Health Insurance #3
Unlike traditional health insurance, long-term care insurance is designed to cover long-term services and supports, including personal and custodial care in home, community organizations, or other facilities. Policyholders can select range of care options and benefits depending on their needs. In most policies, benefits are payable based on insured’s inability to perform two or three specific ADLs, such as eating, dressing, bathing, continence, toileting and transferring. The cost of your long-term care policy is based on age of the time insured buy the policy, the maximum amount of benefits that a policy will pay per day, the maximum periods that a policy will pay, any optional benefits, such as benefits that increase with inflation. The premiums will be less expensive if the insured is young, but the less immediately useful it is and the greater the risk of losing all they have paid in if they stop before they need the benefits. If insured are in poor health or already receiving long-term care services, they may not qualify for long-term care insurance as most individual policies in the underwriting process. However, these applicants still have some options to buy a limited amount of coverage, or coverage at a higher premiums rate.
On the other hand, most of the group policies do not require underwriting. Group coverage of long term care insurance is usually provided by employer to employee that offer the same benefits to all employees or members of
The challenges and impact of Baby Boomers on long-term care systems are going to modify the manner in which traditional health care, patient access, financial payments and treatment are delivered. Baby Boomers will have an extensive amount of care maintenance needs involving various rehabilitation conditions, acute and chronic illnesses, which will require a significant amount of thoroughly trained gerontologists, skilled nurses, nurse practitioners, social workers, community advocates, and family involvement. This article explores options sought to reduce the costs to society and Baby Boomers as innovative savings, tax credit options, and other alternative long-term care financing choices lessening the impact on the long-term care system.
Long-term care is a variety of services that includes medical and non-medical care to people who have a chronic illness or disability. Long-term care helps meet health or personal needs. Most long-term care is to assist people with support services such as activities of daily living like dressing, bathing, eating, and using the bathroom. Long-term care can be provided at home, in the community, in assisted living or in nursing homes. Long-term care can be given at any age depending on
The Long-Term Care Act was to benefit and work with seniors to improve their overall well-being. The Long-Term Care Homes Act guarantees to help residents living within the long-term care system to receive dependable, high-quality, and safe care for the residents. It is often common for seniors to adjust when placed in long-term care as this is a new and challenging transition for the senior and their families. The commonplace goal is to have a long-term care home environment where residents feel comfortable and at home, where residents are treated with the respect they deserve, and have the proper supports and services that cherish to their particular needs for their overall health and well-being. These services are physical and mental health related services- especially one that relates to the Community Worker Program such as Community and Social Workers that are crucial in a senior’s life often.
Long-term care has many funding sources which includes government funding, privet insurance, out-of-pocket payments, and any combination of any of these programs. Privet insurance includes insurance for long-term care and managed care (HMO, PPO, POS). While government funding includes Supplemental security income, Department of veteran affairs, Older American act, Medicare, and Medicaid. With Medicare and Medicaid providing the most funding to long-term care (Pratt, 2016, p. 292-306). If Medicare and Medicaid are the biggest funders for long-term care what services do they cover, who do they cover, and what restrictions are put on the recipeits?
Medicare is a health insurance program purposely created for people over sixty five (65) years of age. However the service is open to people with certain disabilities or permanent kidney failures. The process of choosing the right Medicare involves having to weigh different plans on account of benefits of their cover. Different types of Medicare plans are important in: Inpatient hospital care, outpatient services, doctor visits, home health care, prescription drugs, and care in a skilled nursing facility among others. In addition, the program covers the cost of health care but does not cover all medical expenses including cost of long term care. If one ought to choose an original Medicare coverage, one may buy a Medicare supplement policy from a private insurance company to aid in coverage of costs that are not supported by Medicare. Most of these Medicare expenses are covered by a part of the pay role offered to workers by their employer. This paper covers different Medicare plans; A, B, C, D and their influence towards my decision on the best preferred option.
Drug and health plans are major resources to long-term care. Medicare does not cover most of long-term care services, but it may pay a portion depending on selected coverage. Medicaid may step in and help pay as well. “The Medicare Plan Finder tool provides one central point to view and compare all available drug and health plan
The Continuum of Care is the variety of health care services provided to numerous individuals who are in need of it. All the various Long Term Care providers work as a unit, helping an individual handle their disability with various health care amenities accessible. The Continuum of Care, as stated in Long Term Care: Managing Across the Continuum (2010), is “comprehensive, integrated, and client-oriented”. All the services offered should be client-based and cater to the client’s needs and suitable care. The client’s should be able to obtain services when it is needed from the provider, making it comprehensive. All the different Long Term Care providers should be interconnected between one another, because their goal is all the same. Their goal is to care for the client’s needs. The Continuum of Care consists of: nursing facilities, sub acute care, assisted living, residential care, elderly housing, and a variety of community-based services (Pratt, 2010). All these different providers work together to care for the individuals within the health care industry, creating the continuum and making it integrated. The continuum has many positive attributes, along with many barriers. The range of barriers are: poor transitions from Long Term Care setting to setting for the clients, the continuum is reimbursement-driven, it is fragmented and uncoordinated, it is under staffed with medical professionals, and there are major language and literacy problems.
