Lesson 7 Discussion with students
Responding to two of your peers’ posts
What are the major differences between Medicare, Medicaid, and CHIP? While coverage is provided through the government, Medicare is provided for the elderly, Medicaid is provided for those in financial need and CHIP is a program for children’s healthcare.
What is Medicare? Does the government fund it completely? Medicare is a government managed healthcare program, it is not fully funded by government as there are deductions from our paychecks and taxes paid through our employers.
How is the funding for Medicaid and CHIP different from the funding for Medicare? Medicaid and CHIP is not funded through payroll deductions from employees but funded by the federal government and the states jointly.
What are the four parts of Medicare and what do they cover, in general? Medicare has Part A and Part B, Part A covers inpatient hospital stays, skilled nursing care, hospice, home care. Part B covers Doctor visits, surgery, lab tests, medical equipment and preventative maintenance.
Most Americans pay no premiums for Part A - why? If you or your spouse has medicare tax withheld via payroll deductions you would not have to pay a premium for Part A coverage.
What is meant by the “prospective payment system,” and what part of Medicare does it affect? This is a payment system used by the federal government to reimburse providers for services. They are fixed payments and based on the diagnosis.
2nd students response
Medicare- is an insurance program.Medical bills are paid from trust funds which those covered have paid into. It serves people over 65 primarily, whatever their income; and serves younger disabled people and dialysis patients. Patients pay part of costs through deductibles for hospital and other costs. Small monthly premiums are required for non-hospital coverage. Medicare is a federal program. It is basically the same everywhere in the United States and is run by the Centers for Medicare & Medicaid Services, an agency of the federal government.
There arefour parts of Medicare:PartA,PartB,PartC, andPartD.
- PartA provides inpatient/hospitalcoverage.Most Medicare-eligible people do not have to pay premiums forMedicare Part A(Links to an external site.). If you are 65 and you or your spouse has paid Medicare taxes for at least 10 years, you don’t pay a premium for Part A.
- PartB provides outpatient/medicalcoverage.
- PartC offers an alternate way to receive yourMedicarebenefits
- PartD provides prescription drugcoverage.
AProspective Payment System(PPS) is a method of reimbursement in which Medicarepayment is made based on a predetermined, fixed amount. The payment amount for a particular service is derived based on the classification system of that service (for example, diagnosis-related groups for inpatient hospital service and stay.
Medicaid- is an assistance program.It serves low-income people of every age. Patients usually pay no part of the costs for covered medical expenses. A small co-payment is sometimes required. Medicaid is a federal-state program. It varies from state to state. It is run by state and local governments within federal guidelines.
ChipChildren's Health Insurance Program which is part of Medicaid. Chip provides health coverage to eligible children, through both Medicaid and separate CHIP programs. CHIP is administered by states, according to federal requirements. The program is funded jointly by states and the federal government.
https://www.medicaid.gov/chip/state-program-information/index.html(Links to an external site.)
https://www.hhs.gov/answers/medicare-and-medicaid/what-is-the-difference-between-medicare-medicaid/index.html(Links to an external site.)