Medicare Coursework Example

Medicare Chart Worksheet
Name of the Student
Professor’s Name
Medicare (chapter 8)
Fill in the chart below utilizing content from the lecture and readings.
Medicare A Part B Part C Part D
Who is eligible? Individuals who are 65 years or more and have a record of contributions for 40 quarters are automatically covered.
Younger people with disabilities or receiving social security benefits
Individuals suffering from end-stage renal diseases such as kidney failure or kidney transplantation or requirement of dialysis. Those eligible for premium free Medicare A.
Receiving retirement benefits from Social Security and Railroad Retirement Board Should be enrolled in Medicare A and B. Must reside in the area of Medicare advantage service providers Individuals who are eligible for Medicare A, B, C plans and must reside in the service area of such plans (Sandstrom, Lohman, & Bramble, 2014).
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What services are covered? Covers in-patient hospital stays, care in a skilled nursing facility, availability of hospice care, and certain types of home health care. Cover services that are rendered by physicians in out-patient departments, outpatient care services, medical supplies, and preventive health services.
Well-known as the Medicare advantage plans. The plan is offered by a private company. Al services related to part A and part B can be accessed by the respective stakeholders. These plans include health maintenance organizations, preferred provider care organizations; special needs plan, private fee for service plans, and the Medicare medical savings account plans.

Covers prescription drugs I addition to the Medicare A, Medicare b, and Medicare C plans. These plans are offered by third-party health insurance companies, and certain private companies that are approved by Medicare.
What is the payment system? Funding obtained from the revenue generated from the 2.9% of the payroll tax that are levied on employers and employees.
Payment through separate Trust funds Premiums that are paid by Medicare enrollees and from the general revenue- $140 annual deductible and 20% coinsurance.
25% of Med B costs are paid by employees
Payment through separate Trust funds Premiums paid to managed care companies.
Payment through two separate Trust funds
Premiums that are paid by Medicare enrollees and from the general revenue. Monthly payment from enrollees (Sandstrom et al., 2014).
Payment through separate Trust funds
Impact on OT/Therapy Treat one group at one time and seek reimbursement as a group therapy (Sandstrom et al., 2014).
One patient at one time.
Cannot bill separately for the same or different services provided at the same time to a patient.
Therapy cap is 2010$ (Sandstrom et al., 2014). Can bill separately for each service code (Sandstrom et al., 2014). Can bill separately for medications delivered under each service code (Sandstrom et al., 2014). Pay for service is not always ensured if the code of service is not sanctioned by third party health insurance companies (Sandstrom et al., 2014)
References
Sandstrom, R. Lohman, H, & Bramble, J (2014). Health Services: Policy and systems for the therapist (3rd Edition). Upper Saddle River, NJ: Pearson
Education, 15-31.