Question

Please discuss only ONE: Medicare or Medicaid Give a brief description of Medicaid or Medicare (no more than 2 sentences). Then discuss 3 specific (non-age; non-financial) criteria for services from the program, for an older adult client. Be sure to cover service, length of time, provider types that may provide the service, the channels through which the patient may obtain each service.

Answer 1

Medicare

It is a  Federal Health insurance policy and the system of government subsidies for health care for the elderly and disabled . It is established at the year of 1966 under the social security Administration and currently controlled by the Centers for Medicare and Medicaid services .

Specific criteria for service for an older adult:

People aged 65 or older and the people with disabilities are eligible for Medicare . These category people can get automatically enrolled in Medicare , if they are a U.S citizen.

Non age , non financial criteria for Medicare:

* People who have End stage Renal disease and required to sign up for Medicare.

* People with ALS (Amyotrophic lateral Sclerosis

* If a spouse of a person is paying Medicare taxes for 10 years or a 40 quarters , then he/ she is eligible for Medicare part A. Otherwise they have to pay a premium of $458 ( 2020)

Provider types , services and length of time:

Medicare ( part B) covers all necessary medical services that provides by a Doctor  includes outpatient care, inpatient care. Also Medicare covers the services of ,

Nurse practitioners

Physician assistant

Clinical Nurse specialist

Physical and occupational therapist

Clinical psychologist

Speech language pathologists

Clinical social workers.

Within 1 year of Date of service , all claims must be filed to the appropriate Medicare claims processing contractor .

Part A of Medicare covers Hospital stays

Part B covers preventive services, outpatient care and medical supplies

Part C covers Medicare advantage plans , plans offered by a private company , for health services and drug prescriptions. This advantage plan includes:

Health Maintenance Organisation ( HMOs )

Private- fe - for service plans

Medicare medical savings Account plans

Special needs plans

Part D : Original Medicare service for drug coverage for prescription drugs.