Governmental Health Insurance Programs
Medicare Part A (aka Hospital Insurance or HI)
Provides hospital insurance automatically @ age 65 (if FICA qualified) @ no fee but may have deductible & co-pay.
Reimbursement of Medicaid
Varies state by state and by provider, much lower than private insurance
Block Funding
sum of money granted by the national government to a state government with only general provisions as to the way it is to be spent.
Medicare Part C (Medicare Advantage)
•Replaces and covers expenses found in Part A and B •Medicare private fee-for-service plans (PFFS) •Medicare managed care plans (HMOs and PPOs) •Medicare specialty plans
Entitlement
include medicaid, medicare, social security, unemployment, and welfare programs. Rights granted to citizens and certain non-citizens by federal law.
Eligibility for Medicaid
must meet eligibility requirements including categorical, income level, resources, residency, and immigration status
Medicare
A federal program of health insurance for persons 65 years of age and older and the disabled
Medicare Part B
The part of the Medicare program that pays for physician services, outpatient hospital services, durable medical equipment, and other services and supplies.
Medicare—Part D Prescription Drug Coverage
a United States federal-government program to subsidize the costs of prescription drugs and prescription drug insurance premiums for Medicare beneficiaries.
State Children's Health Insurance Program (SCHIP)
a public health insurance program, jointly funded by the federal and state governments, that provides health insurance coverage for children whose families meet income eligibility standards
Medicaid
joint federal-state program that is administered by the states under federal guidance, states must provide coverage to individuals who meet categorical and financial eligibility criteria. Typically covers low-income, pregnant women, children, and adults with dependent children, the disabled, and the elderly.
Benefits of Medicaid
physician services, lab/x-ray services, inpatient hospital services, outpatient hospital service, home health care services, transportation to medical care. Optional Benefits: prescription drugs, clinic services, dental, hospice
Future of Medicare
post financial challenges due to aging population