The Health-related Insurance - Essay Example

Health Sciences and Medicine related Insurance Q1). What types of health related insurance coverage are you most likely to require? Why these specific types? One of health related insurance coverage I would prefer is Medicare and Medicaid. Medicare was established to handle the escalating medical costs that the elder face relative to the remaining population. This is because it seemed troublesome when compared to diminished earning strength. I am eligible to receive coverage from Medicare and Medicaid. I will be able to pay for the services through the Social Security Taxes. This cover is significant because Medicaid will incur payment for a greater part of Medicare deductibles, parts A and B premiums and copayments. Medicare is available to any individual who is more than 65 years old (green amd Jo 131). The Medicare rules are available to every citizen, and their information is easily accessible at the office of social security. Medicare was established under the Balanced Budget Act of 1997, with the aim of controlling hasty expansion in Medicare expenses and to avail the beneficiaries of Medicare more options. Generally, the overall expenses of Medicare cost an extra 12 percent than conventional Medicare (Care without coverage 119). However, the ACA has re-aligned payments to Medicare coverage plans to those of traditional medicine. Q2). What are the trends in employer provided health insurance for retirees? Why? Employer provided systems of health insurance avails health insurance to many workers plus their families. The current increases in the costs of health care, the attendant increment in premiums of health care insurance as well as the augmentation in employee contribution for coverage cause challenge to employers who are figuring whether to avail such coverage as well as for employees that are considering whether to join up in coverage availed by the employers. The accessibility of employer sponsored health coverage is shrinking. The availability of the services of employer sponsored health insurance is broader for the current working employees than retirees and is different with regard to employer size and economic sector (Green and Jo 236). With the exception of governments, the fraction of full time employees who were employed in places that health insurance was availed to retirees was between the years 1998-2000. The diminishing in offer rate availed to retirees was diverse by size of the organization. For instance for retirees aged 65 years and older from the years 1998 to 2002: In firms with >50 employees, the accessibility of retiree coverage decreased from 5.5 percent to 2.1 percent (Green 199). At firms with more than 100 but less than a thousand employees, the decline was from 18.6 percent to 9.2 percent. Among firms with more than a thousand employees, the decline was from 41.2 percent to 41.1 percent; this was insignificant. In the initial half of the year 2002, 60 percent of uncovered adults lived in a house with at least one worker on a full-time basis. Groups which are less prone to have the advantage of employer sponsored insurance include minorities, workers in minimal establishments, young adults, retirees and elderly working women with unique requirements. In fact, as the size of the establishment increases, the fraction of uninsured workers decreases. The other faction less likely to be covered with health insurance is low-wage workers, self-employed, part time workers and nonunionized workers. In the AHRQ research, a model was established to examine the effects of out-of-pocket total premiums, contributions and workforce characteristics on the decisions of enrolment of workers. The studies estimate that doing away with employee premium contributions had the possibility to decrease the rate of declining coverage of employees by a fifth. If the cost to employees of single coverage were to reduce to zero, 18.1 percent or 2.5 million of 13.8 million employees, in the private sector reducing insurance coverage from employees might go into such insurance (Green and Jo 216). Utilizing a statistical model, the researchers also discovered that the take-up rate with coverage at low cost to employees at predominantly minimal wage establishments increase by 10 percent, compared to an augmentation of 3.9 percentage points in high wage establishments. Q3). What do you think is the most likely source for you to obtain the various types of health related insurance coverage identified in (1) above? Why? Part A of the medical coverage provides the fundamental cover for stays at the hospital, post hospital home health care and nursing facility. Part B of Medicare insurance pays incurs most of the laboratory and doctor expenses plus some outpatient services. This includes medical supplies and equipment, physical therapy and home care. Part D of Medicare provides coverage for prescription drugs. It pays a greater fraction of charge on prescription medications. I will only be paying an annually deductible for Medicare part as well as Medicare part B. under part B coverage, I will only pay doctors 20 percent; the part that Medicare does not incur. Part D requires me to incur a monthly premium, copayments, a deductible plus all the prescription costs of drugs over a particular annually amount. Medicaid is administered by fifty states. In this sense, I can be able to benefit from its services throughout the U.S. information about Medicaid can be retrieved from the local county welfare, social services, of the office of human services department (Care withot coverage 219). Medicaid avails inclusive inpatient as well as outpatient coverage. This includes a number of services and costs. It does not cover diagnostic care, prescription drugs, preventive care, as well as eyeglasses. The quantity of coverage is not the same in all states. Medicaid can incur Medicare deductibles plus 20 percent portion of expenses which are not settled by Medicare. Medicare can at the same time incur the premium of Medicare. Most services of Medicaid are charged less in my state. Q4). What barriers or risks do you foresee for your access to these insurance products in the retirement? What may increase the likelihood of your obtaining this insurance? If the company exits business leading to termination of the retirement plan. In a definite plan of contribution, the administrator of the plan assembles specific retirement tax related information and plan and presents it to the IRS (Green and Jo 413). This procedure may postpone the termination of the plan plus subsequent payments of benefits. There is a likelihood of occurrence of unmet needs of health care. For instance, Social inequalities in the provision of health care through favoring of more advantaged members of the society. This could arise in mixed systems where individuals access superior quality when compared to their uninsured colleagues (Green and Jo 178). The less rich are disproportionately influenced by inferior quality surgical care and that the inefficiencies in the quality of services incurred by different people are adequate to clarify the overall breach in healthcare of these patients. Q5). When including a spouse in the health insurance plan initially, the working individual must append the copies of the papers of domestic partnerships and marriage certificate to the records form. The enrolment particulars can be acquired from the planning office or by downloading the forms from the websites of the insurance. The instructions of filling the forms are straightforward. For long lasting members that are recently married, they must fill a ‘Change with Status Card’ (Care withot coverage 214). The insurer should attach copies of the particulars to the ‘Change of Status Card’ prior to returning to plan office. If an alteration of dependent status is because of separation, death, dissolution of domestic partnership, the worker must give notice to the plan office about this development. Consequently, the ‘change of status card’ must be adjusted accordingly. The beneficiary designation is efficient on the time the enrollment form is accepted at the DC 37 plan office. If the insurer does not wish the spouse to obtain his benefit after his demise he can complete a new alteration of the beneficiary form (Green and Jo 242). On receiving the change of beneficiary form it replaces the previously presented named beneficiaries. Works cited Care Without Coverage: Too Little, Too Late. Washington, DC: National Academy Press, 2002. Print. Green, Michelle A, and Jo A. C. Rowell. Understanding Health Insurance: A Guide to Billing and Reimbursement. Clifton Park, NY: Delmar Cengage Learning, 2013. Print. Read More