Kentucky Medicaid
The Kentucky Medicaid has programs designed for patients who need long term care services. It also outlines the eligibility conditions that must be met for people to qualify for these long term care services. Medicaid is composed of the nursing facility services. These nursing services are provided by certified nursing facilities (CHFS, 2016). The aim of Medicaid is to ensure that patients receive proper health care that will enable them to recuperate.
The nursing facility services are made up of a variety of goods and services that are needed by the patients. These facilities include dietary services; laundry services; medical and surgical supplies; drugs prescribed by the doctors or physicians; nursing services; personal items that are provided by the healthcare facility; prosthetic devices; activities; social services; nutritional supplements; room and board; use of facilities and equipment; respiratory supplies; and respiratory therapy (CHFS, 2016). Other special services include laboratory services; occupational therapy; oxygen supplies; speech therapy; physical therapy; and X-rays.
The eligibility requirements for the Kentucky Medicaid Nursing Facility Services are based on several conditions. Firstly, you have to be resident within a facility that participates in the Kentucky Medicaid Program. You can only receive these services if you are in a bed that is certified by Medicaid. Secondly, you must satisfy the set criteria that determine whether you need the outlined level of care. The elements of the criteria are defined within Section 4 of 907 KAR 1:022 (CHFS, 2016). The criteria considers the care needs of the patient; the age related dependencies; medical diagnosis; the personnel and health services required to meet the needs of the patient; and the feasibility status of meeting the patient’s needs through non-institutional or alternative institutional services. Thirdly, the patient must be able to meet the resource or income limitations that are set by the program.
Medicare
Patients who sign up for Medicare do not need to sign up every year. However, they can make changes to their cover every year. The changes may include change in coverage; cost; pharmacies; and health provider (DHHS, 2016). The people who have health plans for prescription drugs or Medicare health are advised to always review the materials that are sent to them by their health plans. It is important to review these materials so that you can be aware of any changes that are made on the health plan. The patients need to be sure that their health plan can still meet their health needs in the coming year.
Medicare is designed for people who are 65 years and above. However, there are certain people who are below 65 years who can still benefit from Medicare. These are the people who have End-Stage Renal Disease and those with disabilities (DHHS, 2016). Medicare is divided into four parts that include hospital insurance; medical insurance; Medicare Advantage; and Medicare prescription drug coverage.
Hospital insurance covers hospice care; inpatient care; home health care; and skilled nursing facility care. Medical insurance covers outpatient care; services from health care providers and doctors; preventive services; durable medical equipment; and home healthcare (DHHS, 2016). Medicare Advantage covers all the services and benefits offered by hospital insurance and medical insurance; includes extra services and benefits at extra costs; and its plan includes Medicare prescription drug coverage. Medicare Advantage is run by private insurance companies that are approved by Medicare. Medicare prescription drug coverage enables the patients to meet the cost of drugs that have prescriptions; is run by private insurance companies that are approved by Medicare; protects patients from future high costs placed on the prescription drugs; and help in lowering the cost of prescription drugs (DHHS, 2016).
References
CHFS, (2016). Nursing Facility Services. Cabinet for Health and Family Services. Retrieved from: http://chfs.ky.gov/dms/mnfs.htm#who
DHHS, (2016). Medicare and You. Department of Health and Human Services. Retrieved from: https://www.medicare.gov/pubs/pdf/10050.pdf
