As we all know, having a minor procedure or surgery would cost you a high deductible. So, HAS would save you tax on the money that you used. In an Internet video, Female Speaker (2010) states that “The tax benefits at having an HAS are threefold and include tax savings on the contributions, tax-free earnings on the money kept in the account and tax-free distribution of the funds when they’re used for those qualified medical expenses”. HAS balances roll over from year to year, and the account is portable, which means that you can keep it even if you change jobs or retire. Reference: Female Speaker. (2010, December).
What is a health saving account [Video file]. Retrieved from UNIVERSITY of PHOENIX MEDIA LIBRARY website: http://min. Com Choose one of these programs, or a section of the program, listed below and explain the basic concepts of the program. Research, cite, and reference your examples according to PAP requirements. Medicaid: The Medicaid program was established under title xix of the social security act of 1965 to pay for health care for individuals and families with low incomes. Applying for Medicaid benefits, a person must meet minimum federal requirements of the state in which they live, also call.
Medicaid, which has become one of the most complex social-welfare programs, and consider prospects for its reform. “(Rosenberg, 2002, p. 635) Almost ten years ago, I experienced the complex process of Medicaid. I lost my job, and a few month later I was diagnosed with duodenal ulcer. The Emergence Physical advised me to follow up with a Gastrointestinal specialist. Since I have no health care coverage, decided to apply for Medicaid. After filling over 20 pages of the application form and four hours waiting to see a caseworker; finally I was told that I would receive the result via mail.
Two and half weeks later, I had received my rejection letter saying that I did not qualify for Medicaid. The reason for the state to made this decision was I had enough personal properties such has house, car and other assets. If I reside another state, probably qualified but “Each state administers its own Medicaid program. Hence, eligibility criteria, covered services, and payments to providers vary considerably from state to state”. (Shih & Sings, 2012, p. 218) Medicaid offers two types of plan fee-for-service and managed care plan.
Fee-for-service plan allowed patient to choose a provider of their choice, s long as that provider accepts Medicaid. Managed care plans restrict patient to a network of physicians, hospitals, and clinics. Individuals who enrolled in managed care plan must obtain all service and referrals through their primary care provider (PC). If a patient need to see a specialist, the PC must provide a referral; otherwise Medicaid will not pay for the service. Rosenberg, S. , J. D. (2002). Medicaid. The New England Journal of Medicine, 346(8), 635-40. Retrieved from http://search. Procures. Com/deceive/223937422? Accounted=458 Shih, L & Sings, D. 2012). Delivering health care in America: A systems approach (5th Deed). Retrieved from University of Phoenix eBook Collection Database. Affordable Care Act more individuals will have access to health insurance and be able to seek regular care without financial burden. Agree that people do seek care more often utilize more preventative care when they are insured. When I was in college and had no insurance I did not seek any medical care. It was unaffordable and the price of being uninsured was many times greater than the cost for those who were insured. The financial burden was such that the COBRA plan was not affordable at $400 a month.
Many people o not have the option to purchase this coverage due to the cost of no longer receiving the employer subsidy. Usually the cost to the insured doubles under the COBRA plan. As an example, I needed to go to emergency for chest pain while uninsured. The cost to check it out was over $4,000. 00. This is before the Affordable Care Act (AC). Had this been in place at that time, I would have been able to purchase an affordable policy and avoid the financial burden. The United States is the only country in which one-fifth of adults reported serious problems paying health care bills”. Schooner, Osborn, Squires, Dotty, Pierson, & Applicable, 010, p. 2323-34) Schooner, C. , Osborn, R. , Squires, D. , Dotty, M. M. , Pierson, R. , & Applicable, S. (2010). How health insurance design affects access to care and costs, by income, in eleven countries. Health Affairs, 29(12), 2323-34. Retrieved from http://search. Procures. Com/deceive/824059666? Accounted=458 Drug benefits under the Medicare Prescription Drug, Improvement, and Modernization Act (MA) are separated into three phases: Basic Level, Coverage Gap, and Catastrophic Level.
Coverage in Part D requires an additional premium and coverage under Part A or Part B of Medicare. Part D offers two separate plans. One called fee for service and the other under managed care organizations (Moos) (Shih and Sings, 2014, p. 214-15). The coverage provided in Medicare Part D is not substantial. It lacks in the power that the US government has to negotiate drug discounts for the public. Another aspect Part D does not cover all drugs. Leaving many drugs costing full price. Drug costs in the United States remain high even under Medicare Part D.
