Everybody would have access to health care through an application process and health care would be paid for based on tax revenue. Based on how much they make would determine how much help from the government they would receive. Every person with health care would receive a “smart card” with medical information and the bill will be sent to the government. The state will set fixed prices on procedures and medication based on income. There will also be a Co-pay every three months, and government would automatically pay for the poor and pregnant women.
What is meeting the deductible? (0.5 points) Meeting the deductible is when you have paid the deductible amount and the insurance company now has some to pay or all of the rest of costs above that amount. 4. What does health insurance help to pay for? (0.5 points) Health insurance helps pays for your medical bills and expenses.
Under this type of plan, a patient may see providers outside the plan, but the patient pays a higher portion of the fees: Preferred provider plan 12. Which of the following is mandatory for certain health professionals to practice in their field? Licensure 13. The National Practitioner Data Bank: Is accessible only to hospitals and health care plans 14. Licensure to practice medicine is done by: Each individual state 15.
The author will discuss the differences in Parts A, B, and D. Medicare Coverage Part A Medicare Part A is often called the hospital insurance because the coverage is primarily directed at hospital services. Part A covers inpatient care in a hospital, skilled nursing facility (SNF) and “Religious Nonmedical Health Care Institutions” ("Medicare Handbook," 2012, p. 27). In addition to this, Part A covers Home Health and Hospice care. This coverage includes all meals, a semi private room, medications administered during the inpatient stay and general nursing. The deductible that must be paid by the patient in 2013 is $1184.00.
Most people have a managed healthcare plan through an employer or self employment. Premiums are paid on the insured’s behalf for the purpose of covering healthcare costs. The two major healthcare plans are Health Maintenance Organization (HMO) and Preferred Provider Organization (PPO). Health Maintenance Organization (HMO) is an organization that provides healthcare coverage through hospitals, physicians, and other providers which are contracted by the HMO; this type of insurance coverage only pays for services rendered by physicians and other providers who are within the network and have agreed to treat patients according to the guidelines of the HMO contract. The HMO plan is usually less expensive because the patient is limited to certain providers.
This part carries a deductible and a monthly premium. Part B is also voluntary enrollment. • Part C – also known as Medicare Advantage Plans work with HMO and PPO to provide a custom plan for patients to receive accurate care with specific needs. • Part D – requires a premium and a deductible. This part works with private insurance companies.
The government covers the cost of all primary care and inpatient treatment, while drugs and advanced tests require co-payments of up to 30 percent. Children and the elderly do make these payments. You must have health insurance if you want to live in Italy. The government gets the resources to pay for this system from taxes collected at a national level combined with taxes collected at the regional sectors, the doctors and other medical care provider’s work for both the private and public sectors, where they received their payments from. If receiving public health insurance you sign up and you choose a doctor.
Part A is the hospital insurance which helps pay for the in-patient care at a hospital or skilled nursing facility following a hospital stay, some in- home health care and hospice care. Part B is the medical insurance that helps pay for doctor visits and several other medical services and supplies that are not included by the hospital insurance. Part C also known as Medicare Advantage plan is like HMOs or PPOs and is offered by private companies approved by Medicare. The Medicare Advantage Plan provides all of Part A the hospital insurance, all of Part B medical insurance and may offer some extra coverage, such as vision, hearing, dental, and/or health and wellness programs as some include Medicare Part D, which is the prescription drug coverage. Part D is the prescription drug coverage that helps pay for doctor prescribed medications for treatment (Medicare, 2012).
In this journal, I will be reflecting about how insurance companies, hospitals, and patients can use Cost-benefit analysis for sustaining a life. First and foremost, Insurance companies routinely use cost-benefit analysis in healthcare to set policies and decide whether to approve claims. Many companies have blanket policies on general treatments, to either approve or deny them. If the cost is unacceptably high and the benefit is marginal or low, the company may deny treatment. In the event of an appeal, it can perform a more rigorous analysis of the situation.
Its Primary purpose is to ensure quality patient care and managing the cost of that care. Its secondary purpose as defined by the Institute of Medicine (IOM) deals with individual users for education, regulations, policies and public health from data entered, verified, corrected or analyzed directly or indirectly. Homeland Security has recently been added to the list of users, including patient care providers, managers and staff, coders and patients themselves. Patients can make changes as necessary. Other users might include lawyers, employers, law enforcement and researchers.