Seniors who fall under a coverage hole will start getting some help. Some are saying that seniors may lose Medicare benefits they now enjoy, but that is not true. The health reform act will not cut guaranteed benefits; a person will still be able to maintain the coverage they want. Americans on Medicare will receive free preventive care without co- payments or deductibles. Seniors will also receive $250 to help pay for their prescriptions. There will also be alternatives to nursing home placement, such as day-service programs, home-care aides, meal programs, senior centers and transportation services. A public, voluntary long-term care insurance program known as the Community Living Assistance Services and Supports, have enrolled individuals who have substantial daily needs to receive at least $50 a day. This money is to be used to defray the costs of services such as home care, family caregiver support, and adult day-care or residential care.
The purpose of this paper is to give an overview of two federally and/or state funded programs. The programs that will be discussed are Medicare and Medicaid. In this paper will be information about who receives Medicaid/Medicare, the services offered by these programs, and those long term services that are not.
The continuum of institutional long-term care is for patients whose needs are not adequately met in a more community-based setting. It is for individuals who need more dependency. There are two ends of the continuum of institutional long-term care spectrum. On the one end there are the individuals that may only need basic personal or custodial care (Shi & Singh, 2015, p. 399). An example of personal and custodial care can include help with walking, bladder training, or just helping with bathing. On the other end there are the individuals that may need more round the clock care with nursing or specialized services along with the basic needs (Shi & Singh, 2015, p. 399).
Medicaid is a social health care program that covers nearly 60 million Americans, including children, pregnant women, seniors, parents and individuals suffering with disabilities. Medicaid is the biggest source of funding for health related services and medical needs for the people with low income in the United States. This program is funded jointly by the state and federal level governments, but it is the state’s responsibility to manage this program. The Medicaid program is not a required program that states have to use, but all 50 states have implemented this program. With the introduction of the Affordable Care Act (ACA), and its passing in 2010, the ACA unveiled its plans to expand Medicaid eligibility to nearly all low-income adults as an addition to the other groups that fall into the Medicaid eligibility. The Medicaid program had “many gaps in coverage for adults” because it was only restricted to the low income individuals and other people with needs in their own specific category. In the past, the majority of the states who had adults that did not have children dependent on those parents were not eligible for Medicaid. These low income adults without dependent children would be without medical insurance assistance before the ACA was introduced. Medicaid is now available to all Americans under the age of 65 whose family income is at or below the federal poverty guideline of “133 percent or $14,484 for an individual and $29,726 for a family of four in 2011” (NSCL).
Long-term care is a result of people having terminal conditions, disabilities, illnesses, injuries, or being elderly. The purpose of long-term care is to provide services to people and to aid people at a time in their lives when they cannot depend on themselves to maintain daily activities. There are many variations of long-term care available – such as home care, adult day care, and independent and assisted living, personal care facilities, nursing homes, and hospice.
Long-term care can be defined as a broad set of paid and unpaid services for people who are mentally or physically disabled, or whose chronic illness places them in need of medical or personal assistance for long periods of time. “It is estimated that there are more than twelve million Americans of all ages whose mix of serious disability and chronic illness places them at the high risk for functional decline, hospitalization, or nursing home placement.” (Benjamin) Several different populations require long-term care services, and the needs of these populations vary. In addition to the elderly, many of the long-term care users are younger persons with physical disabilities; persons with developmental disabilities; and persons with chronic
This paper will review the many aspects of long-term care problems and many challenges there are within Long-Term care. We will look at rising costs within long-Term Care, patient abuse, will look at the quality of life, shortages of nurses and demand that the elderly are putting on the medical field. The type of care that Long-Term Care had been giving to its patients and the changes within Long-Term Care.
Life insurance provides a guarantee of compensation in the case of loss of life in return for a payment of a premium paid to a company. Life insurance, in different forms, may be offered by many companies as part of a comprehensive benefits package. It is a significant benefit as it provides family members with financial assistance and peace of mind in the event of death. There are several different options for to choose from and deciding what options are best for each will depend on several factors and the advantages of each option and the goals of each. This paper will define the different insurance programs that may be available in organization 's compensation and benefits package precisely term life insurance, universal, whole life insurance, accidental death & dismemberment, and long and short-term disability insurance. It will further outline the advantages of each.