Sunday, October 25, 2015

Knowing Medicare Options

Knowing Medicare Options
by Ricky Ocampo RN

            It appears the nation's woe for affordable healthcare has led the federal government to take action in educating the country on its options and ensuring accessibility to government enforced and regulated plans, but for skeptics of government competence, no songs of praises will be sung until an extensive assessment of how resourceful, affordable, accessible, and generally effective the options are has been conducted. Medicare.gov is the web-based one-stop information center for all topics and dynamics associated with both signing up for and accessing Medicare services (Medicare, 2015). Instant usability consideration is found in URL address of the website alone; Medicare is all that's needed to be remembered, and aside from this, the .gov domain provides users with confidence that the site is an official government one. The process of shopping for health insurance can be very complex and frustrating if one isn't completely sure of which option one wants beforehand, and it's nearly impossible to be sure of such factor without being aware of what options are available. Luckily Medicare.gov has all of the necessary information collected on site. Admittedly, the many links, pages, and texts available on the website can make the website appear intimidating to some users; it's likely that information of such scale can make healthcare appear more complex than it actually is. On the home page for instance, even something as simple as placing the mouse cursor over the 'Sign Up/Change Plans' tab reveals a scripted display of more links and options. The positive side of the amount of information available on the site is that it would only be more frustration if—at the end of it all—one isn't able to find answers to questions one might have, but this is very unlikely to happen.

            One thing to naturally expect is that the process will consist of filling out a lot of forms and completing various assessments and surveys. Initially, one has to first determine eligibility. Right away upon entering one's age, the criteria are simple. As the site blatantly warns, “Medicare is for people age 65 and older and those who have special condition or disability” (Medicare, 2015); anyone short of meeting this requirement will not be able to move on the next step. Medicare plans are generally divided into two main options: Part A and Part B. Part A is explained to cover hospital care, skilled nursing facility care, hospice, nursing home care, and home health services. It's explained that “Medicare Part A (Hospital Insurance) covers hospital services, including semi-private rooms, meals, general nursing, drugs as part of your inpatient treatment, and other hospital services and supplies”, elaborating that “this includes the care you get in acute care hospitals, critical access hospitals, inpatient rehabilitation facilities, long-term care hospitals, inpatient care as part of a qualifying clinical research study, and mental health care” (Medicare, 2015). Things like private duty nursing, unneeded private rooms, television/phone in the patients' room, and personal care items like slippers and socks aren't covered. For skilled nursing facility coverage, Part A covers the typical provisions like a semi-private room, meals, skilled nursing care, physical and occupational therapy, speech-language pathology services, medical social services, medications, ambulatory services, dietary counseling, and more (Medicare, 2015). Part A also covers long-term care hospital (LTCH). The website explains that “generally, you won't pay more for care in a long-term care hospital than in an acute care hospital. Under Medicare, you're only responsible for one deductible for any benefit period. This applies whether you're in an acute care hospital or a long-term care hospital (LTCH)” (Medicare, 2015). Part A also covers hospice care and home health services. Generally, Part A is likely to cover all that an elderly patient would need, unless such patient has multiple illnesses that require very specific and exclusive attention and treatment. Upon assessing the coverage of Part A, it's perhaps a bit more practical to press on towards viewing the provisions of Part B, as opposed to just settling for Part A.

            Part B of Medicare is immediately explained to cover medically necessary services and preventive services. Clinical research, ambulance services, durable medical equipment, mental health, inpatient, outpatient, partial hospitalization, obtaining a second opinion prior to surgery, and more, are all listed as services covered under Part B. Part B covers and Part A cover clinical research, “which help doctors and researchers see if a new treatment works and it's safe” (Medicare, 2015). The ambulance service coverage is rather extensive, as it includes aircraft transportation, given the condition that the patient's location can't be easily reached by land vehicles, and/or the patient's condition is too critical to and obstacles found in land travel—heavy traffic and distance—can take away from crucial time the patient might not have. A third option is Part C, which is also referred to as Medicare Advantage (MA), includes both Part A and Part B, and is covered by private insurance companies that have been approved by Medicare. Most programs require the use of doctors provided by MA, otherwise one would have to pay some or all of the costs out of pocket. Most people pay 104$—the Plan B premium—a month for MA but usually pay additional monthly premiums to get MA. Medicare also warns that one may “pay a copayment or coinsurance for covered services. Costs, extra coverage, and rules vary by plan” (Medicare, 2015). MA plans costs would appear worthwhile due to the factor that—as Medicare boldly declares—they cover all Medicare services. Lastly, Part D simply covers medical prescription drug costs. Admittedly the Part D appears a bit more complex than what just drug costs coverage would initially appear to involve. For instance, prior authorization might be required, meaning—as Medicare explains—that one's prescriber must contact the drug plan before you can fill certain prescriptions, as the prescriber “may need to show that the drug is medically necessary for the plan to cover it” (Medicare, 2015). There are also limits on how much medication a patient can get at a time, and for sleep therapy, the patient must try a similar drug of lower costs before the plan will cover any further prescriptions. After having learned the provisions and limits of each option, one central factor that might be an important part of the decision making process is that of costs. A Part A cost is set at a monthly premium of $407, and Part B is $104.90/month for most people. Part D costs are a bit more complex as they're codependent on the amount of annual income the customer makes. People who make under $85K get the Part D coverage as part of their regular coverage (Part A or B), and people who make over $85K pay a $12.30/month premium, in addition to the costs of their regular coverage; people who earn between $107K pay $31.80 in addition to their regular Medicare premium, people between $160K and $214K pay $51.30 in addition to their regular premium. Lastly, people who earn above $214K pay $70.80.
           
            Upon a close assessment of the costs/coverage of each option, it would appear that Part B is perhaps the most practical option. Part A, while being adequate for covering a basic patient with no chronic illness, it doesn't appear to be ideal for patients who are likely to fall ill; such patients can be hung out dry upon realizing the treatment needed by their sudden illness isn't fully covered by Part A. Part B, on the other hand, appears to provide nearly as much coverage as Plan C, but leaves room for incidences where the patient isn't ill enough to need all of the coverage provided by Plan C, where he/she would have to pay a higher premium and be possibly left to cover part of the overall costs. Part D is obviously not ideally meant for being the only form of coverage any patient would have. Part D should generally be ignored as it's not needed if one has any of the other three options.  From all of the information provided, Plan B is perhaps the best way to go, for the preceding premises established.
           
            To conclude, generally, the decision making process isn't necessarily complex, but is rather intimidating, as all of the content on the website can be seen as overwhelming to people shopping for coverage. The contexts within the site are made for people over the age of 65, but it's very likely that people of such age would need the assistance of a younger professional to guide them through the process. In the long run, it's all there—everything that needs to be known. The website takes on a simple and clean presentation focused solely on providing clear and direct information, in contrast of flash and attention retention. Medicare can perhaps benefit from simplifying and/or reducing the amount of links and sub links and texts available on each page, so older adults who are less computer-savvy won't find the site to be confusing and not resourceful.


References

Medicare. (2015, January 1). Medicare.gov. Retrieved March 5, 2015, from            http://www.medicare.gov/

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