In: Nursing
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.
MEDICAID
DESCRIPTION
Medicaid in US is a Federal state program which helps the who is in the poverty line with less resources,providing their medical cost.Medicaid also provides nursing home services and personal care which is not offered by Medicare.The Health Insurance Association of America terms Medicaid as "A GOVERNMENT INSURANCE PROGRAM FOR PERSONSOF ALL AGES WHOSE INCOME AND RESOURCES ARE INSUFFICIENT TO PAY FOR HEALTH".
CRITERIA FOR THE SERVICE OF THE PROGRAM
(To know detaily about it go through the Medicare laws)
-Low income children below certain wage
-Pregnant woman
-Parents of medicaid eligible children who needs certain income requirements
-Disabled people with low income who receive SSI(Supplemental Security Income) and/orSSD (Social Security Disability).
-Low income seniors 65 and older.
-This is eligible only for tha US citizens and Lawfully admitted immigrants
-Individual who is approved as a beneficiary in SSI is also eligible for Medicaid coverage( depending on tha laws of the state they live in).
FEATURES
-Medicaid recipients are enrolled in a private health plan, in which the recipient receives a fixed monthly premium from the residing state
-As of 2014,26 states have contracts with magaged care organizations (MCOs) to delliver a longterm care for tha elderly and disablie ones.
-After the passing of Affordable Care Act, many dental organizations to provide business managements and support,allowing practices to minimize the coat and pass the saving on patients who doesn't have adequate dental care.
ENROLLMENT PROCEDURE
-It can be applied by approaching the Health Insurance Marketplace. By filling out the application,If any individual qualifies for Medicaid or CHIP.Authorities would automatically send the information to the residing state agencyand they will contact the qualified individual for the further enrollment process.
-It can also be applied directly by approching the State Medicaid Agency too.