Question

Identify three major components of the Medicare and Medicaid programs and, based on these components, identify at least two patient coverage gaps for each of the programs. Be clear when you describe the coverage and the gaps as they may relate to specific ages, patient populations, or disease entities. Use primary sources to identify the components and the gaps. Additionally, discuss your stand (criticize or defend) regarding the relevance of the Social Security program to the American public. Should the program be left alone, modified, drastically changed, or eliminated? Provide the rationale and use facts to defend your position.

Answer 1

Answer :

Medicare :

• Medicare is health insurance managed by the US government For people age 65 or older and For some people under the age of 65 with certain disabilities .
• The medicare program also funds residency training program For the vast majority of physicians in the US.
• Medicare is managed by the centers For medicare and medicaid services ,a division of US dpartment of health and human services.
• Medicare provides assistance For some 45 million people ,according to the latest statistics .

Components of medicare :

• Medicare has two main parts , there is part A and part B
• PartA is For hospital coverage and partB For medical coverage such as seeing a doctor.
• Part A helps pay For in patient care you get in a hospital ,skilled nursing facility or hospice and For certain conditions of homeostasis health care.
• Medicare part B helps pay For medically necessary doctor's services and other out patient care .
• It also pays For some preventive services like flu shots.
• There is original medicare and medicare advantage plans also called partC.
• Original medicare is in two sub sections medicare part A and part B .people can choose to have either one or both parts .paying a deductable is required For either one and usually a patient must pay each time they get services.
• Part D can be added by joining a medicare prescription drug plan .
• Part D moves some costs of prescription drugs to patient through what is called the "donot hole or coverage gap ".
• Eligibility : low income groups , but eligibility also depends on meeting other requirements based on age (age of 65),pregnancy status , disability and other assets and citizenship .

Medicaid:

• Medicaid is health insurance available to certain people and families who have limited income and resources .
• It covers an estimated 58 million people.
• Medicaid is overseen by the federal government but each state stablishes its own eligibility standards and determines the scope of services
• Medicaid is overseen by the centers For medicare and medicaid services of department of HHS..

Services provided by medicaid :

• Inpatient and outpatient hospital services.
• Prenatal care.
• Vaccines For children .
• Nursing facility services For people ages 21 and older.
• Family planning services and supples .
• Rural health clinics
• Homeostasis health care For persons eligible For skilled nursing services .
• Laboratory and x- ray services.
• Pediatric and family nurse practitioner services.
• Nurse midwife services
• Screening ,diagnostic and treatment services For children under age 21.

Medicare not provide services For non residents , who are not under age of 65 .

People are suffering variuos health problems in adult age and spending out of pocket money .

Health care cost also increased ,low income people are not getting effective care due to poverty . So medicare and medicaid should provide services For common chronic condition which are in adult age such as obesity , CAD s , hypertension , diabetes mellitus etc .

And also should provide services to non resident people .