a prescription plan that covers your medicine. Otherwise you could be forced to pay for these medications yourself.…

    • 615 Words
    • 3 Pages
    Improved Essays
  • Improved Essays

    Medicare reimbursement refers to payments to hospitals and doctors receive as a result of services provided to patients that are covered under Medicare. It is considered an example of discounting (Penner, 2016, p. 40.) As discussed above, the base payment reimbursement is usually less than amount that private insurance companies pay. The federal government sets this rate (Ku & Broaddus, 2008).…

    • 215 Words
    • 1 Pages
    Improved Essays
  • Improved Essays

    The History Of Medicare

    • 561 Words
    • 3 Pages

    Part C and D get a little complicated. Part C is not separate but the part that allows private health insurance companies to provide Medicare benefits. You can choose plans such as HMOs and PPOs depending on if you want to add Part C to your plan. Part D covers prescription drugs. It is provided only through private insurance companies that have contracts with the government.…

    • 561 Words
    • 3 Pages
    Improved Essays
  • Superior Essays

    Medicare has four different parts that it offers which are Medicare part A, B, C, D. Medicare part A is a hospital insurance program that covers hospital stays, skilled-nursing facilities, hospice, and home health. When you are an inpatient in a hospital you are subject to a deductible and daily coinsurance after the sixtieth day. When it comes to skilled-nursing facilities you are covered 100 days after a 3 day hospital stay but are still subject to a coinsurance after the sixtieth day as well (Yesalis, Holt & Politzer 2013)…

    • 1350 Words
    • 6 Pages
    Superior Essays
  • Decent Essays

    1. 1. When a pensioner that is 65 and older or receiving Social Security Disability for more than 2 years contacts the pension office I am able to assist them with navigating the Medicare system. In some cases these situations involve explaining to the Medicare recipient the procedure, which involves applying for Medicare Part A and Part B and providing the Office of Pensions with a copy. Once the copy is obtain then it involves reviewing the pension application to include years of service, date of retirement and date of hire to establish which plan they will be eligible to enroll in.…

    • 233 Words
    • 1 Pages
    Decent Essays