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Healthcare, Coursework

Medicare and Medicaid in New York

Medicare and Medicaid in New York

What is meant by Medicare for all?

The Medicare for All Act is a program that provides comprehensive health care to every US citizen without out-of-pocket expenses. Under this program, there are no deductibles, co-payments, or insurance premiums. Furthermore, it expands Medicare coverage to include vision, hearing, and dental care (Sanders, 2020). Coverage under the Medicaid expansion became effective on January 1, 2014, in all states that adopted the expansion. To date, 39 states have adopted the Medicaid expansion, except for only 12 states.

What happened under Medicare expansion?

Medicare expansion is a provision in the Affordable Care Act that seeks to extend medical coverage to include people with household incomes below a certain level. One qualifies for the coverage based on income if their household income is up to 133% of the federal poverty level (which comes to 138% with the addition of a 5% income disregard). Age-wise, eligible persons are above 64 years. The federal government funds the program from 100% to 90%, with the residual amount catered for by the states that have adopted it.

How much is the monthly premium for Medicare hospital benefits? And how much is the monthly premium for Medicaid in NY?

For individuals having at least 30 quarters of coverage or married to someone with at least 30 quarters of coverage, the Part A monthly premium rate is $252. On the other hand, uninsured individuals with less than 30 quarters or individuals with disabilities who have exhausted other insurance entitlements pay a $458 monthly premium (CMA, 2019). The monthly premium for Medicaid in New York is $ 144.6 for Part B.

Who should enroll in a Medicare Advantage plan? Who would you recommend should NOT enroll in a Medicare Advantage plan?

Those who should enroll in the Medicare Advantage plan are those with Part A and Part B Medicare coverage. Furthermore, those with low incomes may benefit from the lower premiums. Those who should not join are people whose residencies don’t offer the plan and those who want to have a great degree of freedom in accessing services.

What is the income requirement for an individual to qualify as “dual eligible”?

The income requirement for an individual to qualify as dual eligible is up to $ 1,061 for a single applicant or $ 1,430 for a married couple.

 Does Medicare pay for nursing home care?

While Medicare does not cover most of the nursing home care, which qualifies as custodial care, it covers skilled nursing care (Medicare, 2020).

References

Bernie Sanders. (2020). Medicare for All Act of 2019. https://www.sanders.senate.gov/download/medicare-for-all-2019-summary

CMS. (2019, November 8). 2020 Medicare Parts A & B Premiums and Deductibles. https://www.cms.gov/newsroom/fact-sheets/2020-medicare-parts-b-premiums-and-deductibles

Medicare costs at a glance. (n.d.). Retrieved November 08, 2020, from https://www.medicare.gov/your-medicare-costs/medicare-costs-at-a-glance

Medicare. (n.d.). Nursing Home Care. Retrieved November 08, 2020, from https://www.medicare.gov/coverage/nursing-home-care

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Question 

Medicare and Medicaid in New York

HOMEWORK: Post to Bb “Assignment Six Questions”

In a couple sentences, with references:

  1. What is meant by Medicare for all?
  2. What happened under Medicare expansion?

    Medicare and Medicaid in New York

    Medicare and Medicaid in New York

  3. How much is the monthly premium for Medicare hospital benefits? And how much is the monthly premium for Medicaid in NY?
  4. Think back to your assignment to shop for health insurance on NY’s Exchange and now make a recommendation: who should enroll in a Medicare Advantage plan? Who would you recommend should NOT enroll in a Medicare Advantage plan?
  5. What is the income requirement for an individual to qualify as “dual eligible”?
  6. Does Medicare pay for nursing home care?

Link to use: (copy and paste the link to your browser)

https://www.medicare.gov/your-medicare-costs/medicare-costs-at-a-glance#:~:text=The%20standard%20Part%20B%20premium,higher%20depending%20on%20your%20income).&text=varies%20by%20plan.,for%20specific%20Part%20C%20plans.&text=The%20Part%20D%20monthly%20Premium,income%20consumers%20may%20pay%20more