The coverage provided in Medicare Part D is not substantial. It lacks in the power that the US government has to negotiate drug discounts for the public. Another aspect Part D does not cover all drugs. Leaving many drugs costing full price. Drug costs in the United States remain high even under Medicare Part D. Disagree with Ellen Jackson. I do not believe that creating a high deductible plan creates an incentive for people to avoid the cost of a specialist. As an example, I have a suspicious looking spot on my arm. I have a higher deductible to see a dermatologist than my primary physician.
Would the higher deductible discourage me from seeing a specialist and encourage me to see my primary physician instead? How does it benefit the insurer to encourage me to get n unqualified opinion from someone who will most assuredly refer me to a dermatologist anyway? Now will incur the cost of my primary physician as well as that of the specialist. According to Reedy, Ross-Design, Skylark, Consumer & Harm ” Higher patient cost-sharing has raised concerns that high deductible health plans (Heads) might lead to unintended reductions in routine, effective care”. 2014, p. 86) Another example might be obtaining an x-ray for a broken bone. Knowing I have a high deductible would again not discourage me from obtaining the x-ray even though the cost may be higher. It is of some concern that the Heads have little benefit to anyone but the insurer. Reedy, S. R. , Ross-Design, D. , & Skylark, A. M. , Stephen B. S; Harm,J. F. (2014, January). Impact of a High-deductible Health Plan on Outpatient Visits and Associated Diagnostic Tests. Medical Care, 52(1), 1-7. Retrieved from http:// move. Law-Medicare. Com.
The Affordable Care Act (AC) addresses the level of care question by dividing care into specific groups. It expanded those eligible for Medicaid (the poor), provided National Health Care Policies on exchanges for the population between he ages of 26 to 65, and excluded those over 65 for coverage under Medicare. The level of care is further defined requiring that insurance provides preventive care and other essential health benefits, coverage of dependents under parents’ insurance up to age 26 and coverage for people with health conditions that previously were excluded for a pre-existing condition. Shih & Sings, 2014) It also fines those who do not purchase coverage in an attempt to encourage all citizens to participate. Then the exchange which addresses a large segment of the population was given options as to the level of care that they could purchase. These were described as bronze, silver, gold or platinum levels. The insurers who offer plans in each level must meet the same requirements for that group such as bronze (lowest premium, 60% coverage) or platinum (highest premium, 90% coverage). (Nevada Health Link, 2014, Table. ) Other criteria are also considered as to whether you may participate in the exchange and how much subsidy you are qualified for. These “redistributive policies (designed to benefit only certain groups), in particular, are believed to be essential for addressing the fundamental causes of health disparities. ” (Shih & Sings, 2014, p. 21 ,522) After looking at all of these different elements insurance is clearly not the same level of care across the board and designed mainly to address the basic disparity. References: Nevada Health Link. (2014). Health insurance plans & levels of coverage.
Retrieved November 05, 2014, from HTTPS://www. Environmentalist. Com/about-Nevada-health-link/plans-available/ How does the Affordable Care Act (AC) address whether citizens have a right to the same level of heath insurance or some minimum level of care? Previously were excluded for a pre-existing condition. It also fines those who o not purchase coverage in an attempt to encourage all citizens to participate. Then the exchange which addresses a large segment of the population was given options as to the level of care that they could purchase.
These were described as bronze, silver, gold or platinum levels. The insurers who offer plans in each level must meet the same requirements for that group such as bronze (lowest premium, 60% coverage) or platinum (highest premium, 90% coverage). Other criteria are also considered as to whether you may participate in the exchange and how much subsidy you are qualified for. These “redistributive policies designed to benefit only certain groups), in particular, are believed to be essential for addressing the fundamental causes of health disparities. ” (Shih & Sings, 2014, p. 21 ,522) After looking at all of these different elements insurance is clearly not the same level of care across the board and designed mainly to address the basic disparity. The Medicaid program was established under Title XIX of the Social Security Act of 1965 to pay for health care for individuals and families with low incomes. Applying for Medicaid benefits, a person must meet minimum federal requirements of the state in which they live. Medicaid offers two types of plans, fee-for-service and managed care plan. Fee-for-service plan allows patients to choose a provider of their choice, as long as that provider accepts Medicaid.
Managed care plans restrict patients to a network of physicians, hospitals, and clinics. Individuals who enrolled in the managed care plan must obtain all services and referrals through their primary care provider (PC). If a patient needs to see a specialists, the PC must provide a referral; otherwise Medicaid will not pay for the service. (Shih & Sings, 201 2) Almost ten years ago, I experienced the complex process of Medicaid. I lost my job, and a few months later I was diagnosed with a duodenal ulcer. The Emergency Physician advised me to follow up with a Gastrointestinal specialist.
