Major components of the Medicare and Medicaid programs
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.
Sample Solution
Medicare is a federal health insurance program for people aged 65 and older, people with certain disabilities, and people with end-stage renal disease. The program is funded by payroll taxes and general revenues.Full Answer Section
The three major components of Medicare are:- Part A:Â Hospital insurance. This covers inpatient hospital care, skilled nursing facility care, home health care, and hospice care.
- Part B:Â Medical insurance. This covers doctor's services, outpatient care, and preventive services.
- Part D:Â Prescription drug coverage. This covers prescription drugs.
- Ambulatory services:Â This covers doctor's services, outpatient care, and preventive services.
- Long-term care:Â This covers nursing home care, home health care, and assisted living care.
- SCHIP:Â This is the State Children's Health Insurance Program, which provides health insurance to low-income children.
- Medicare Part D donut hole:Â The Medicare Part D donut hole is a coverage gap in prescription drug coverage. When a Medicare beneficiary's prescription drug costs reach a certain threshold, they must pay the full cost of their prescription drugs until they reach another threshold.
- Medicaid coverage for long-term care:Â Medicaid does not cover long-term care for all low-income individuals and families. In some states, there are waiting lists for long-term care services.
- Medicaid coverage for children with special needs:Â Medicaid does not cover all children with special needs. In some states, there are waiting lists for services for children with special needs.