Healthcare System Issues for the Elderly Medicare Decisions Essay

Healthcare System Issues for the Elderly Medicare Decisions

The Center for Medicare and Medicaid (CMS) was established in 1967 in efforts to increase health coverage. For that matter, Medicare was purposely established to increase health coverage and as well as allow the less fortunate/vulnerable individuals in the society access quality and affordable healthcare (CMS, 2015). Today, Medicare and Medicaid collectively cover about one hundred million Americans. Among the largest group covered by Medicare are the elderly persons. At the old age, the vulnerability to various illness increase. Despite an increasing elderly population in the country, the majority of them cannot afford to pay out of pocket for health care services or pay for a private health insurance. As a result, Medicare aims at providing different coverage plans that are also affordable (CMS, 2015). For that matter, this paper will focus on the various coverage plans offered by Medicare and the ease with which elderly persons can make decisions regarding the coverage plans.

Medicare Health Coverage Plans

Medicare is funded and managed by the federal government to offer a broad range of health coverage services. However, there are four major coverage plans. These programs are designated by the letter A, B, C and D (Medicare, 2015).

The first health coverage plan is the hospital insurance, and it is typically represented by letter A. the hospital insurance covers several services that are considered medically necessary for a hospital. They include hospice care (care for chronically ill patients), home health and skilled nursing. The hospital insurance is offered for free by Medicare if the patient meets the set requirement. The condition in this case is that the patient must have worked and contributed social security taxes for at least ten years ("at least 40 calendar quarters"). For those individuals who fail to meet the requirement as mentioned above, Medicare requires them to pay monthly premiums to be covered (Medicare, 2015).

The second Medicare health insurance coverage plan is known as medical insurance or plan B. This plan is specially designed to cover doctor's services that are considered medically necessary. The plan also covers a broad range of areas such as the ambulance services, home health, mental health care, xray services, laboratory tests, outpatient hospital services, longterm medical equipment such as wheelchairs and crutches and preventive care (CMS, 2015). Compared to the hospital insurance, health insurance covers a broad range of services. However, the rates for this insurance plan are higher compared to the hospital insurance plan. Moreover, all the persons subscribed to this program are required by Medicare to remit their monthly premiums (Medicare, 2015).

The third Medicare plan also called Plan C is not an entirely separate benefits plan. Plan C of the Medicare coverage allows the private health insurance companies to provide the Medicare benefits. Most of the common private Medicare health plans include the PPOs and HMOs. These plans are also termed as Medicare Advantage Plans. Hence, plan C is not mainly considered an original Medicare Plan. (Medicare, 2015)