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.
A copayment is: A set amount that each patient pays for each office visit 9. Under this type of plan, insured patients must designate a primary care physician (PCP) Health maintenance plan 10. When physicians, hospitals, and other health care providers contract with one or more HMOs or directly with employers to provide care, this is called. A physician-hospital organization 11. 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.
Medicare is a Federal Government program designed to cover people age 65 or older, people with certain disabilities and serious kidney failure. Within this program, there are four sub divisions also called “parts”. • Part A - cover hospital insurance such as hospital stays, nursing facilities, supplies, etc. • Part B – cover Supplementary Medical Insurance such as physician and nursing services, home – health services, outpatient visits. This part carries a deductible and a monthly premium.
In a spend-down program, individuals are required to spend a portion of their income or resources on health care until they reach or drop below the income level specified by the state. The concept is similar to an annual deductible, except that it resets at the beginning of every month. Each month, the enrollee pays a portion of incurred medical bills, up to a certain amount, before the Medicaid fee schedule takes effect and Medicaid takes over payments. For example, a patient who has a $100 spend-down visits the physician on March 3 and is billed $75. The patient is responsible for paying the entire $75.
Impact on patients Conclusion/Closing: With the changes made by the Patient Protection and Affordable Care Act, consumers no longer have to worry about being turned down by health insurance companies for pre-existing conditions or the inability to afford healthcare. The Patient Protection and Affordable Care Act better known as “Obamacare” has changed the way healthcare is administered, especially in the way it protects patients (consumers) from unfair insurance practices. This is not socialized health care nor is it a single payer system. Consumers will still have to purchase insurance from private companies, not the government however, The Patient Protection and Affordable Care Act is a set of guidelines and regulations put into action to protect patients. Insurance companies have unfairly treated consumers for many years, making it very difficult to access care.
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).
They may have tasks that include cleaning the exam rooms, setting up instruments and equipment as well as cleaning the sterilizer according to the maintenance schedule. Assistants may also be responsible for greeting patients, answering the phones, managing payroll, performing data entry and scheduling patient appointments. Clinical duties may include keeping a record of patient’s medical history and vital signs, explaining treatment procedures to the patient and answering question that the patients may have. They may be required to help elderly patients with the removal of shoes as well as helping to put their shoes on and may have to help the patients move around the exam area. Assistants are responsible for preparing the patient for procedures by giving a foot bath and clipping toe nails as well as bandaging the patient’s feet.
• Overview of the different Medicare and Medicaid services Medicare covers the services such as lab tests, surgeries, and doctor visits (CMS.gov). Supplies such as wheelchairs and walkers that are considered medically necessary are also covered (CMS.gov). Other services covered are the following: Hospital Care Skilled Nursing Facility Care Nursing home care (as long as custodial care isn’t the only care needed) Hospice Home health services (CMS.gov) Medicare health plans cover: • Medicare Cost Plans • Demonstrations/Pilot Programs • Programs of All-inclusive Care for the Elderly (PACE) • Medication Therapy Management (CMS.gov) Medicare coverage is based on 3 main factors (CMS.gov): 1. Federal and state laws (CMS.gov). 2.
The services offered at Hospital Acute care include: consultation with specialist clinicians (consultants, nurses, dieticians, physiotherapists and a wide range of other professionals); emergency treatment following accidents; routine, complex and life saving surgery; specialist diagnostic procedures; and close observation and short-term care of patients with worrying health symptoms. Many hospitals are addressing acute care needs of older adults by establishing separate geriatric unit – often referred to as acute care for elders (ACE) units – staffed by a specially trained multidisciplinary team (Miller,2004). Standard Older people’s care in hospital is delivered through appropriate specialist care and by hospital staff who have the right set of skills to meet their needs. Osteoarthritis is characterized by joint pain, tenderness, limitation of movement, crepitus, occasional effusion and variable degrees of local inflammation, but without systemic effects (Scotts et al, 1998). Osteoarthritis is a degenerative disease affecting
People should value life according to the impact a person has contributed to society. Valuing someone’s life shouldn’t be done in number and statistics, but rather the people that they touched while they were here on this earth. Everyone that has existed has made an impact on other people whether that person is the unborn baby, or the homeless person living in the park. So, when people say someone is worthless they aren’t considering the impact that person has made on the people around them. Before assigning value to life it should be considered what that person did in their lifetime not just their job, or their major achievements, but how they affected other people in either a positive or negative way.