Medicare: Federal Health Insurance for Aged, Disabled & ESRD - Essay Sample

Introduction

Medicare is a health program within my practice and it is a federal health insurance program for the aged in the group of 65years and above, younger and old disabled people and patients with ESRD. It has 3 main divisions which include; Medicare Part A, which covers the Hospital Insurance for the inpatient patients, some home cares, hospice care and care in an experienced nursing facility. The second is the Medicare Part B, which covers the Medical Insurance for the outpatient care services, some specific doctors' services, preventive services, and medicinal supplies. The third is the Medicare Part D, whose cover extends to the prescription drug, some Cost Plans, some Private-Free-for Service-Plans and Medical Savings Account Plans. Part C incorporates both Medicare Part A and Part B packages ("Medicare.gov: the official U.S. government site for Medicare | Medicare", 2016).

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Part A Medicare requires on to pay a once-a-month Premium of $437 per month if the Medicare taxes one has paid are for fewer than 30 quarters, and if one has paid Medicare taxes for 30-39 quarters is required to pay premiums of $240. For the inpatient and coinsurance, the patient pays $1,364 deductible for each period, for the days 1-60, $0 are applicable for every period, 61-90, $341 are applicable per day for the coinsurance for each benefit period, for 91 days and above, $682 are applicable for the coinsurance per every benefit period. For Part B Premium, the standard amount is $135.50 which one can pay higher, depending on their earnings. The person undercover pays $185 per year, and after a deductible is met, 20% of the Medicare-approved amount is paid for most of the doctor services. The Part D Premium is variable by the plan, and the Plan C Premium as well ("Medicare.gov: the official U.S. government site for Medicare | Medicare", 2016).

The roles of the nurses in providing input to the design of the healthcare program will be through providing the information pertaining the patients who have visited the facility within a certain period of time (McGinnis, Olsen, & Yong, 2010). This data, which includes their contacts will assist in direct contacting them to mobilize them to enroll in the program, providing the benefits in each package. For example, if a nurse deals with care for the aged, he or she will record information for all the patients within the age gap of 65 years and above, stating whether the person has any medical insurance cover or not.

As an advocate, my role for the target population will be to capture the data provided by the nurses, analyze it and use the contacts provided to contact the target population members making them aware of the packages offers and sensitize the benefits of such packages. For those having challenges to raise the money at once, I can come up with a plan that one will either contribute a very small amount either daily or weekly, that will favor their income.

The nurses play a vital role in the implementation of the program. They are the ones who interact the most with the patients, (Needleman, & Hassmiller, 2009) therefore their influence on the patients to enroll in these programs can be of a high impact through convincing the patients by explaining to them how the program works under each Plan and what are the advantages of enrolling in to the program (Nardi, & Gyurko, 2013). For example, an inpatient who is struggling to pay a huge hospital bill can be communicated to by the nurse and helped how to overcome the huge bill next time, through enrolling in the Medicare Federal Insurance Program.

Other members who can be involved in this program include; geriatric physicians, who deal with the elderly, Nephrologists, who deal with ESRD patients and the doctors who deal with people with disabilities.

References

Nardi, D. A., & Gyurko, C. C. (2013). The global nursing faculty shortage: Status and solutions for change. Journal of Nursing Scholarship, 45(3), 317-326. https://doi.org/10.1111/jnu.12030

McGinnis, J. M., Olsen, L., & Yong, P. L. (Eds.). (2010). Value in Health Care: Accounting for Cost, Quality, Safety, Outcomes, and Innovation: Workshop Summary. National Academies Press.

Medicare.gov: the official U.S. government site for Medicare | Medicare. (2016). Retrieved from https://www.medicare.gov/

Needleman, J., & Hassmiller, S. (2009). The role of nurses in improving hospital quality and efficiency: real-world results. Health Affairs, 28(4), w625-w633. https://doi.org/10.1377/hlthaff.28.4.w625