Medicare is a federally funded program that offers healthcare coverage to Americans 65 years and older
Medicare is a federally funded program that offers healthcare coverage to Americans 65 years and older
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Post #1 – Sommer
Medicare vs. Medicaid
Medicare is a federally funded program that offers healthcare coverage to Americans 65 years and older, Americans who are permanently disabled, and, all Americans who have end-stage renal disease. Medicare is divided into four parts A, B, C & D. Part A covers hospital visits, skilled nursing facilities, home health, and hospice care. Part B covers outpatient services and physician services, but the patient will pay a monthly premium.Part C was added to help those with managed care, with Parts A & B, and lastly, Part D covers prescription drugs.Medicaid programs are state and federally funded and provide coverage to Americans who cannot afford healthcare insurance and those who are considered “medically needy”(Austin & Wetle, 2016, p. 52). There is also the Children’s Health Insurance Program (CHIP), which is health coverage for low-income parents who do not qualify for Medicaid but cannot afford private healthcare insurance.CHIP is funded by the state and federal governments.
Coverage Gaps for Medicare
Medicare does not provide coverage for long-term nursing or home health care. This is a significant issue for the elderly population. Another coverage gap is the deductible patients have to pay until their medical expenses reach a certain amount. Medicare only covers 75% until expenses reach a certain amount and then Medicare will not cover additional expenses until they reach an even higher amount. This can cause financial hardship for many Americans with chronic conditions like diabetes or HIV, who need continuous care and medications.
Coverage Gaps for Medicaid
Medicaid does not cover all Americans equally. Because Medicaid is state and federally-funded and based on per capita state income levels, eligibility for Medicaid is not equally accessed.If a person meets the criteria and qualifies as being “medically needy” they may qualify for coverage. This can benefit the elderly, disabled, women, and children. Medicaid does not cover abortions for women due to federal laws. Another gap with Medicaid is that nursing homes and physicians are not required to accept Medicaid, which may limit a person’s choice and access to local providers, especially when they live in more rural areas (Mason et al., 2015, p. 53).
Social Security Stance
Social Security is not a reliable or adequate source of supplemental income. According to Mason et al., “Social Security is not bankrupt or in crisis, and it can pay all promised benefits in full for the next 20 years, through to 2033. After that, the program will still be able to pay 75% of all benefits that are owed to Social Security beneficiaries in subsequent years” (Mason et al., 2015, p. 236). If this isn’t concerning enough, women are considered to be more vulnerable and dependent on social security, as they age. Statistically speaking, women live longer and have lower or no pensions. According to Mason et al., “Women, and especially women of color, are less likely than men to have employer pensions. On average, only 28% of women aged 65 to 74 receive a pension income compared with 42% of men aged 65 to 74”(Mason et al., 2015, p. 230). Women have lower pensions because of gaps in employment to serve as caregivers to their children or other family members. Some proposed solutions to strengthen the Social Security System include eliminating a cap on an employee’s payroll contributions, increasing the overall contribution percentage and rate over the course of 20 years, and taxing flexible spending accounts(Mason et al., 2015). Personally, it feels as though many of us are going to be forced to pay for the mismanagement of the Social Security System. It seems we are left with no choice but to correct a pretty bleak situation and proactively contribute to other retirement plans to secure more financial stability, as we age.
Post#2-Maria
“Medicare is a federal government-administered health insurance program for the disabled, and those over 65 years and Medicaid, until recently has been a state and federal government-administered health insurance program for low-income people, who are in certain categories, such as pregnant women with children” (Freida, 2015, p. 173). Before the Affordable Care Act Medicare Program consisted of:1. Medicare Part A covers hospital costs. 2. Medicare Part B covers outpatient services, occupational services, medical equipment, home care, outpatient mental health services, physician services, laboratory, and physical therapy. 3.Medicare Part C or Medicare Advantage Program covers hearing and vision services. 4. Medicare Part D covers prescriptions. A change after the Affordable Care Act in Medicare is that people won’t have access to hearing or vision services. Another change after the Affordable Care Act in Medicare is that it eliminates Medicare Part D leaving many seniors unbale to pay for their medications.
Before the Affordable Care Act Medicaid Program eligibility consisted of those who are receiving: 1. Social Security Income (SSI) 2. Temporary Assistance To Needy Families (TANF) 3. Or are children and pregnant women whose family income is at or below 133% of the poverty level. A change with the Affordable Care Act in Medicaid has been that the poverty level is now 138%. This was increased to expand those who are eligible for Medicaid. Another change was that anyone below the age of 65 years old and income at poverty level would qualify for Medicaid. This change was so that there would be more people that would qualify for Medicaid instead of it only being those in the three categories. This however is state by state basis as they can decide if they want to participate in the expansion of Medicaid. With states not fully on board with the expansion it left many to not be qualified for Medicaid and without access to healthcare. Insurance will pay for a person’s medical condition or any medical costs but that does not include public health. Public health focuses on conditions as a group or community which insurances do not cover. These programs are important in the prevention of communicable diseases. The Affordable Care Act authorized funds to be used for public health but Congress reduced the amount that was set for public health. This led to an increase of infectious diseases.
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