Week 5 DiSCussion 2: Medicare Reimbursement Many people think that after the age

Question

Week 5 DiSCussion 2: Medicare Reimbursement Many people think that after the age of 65, Medicare covers all medical expenses including long term care. Unfortunately, when the time comes to utilize their benefits, due to the government restrictions, many such benefits are severely limited for long term care Many people say that they are entitled to get Medicare benefits, because throughout their employment time they paid for them. If that is the case, why isn't government paying for long term care? On the other hand, if Medicare does cover millions of Americans aged 65 and above, there will be very little funding left for the next generation Choose one of the ideas mentioned above and make a posting with supportive arguments In your posting, also discuss whether such governmental restrictions forcing people to purchase supplemental insurances and how would you resolve this issue?

Explanation / Answer

Medicare is a national health insurance program which is now administered by the Centers for Medicaid and Medicare Services of the U.S. federal government and started in 1966 under the Social Security Administration. This is funded by combination of a payroll tax, premiums and surtaxes from beneficiaries. This health insurance is for the Americans aged 65 and older who have worked and paid to system by payroll tax. This also provides health insurance to younger people with some disability status as determined by the Social Security Administration and peoples having end stage renal disease and several others chronic diseases.

Presently one out of five elderly Americans have been suffering every day on a his limited income with less flexibility for the extra medical expenses. About 6 million poor elderly Americans mostly depend on Medicare for the help with their medical bills. Although coverage of Medicare assures to the peoples for the entry into the America's health care system and offers for the protection from financial catastrophe whenever illness strikes. However there is gap in the scope of Medicares benefits and financial obligations for the coverage which can result in financial burdens.

As per 2010 reports, nationwide the average annual cost of a nursing home was $75,000 with room and board in an assisted living facility and with no any additional help it was $37,500.

These expenses are being left in the case of elderly peoples who have to pay for out of pocket. In the recent study it was found that for the long-term care required from 166 percent to 393 percent of the average annual income of America’s elderly. At least 70% elderly peoples need the long term care before they die.

Elderly peoples with low income more prone to health problems and they require medical services than those who are good in economically, but they are not able to afford required care because of their lower incomes. For the low income elderly peoples for the normal routine like as physician visits or prescription drugs require older and poorer beneficiaries to make hard decisions between his basic needs and health care services. Medicaid serves as an important complement to Medicare through assisting low-income Medicare beneficiaries with their Medicare premiums and cost-sharing and by providing coverage for prescription drugs and long-term care services which is not provided by Medicare. Therefore without Medicaid's help costs for the essential medical care may hamper access to care and erode financial security to the low-income elderly people.

I think special importance should be given to avoid the burdens of medical expenses for the low-income elderly people through the coverage to supplement Medicare which could help in alleviating the impact of financial burdens on access to health care. The implications of the significant changes in the scope and structure of Medicare and Medicaid for the elderly low-income population will be very helpful.

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