Medicare is the federal health insurance program, whose benefits are awarded in three groups; first is the beneficiaries exceeding 65 years of age and comprises the largest group. The second group comprises the disabled persons while the last one covers individuals with end-stage renal disease. The beneficiaries acquire assistance through a traditional plan where they can attend any healthcare facility, which approves Medicare. The other way is the Medicare Managed Care Plan such as Medicare advantage where beneficiaries are registered to a private healthcare plan with a limitation of healthcare providers within the network. Medicare managed care plan awards extensive advantages often give physicals as well as prescription drugs to counterbalance their limited networks (Cleverly et al. 2010).
Medicare cover comes four parts which include parts; Part A- Hospital insurance covers inpatient hospitalization, paid through monthly premiums. Part B- medical insurance pays for outpatient and physicians fee and includes physical as well as occupational therapy. Part C enable healthcare organizations to award insurance plans as added benefits to Medicare beneficiaries like dental care, but is limited to network members only. Part D- Medicare Drug Plan ensures provision of prescription drugs, which cover only drugs and Medical advantage Plan, which covers medical services as well as drugs via private insurers. Added premiums have to be paid to cover for the services. Original Medicare plan has the most members especially the elderly, who pays monthly premiums for part B as well as D and have to pay for deductibles & coinsurance sums through policies such as Medigap or Supplemental Medicare insurance, if they are not covered by Medicaid (Cleverly et al. 2010). The Medicare program would even be more beneficial if it retained rational payment for echocardiography facilities in non-hospital set-ups.
Reference
Cleverley, W. O., Cleverley, J. O and Song, P. H. (2010). Essentials of Health Care Finance. Sudbury, MA: Jones & Bartlett Learning.