Essays on Medicare Advantage

Medicare

What are the purposes of Medicare regulations other than the one mentioned above? Medicare was signed into law in 1965 with the intention of providing better healthcare to the citizen through medical insurance. It provides protection to its recipients, and it is a government program intended to provide insurance to the aged and people living with certain disabilities (Moon, 2006). It is mandated by the law to provide hospital insurance, medical insurance and cover drug prescription for its recipients. How will the federal government enforce compliance in the Medicare Advantage program? Which two other Medicare regulations do you think ...

Medicare and Managed Care

The U.S. government started initiatives to make medical assistance to as many citizens as possible. This program is one such initiative by the government. Medicare is a health program under the federal government that covers individuals who are 65 years and above. It also includes younger people with various disabilities. Also, people with renal diseases that require dialysis and any other medication are covered by this program. Medicare was created in 1965, ("What is the History of Medicare? | National Academy of Social Insurance", 2017). At this time, many people above 65 had difficulties accessing health care. In essence, this ...

Abstract

Medical care is an obligation of the government in the United States because all citizens are entitled to the access of healthcare services. Nonetheless, the healthcare programs are not only executed on the premise of providing health services alone; but such services are to be affordable as well. Medicare part D refers to the program where the United States federal government subsidizes the cost of drugs prescribed for the patients. It also covers the drugs and the associated insurance premiums, and all these are executed to benefit the healthcare beneficiaries. This paper analyzes the Medicare Part D and the ...

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; ...

Aetna. Inc. Aetna provides advanced benefits to the consumers, businesses, health care professionals, and producers. Aetna is a managed care organization that provides traditional and consumer focused health care insurance plans and associated services including medical, dental, social health, long-term care, and ill health plans. Insurance plans grouped into Bronze, Silver and Gold for individual or family, medical insurance, student insurance and international insurance. Few of the many insurance plans from the company are Aetna Affordable Health Choices, Aetna Choice POS, Aetna Signature Administrators, Aetna Student Health Program, Aetna Savings Plus PPO, and Aetna Open Access Elect Choice . Depending ...

Summary

Medicare Advantage program offers Medicare beneficiaries the option of enrolling in a private health plan as opposed to the traditional fee-for-service system. The Centers for Medicare and Medicaid Services (CMS) applies a Star Rating system to Medicare plans based on defined quality measures that range from one to five stars. The stars are assigned on a contract rather than an organizational basis. The main source of Medicare Advantage star ratings is performance measure data collected from five different types of research. The Healthcare Effectiveness Data and Information Set (HEDIS), evaluates plans accessibility to members, clinical effectiveness, and resources utilization. ...