Since I had no health care coverage, decided to apply for Medicaid. After filling out over 20 pages of the application form and four hours of waiting to see a caseworker; finally I was told that I would receive the result via mail. Two and half weeks later, I received a rejection letter saying that I did not qualify for Medicaid. The reason the state made this decision was that I had assets such as houses and cars. In another Tate, I might qualify because “each state administers its own Medicaid program. Hence, eligibility criteria, covered services, and payments to providers vary considerably from state to state”. Shih & Sings, 2012, p. 218) Medicare Part D fails to utilize the enormous purchasing power wielded by the U. S. Government on behalf of Medicare enrollees. The program pays 75% of the cost of brand-name drugs in the first phase but the upper limit is held at a low threshold. We know that a large amount of the elderly population suffers from chronic conditions. They also have adjunctive conditions and often require ore than one medication. Many new drugs for the chronically ill carry price tags upwards of $10,000 per dose. My elderly close friend pays between $7000- $15,000 for the Reminded that she takes every four weeks.
The $2480 limit seems highly ineffective for this group. Furthermore, the second phase requires payment of 50% of brand name drugs priced at the highest amounts charged in the world. The modest discount of 7% on generic drugs does not reflect the aggressive negotiation expected by one of the largest buyers in the world. The last phase named Catastrophic pays the smallest discount of 5% (Shih and Sings, 2014, p. 14-21 5). While drug manufacturers post windfall profits their political influence grows as well with new limitless political donation rules (The Associate Press, 2012).
The discount procured by other countries is much more substantial for the rest of the year. The coverage provided in Medicare Part D is not substantial. “It lacks in the power that the US government has to negotiate drug discounts” for the public (Films Media Group, 2008). Another important aspect is that Part D does not cover all drugs. Leaving many drugs costing full price. Drug costs in the United States remain high even under Medicare Part D. It is my opinion that a hard look at these costs is overdue. Films Media Group (n. D. ). Sick around the world [Video file].
Retrieved from Films on Demand website:http://digital. Films. Com/Proportionality. Asps? Aid=7967&xtid= 40902 The Associated Press, . (2012, June 26). Supreme Court’s decision to uphold limitless political donations from corporations could propel more deregulation. The Associate Press. Retrieved from http://www. Syracuse. Com/news/index. SF /2012/06 campaign_money_case_could_prop. HTML. The uninsured My closest experience with services for one of these groups is medical services for the uninsured. My brother came to this country to begin a new life and new career.
He came with modest funds and unknowingly a medical condition that needed monitoring and treatment. As a new member of our society, he held a green card and was able to find employment here in the US. Starting positions are not extremely well paid, but any position is a good beginning. But at the same time his income does not allow him to purchase health insurance. Here in Nevada my brother found a group called Volunteers in Medicine of Southern Nevada (VANS). ‘VANS provides close to $250,000 worth of FREE diagnostic evaluation to their patients each year. Their Medical Dispensary provides close to $3, 100. 00 worth in FREE medications through cash and in-kind services each year”. (Volunteers in Medicine of Southern Nevada, 2014, Para. 1) Through VANS, he was diagnosed with diabetes and received testing, treatment and supplies. They also provide annual eye and wellness exams for him. “This program is funded by community organizations, grants and various kinds of resources and supports” (Volunteers in Medicine of Southern Nevada, 2014, Para. 3). The wonderful thing about this program is that it is a volunteer program operated by medical professionals who volunteer their free time.
This program should be looked at as a model for other communities to provide medical services for the uninsured. Volunteers in Medicine of Southern Nevada (2014). Services. Retrieved from http://www. Vans. Org/become-a-patient/eligibility Childhood Disease Recent news regarding vaccinations has led many celebrities to support policies of non-consent for school age children. Most notably Mrs.. Dennis Squad spoke against childhood vaccination on talk shows convincing many parents that vaccinations were dangerous to their child’s well-being. One of the most important preventative policies for children is a requirement for connation.
Most schools enforce this policy by requiring proof of vaccination for admission. This strict policy cause for the U. S. To declare measles eliminated in 2000. “Measles elimination from the Americas was achieved in 2002 and has been sustained since then. In 2008 140 measles cases were reported. In this resurgence ‘the cases occurred largely among school-aged children who were eligible for vaccination but whose parents chose not to have them vaccinated.
