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Changes To The Medicare Program Essay

942 words - 4 pages

Medicare currently pays for many preventive services that can detect health problems early when they’re easier to treat, give better access to claims and personal health information, and allow for savings on brand-name and generic when coverage gaps are met. The actual benefits of Medicare will not be changing. There will however be a new plan that is key to the Affordable Care Act that will take place in 2014. This plan is the Health Insurance Marketplace that allows individuals, families, and employees of small businesses to get health insurance. (Services, 2013 ) The Marketplace offers insurance plans through private companies that will provide essential health benefits regardless of gender, preexisting conditions, or preventative coverage needed. The essential health benefits include but not limited to “ambulatory patient services, emergency services, hospitalization, maternity and newborn care, mental health and substance use disorder services, including behavioral health treatment, prescription drugs, rehabilitative and habilitative services and devices, laboratory services, preventative and wellness services and chronic disease management, and pediatric services” In addition to the Marketplace, “middle and low-income families will get tax credits that cover a significant portion of the cost of coverage, the Medicaid program will be expanded to cover more low-income Americans” (Services U. C., 2013).
There will be an increased financial burden for Medicare enrollees, especially for women. The increased spending of the Medicare program is expected to skyrocket over the next few years. The rise in health care costs will cause enrollees to have higher premiums, cost-sharing and out-of-pocket expenses. The increased out-of-pocket expenses can include higher payments for prescription drugs. When enrollees have to pay more from their own pocket, they become more at risk for having medical debt. Since women generally have a lower income than men, they are at an even higher risk for this type of debt. Some other things that will cause increased out-of-pocket expenses is the fact that Medicare does not cover payments for expensive services and supplies for people with disabilities. Medicare also does not pay for long-term care services, routine dental care and dentures, routine vision care or eyeglasses, or hearing exams and hearing aids. The deductibles are extremely high for the enrollee and their beneficiaries and there is not a limit on the annual out-of-pocket expenses that one could accrue. (Carroll L. Estes, 2013)
The new health reform law will reduce the amount that enrollees will have to pay for prescriptions after they reach a coverage gap. The law will reduce the out-of-pocket expenses for enrollees who are considered to have catastrophic coverage. The law will be reducing the federal payments to the program and this will reduce what Medicare pays for beneficiaries. The law will reduce the amount of annual updates that Medicare pays to...

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