Medicare Advantage: A Case Study

Medicare is a social program that was specifically designed with a set of objectives, it is a national program that seeks to provide a measure of health insurance/or coverage to those individuals that are aged sixty-five or over, those individuals that are entitled to Social Security disability payments for two years or more. Additionally, people with end-stage renal disease regardless of their income. The program has two distinct separate components, but they are coordinated:
Hospital Insurance or Part A, which is available to all assignees/ or recipients. This designed program is available to those that qualify under Medicare guidelines, areas that are covered include, but not limited too; inpatient hospitalization, home health care, and hospice care. Recipients from my understanding pay a deductible.
Supplementary medical insurance or Part B, which offers optional coverage that Medicare receivers may acquire.
Part B is coverage that would be applied to services of a physician and outpatient clinics, and is therefore an optional package.
Medicare Advantage originated within the Medicare Prescription Drug Improvement and Modernization Act or MMA. Under this legislative act, Medicare + Choice was replaced by Medicare Advantage, under this new program, major types of Medicare Advantage plans may compensate providers on a capitation or a modified capitation basis, or may be private, unrestricted fee-for-service plans. Medicare Advantage is also considered Part C, the capitation program is generally funded by: (1) Trust fund and (2)
account.
Medicaid has eligibility requirements that are: Temporary Assistance Needy Families, those individuals on SSI or Social Security Insurance, individuals who are stricken and living with AIDS, low income pregnant women/children and the elderly. The Medicaid program is a social service program, or a welfare program which was formulated to establish a mandated health service initiative and health services to a targeted population.