Your grandmother just turned 65 and is very confused about Medicare. She doesn’t understand why there are four parts to this health insurance program. She has asked you to help her with enrolling in Medicare. ACTIVITY: Explain what changes to Medicare benefits were made in 2017, what changes are expected in 2018, and why it may be important to your grandmother. You can created a brochure, PowerPoint presentation or a report. You must use 7th edition APA formatting for this activity.
Title: Understanding Medicare: Changes, Projections, and Their Relevance
Introduction:
Medicare is a federal health insurance program in the United States that primarily covers people aged 65 and older, as well as certain younger individuals with disabilities. Understanding the various parts of Medicare can be complex, particularly due to ongoing changes in benefits and coverage. This report aims to explain the changes to Medicare benefits made in 2017, project anticipated changes for 2018, and emphasize the importance of these changes to your grandmother’s healthcare.
I. Changes to Medicare Benefits in 2017:
In 2017, Medicare underwent several changes aimed at improving the program’s efficiency and expanding coverage. These changes can be summarized as follows:
1. Closing the Prescription Drug Coverage Gap (Donut Hole):
One significant change that took effect in 2017 was the gradual closure of the prescription drug coverage gap, commonly known as the “donut hole.” This gap previously existed in Medicare Part D, where beneficiaries faced higher out-of-pocket costs for prescription drugs once they reached a certain spending threshold. The closure of this gap resulted in reduced out-of-pocket expenses for prescription drugs, providing significant relief for Medicare recipients with chronic conditions.
2. Expansion of Preventive Services:
To prioritize preventive care, Medicare expanded its coverage of preventive services in 2017. This included an increased number of covered screenings, vaccinations, and wellness visits. These measures aim to promote early detection, prevention, and better long-term health outcomes for beneficiaries.
3. Enhanced Coverage for Chronic Care Management:
Recognizing the importance of managing chronic illnesses, Medicare introduced additional coverage for chronic care management in 2017. This allowed doctors to provide more comprehensive care and coordination for individuals with multiple chronic conditions, helping to improve their overall quality of life and reduce hospital readmissions.
II. Projected Changes to Medicare Benefits in 2018:
As we anticipate the year 2018, several proposed changes to Medicare benefits are under consideration. While final decisions have yet to be made, it is essential to stay informed about potential changes and their implications. The projected changes for 2018 include:
1. Restructuring of Medicare Advantage:
Medicare Advantage (Part C) plans, which offer an alternative to the traditional fee-for-service Medicare, may undergo restructuring in 2018. The proposed changes aim to increase plan choices and improve out-of-pocket cost transparency for beneficiaries. It is important for your grandmother to review the updated plan options to ensure she selects the most suitable coverage for her healthcare needs.
2. Medicare Part B Premium Adjustments:
Medicare Part B, which covers outpatient services and medical supplies, may see an adjustment in its premiums for 2018. While the exact changes have not been finalized, potential premium adjustments should be closely monitored by beneficiaries to anticipate any cost increases.
3. Potential Changes to Medicare Supplement Plans:
Medicare Supplement plans, also known as Medigap policies, provide additional coverage options to fill gaps in traditional Medicare. In 2018, there may be revisions to Medigap plans, which could impact their availability and coverage options. Staying updated on these potential changes will help your grandmother make informed decisions regarding supplementing her Medicare coverage.
III. Importance of Understanding and Navigating Changes:
Understanding and monitoring changes to Medicare benefits is crucial for your grandmother’s healthcare management. Here’s why these changes are significant:
1. Cost Optimization:
By staying informed about Medicare changes, your grandmother can effectively optimize her healthcare costs. For example, she can take advantage of the closure of the prescription drug coverage gap, ensuring she receives necessary medications at reduced out-of-pocket costs. Similarly, being aware of potential premium adjustments can help her plan for any potential increases in expenses.
2. Access to Quality Care:
Changes in Medicare often focus on improving care quality and access. Recognizing the expanded coverage for preventive services and chronic care management, your grandmother can benefit from these enhancements by proactively seeking necessary screenings, vaccinations, and chronic disease management assistance.
3. Personalized Healthcare Options:
With the possible restructuring of Medicare Advantage plans and revisions to Medigap policies, your grandmother should explore updated plan options. Understanding the changes will enable her to personalize her healthcare coverage to adequately address her unique needs and preferences.
Conclusion:
Medicare is a dynamic program that undergoes changes aimed at improving healthcare access, quality, and cost management. Remaining informed about changes in benefits, both past and projected, is essential for your grandmother to make informed decisions about her Medicare enrollment. By understanding the changes made in 2017, anticipating the projected changes for 2018, and understanding the relevance of these changes, your grandmother can ensure her healthcare needs are optimally met under the Medicare program.