Compare and contrast the characteristics of the following reimbursement sources: - Research Paper Example

The paper will end at the section of conclusion. The Reimbursement Sources Medicare Summary: Medicare is a program under social insurance, which is administered by the federal government of USA. It involves allocation of the funds gathered by the collection of the payroll taxes under the Self-Employment Contributions Act and the Federal Insurance Contributions Act of 1954. The program finances residency training sessions too for the majority of doctors in USA. (Colamary, 2003) Purpose: By imposing tax on the salaries in connection to employment, the program helps to allocate funds for the healthcare of the elderly and certain categories of disabled people.

It is a social security program and provides financial relief in the form of reimbursements and insurance coverage. (US Department of Health and Human Services, 2011a) Eligibility: All the individuals aged sixty five years or above, who are legal residents of USA for a minimum of five years are eligible to be covered under this program. Disabled people, below the age of sixty five, who get the Social Security Disability Insurance benefits, are also eligible for the scheme. People suffering from certain medical conditions like end-stage renal complications, Amyotrophic Lateral Sclerosis (ALS), etc.

may also get reimbursements. (US Department of Health and Human Services, 2011a) Benefits: 1. Part A – Hospital Insurance: Reimbursement is given when the patient is admitted in a hospital. It includes doctor’s fees, tests, food, room charges, etc. 2. Part B – Medical Insurance: This is the reimbursement on the payment of some products and services, which are not covered under hospital insurance. Medicare provides 80% costs of such approved services. 3. Part C – Medicare Advantage Plans: Provide reimbursements on prescription drugs.

Can be availed through private sector health insurance programs too. 4. Part D – Prescription Drug Plans: A flexible scheme involving private sector health insurance providers, where the beneficiaries can choose the drugs they wish to be reimbursed from a wide variety of the classes of drugs. (US Department of Health and Human Services, 2011a) Medicaid Summary: This program is jointly financed by the federal and state governments, and is controlled mainly by the states. It is the biggest source of finance and health insurance for the people with low earnings in USA.

Of late, the Deficit Reduction Act of 2005 has implemented certain rules to determine that who are actually in a situation of need to avail benefits from Medicaid. (Ketler, 2008) Purpose: Provides financial reimbursements to the people who are included in the lower income groups. This is a needs-based, means-tested social welfare program, which covers a wide variety of healthcare facilities and services. (US Department of Health and Human Services, 2011b) Eligibility: Eligibility criteria differ from one state to another.

However, it follows the basic framework of needs-based approach. The beneficiary should be a citizen and permanent resident of USA. Generally, low-asset individuals including pregnant women, children, elderly, and disabled people requiring nursing home care are considered eligible for the scheme. (US Department of Health and Human Services, 2011b) Benefits: Beneficiaries of the Supplemental Security Income Program may be eligible for the Medicaid benefits