Carlos Albizu University Medicare Health Insurance Program Discussion
ReplyIntro to Healthcare ManagementMy Parents Are Turning 65 and Need Help Signing Up for Medicare Discussion Prompt Reply to each Peer about their post.1. My Parents Are Turning 65 and Need Help Signing Up for Medicare Reply 1 Tia Berry:Hello Class,Medicare is one of the largest government-sponsored health insurance programs in the history of the U.S. Persons over the age of 65 are covered under Part A Medicare for hospital care and under Part B for outpatient health services. Coverage under Medicare has since been extended to younger people with permanent disabilities, with end-stage renal disease (ESRD), and persons under hospice care (Chiras, 2011, p. 203). I was always under the impression that Medicare is for elderly people until my brother who is in his 40’s and currently suffers from TBI had to apply for Medicare coverage. He cannot work and is considered disable.Medicare consists of different parts that includes coverage for different medical needs. All these parts are ways to get coverage under Medicare depending on the care you need and will qualify for. Medicare Part A is Hospital Insurance and it covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care (“What’s Medicare?,” n.d.). Medicare Part B is Medical Insurance and it covers certain doctors’ services, outpatient care, medical supplies, and preventive services (“What’s Medicare?,” n.d.). Medicare Part C is the Medicare Advantage and it is an “all in one” alternative to Original Medicare. It is a bundle plan that includes Part A, Part B, and usually Part D (“What’s Medicare?,” n.d.). Medicare Part D is prescription drug coverage (“What’s Medicare?,” n.d.).People age 65 and older will receive a Medicare pamphlet in the mail. If enrolled in Medicare, they will receive Part A automatically but must enroll in Part B, Part C, and Part D for coverage. People 65 years or older are eligible for free Medicare Part A if they worked and paid Medicare taxes. If people do not qualify for free Medicare Part A, a premium of $458 each month would be required. Part B premium amount would be $144.60 (or higher depending on your income). Part C and Part D monthly premium varies by the specific plans (“What’s Medicare?,” n.d.).Given the parents’ medical conditions, they do need Parts A, B, and D. They need Part B for coverage of doctor visits due to dad having diabetes and mom having annual check-ups. Since Part A is free for both parents due to age and work history, they would benefit from having Part A if something was to happen and hospital stay was needed, it would be covered. Part D is also needed to help with dad’s medication for diabetes and mom’s cholesterol.ReferencesChiras, D. (2011). Human Biology (9th ed.). Jones & Bartlett Learning.(n.d.). Medicare.gov: the official U.S. government site for Medicare | Medicare. https://www.medicare.gov/what-medicare-covers/your…What’s Medicare?2.My Parents Are Turning 65 and Need Help Signing Up for Medicare Discussion Reply 2 Priscilla Berry:Medicare is a federal government health insurance program that “provides access to health care for the elderly over 65 years of age, for permanently disabled younger adults, and for those suffering from end-stage renal disease (ESRD)” (Buchbinder & Shanks, 2017, p. 220). To be eligible for Medicare, that person needs to meet one or more of the requirements mentioned previously.There are different parts (A, B, C, and D) of Medicare, which can help to cover specific services. Each part offers different types of coverage. Part A is Hospital Insurance, which provides coverage for inpatient hospital stay, inpatient skilled nursing care, home health care services, and hospice care. Part B is Supplemental Medical Insurance, which covers physician visits, outpatient treatments, and preventive services. Part C is Medicare Advantage Plans, which includes Medicare Parts A and B coverage benefits. It can also include Part D and other added coverage. Part D is The Prescription Drug Benefit, which provides coverage for prescription drugs (Buchbinder & Shanks, 2017, p. 220). Not everyone automatically get coverage under these parts. It all depends on what they are qualify for. The cost to the individual enrollee will all depend on their choices of Medicare coverage. For those who did not get premium free for Part A, they pay $252 per month if they “worked/ paid into Medicare between 7.5 and 10 years” and $458 per month if they have a “work history of less than 7.5 years” (Norris, 2020). For the Part B premium, it is $144.60 per month, and depending on their income, they would need to pay more. For Part D, the average premium is about $42 per month, and for people with high income, they would need to pay a higher cost (Norris, 2020).Given the parents’ medical conditions, they do need Parts A, B, and D. Part A is needed in case something were to happen that requires them to stay in the hospital. Part B coverage is needed for doctor visits and treatments since the dad has diabetes, and the mom needs yearly check-ups. Part D is needed because the dad needs medications for diabetes, and the mom needs medications for cholesterol.References:Buchbinder, S. B., & Shanks, N. H. (2017). Introduction to Health Care Management (3rd ed.). Burlington, MA: Jones & Bartlett Learning.Norris, L. (2020, January 3). 2020 Medicare coverage costs at a glance. Retrieved from https://www.medicareresources.org/medicare-eligibi…
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