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Medicare and Insurance Coverage - Essay Example

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Medicare and Insurance Coverage

The Medicaid, on the contrary, is a program designed to assist people with a few resources to access health care services. For a State to access the Medicaid services from the Federal State, it has to meet some set standards. Thus, by studying a case, it becomes necessary to answer some questions that aid in understanding the functionality of these programs. The case study provided presents Mrs. Zwick, a 77-aged woman, a permanent resident of the United States, hospitalized due to a mild stroke. The study has indicated that, she underwent an admission for five days and later transferred to a different facility for rehabilitation services. After a considerable time, the doctor diagnoses her with a hospital obtained “Urinary Tract Infection” (UTI) (Kaplan, 2004). As a result, the doctor prescribes some medications for her. The case has further highlighted the fact that Mrs. Zwick has the Medicare part A, B and D coverage. Mrs. Zwick’s daughter lacks sufficient knowledge concerning how the coverage indicated above can assist her mother in settling the hospital bills (Kaplan, 2004). Therefore, the administration has demanded that I discuss with the daughter on costs covered fully or partially by the three parts of the Medicare program entitled to h er. The part A of the Medicare also identified by the name Hospice Insurance (HI) will cater for the following bills (Kaplan, 2004). For instance, it will settle all costs incurred due to her stay in the facility. These entails the meals, tests performed on her for diagnosing reasons, as well as for her stay in the skilled nursing home, where she underwent the rehabilitation. In addition to the above, the Medicare part A will settle bills needed for the walker. Moreover, the Medicare part B will also play a monumental part in helping cover the different costs entitled to her. This part, for instance, will cover all-home care services entitled to Mrs. Zwick after her discharge. Finally, the Medicare part D will also be necessary, as it will cater for costs incurred in accessing her medication. In addition, the later part will partially repay the bills arising from the medication of the hospital acquired UTI. The current medical policies enacted discourage the reimbursement for hospital-acquired infections. In 2006, George Bush who was the United States president enacted an act aimed at plummeting the amount of finances dedicated to treating disorders resulting from medical errors. This was due to a rise in the occurrence of such errors thus costing the federal government enormous funds. As a result, payers of such services decided to monitor the expenditure of such finances. According to the board in charge of budget in the US, the decision would help the local government save $29 billion (Kaplan, 2004). The current policy formulated would adversely affect Mrs. Zwick. Therefore, she will have to spend her own finances for the treatment of her UTI. The infection she has acquired is amongst the ten conditions that Medicare does not compensate. Therefore, catering for the treatment of such an infection might result to the risk of deprived health or death. Mrs. Zwick may not pay all finances needed for her treatment thus a decline in her health. The “Consolidated Omnibus Budget Reconciliation Act” ...Show more

Summary

Medicare and insurance coverage Name: Instructor: Task: Date: Medicare and Medicaid have been in use, in the United States, and their main concern is the provision of healthcare, as well as medical services to a certain category of individuals. Sources have distinguished the two programs by revealing the Medicare as a federal health insurance program mandated to cater for the elderly, as well as the disabled…
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