Summary of Intervention and Implementation
My product was a hand out intended to help the older adults and their families in society understand their Medicare and Medicaid alternatives. The product would guide people on how to gain maximum benefit of the programs while spending little in healthcare. I conducted a team of healthcare professionals in conducting a study. The focus was on households of the older adults or families that we knew had an older family member of age 65 and above. The family member could either be staying with the people or in a health institution.
The study indicated that older adults suffer a lot when trying to access healthcare. Some of the factors that contributed to the problems of older adults include:
Most older people reported suffering from poverty after spending their savings in the earlier years after the recession (Tinetti et al., 2019). The Kaiser Commission report on Medicaid in 2010 indicated that the poverty rate among older adults had risen by 14 percent. Before the recession, many women had joined the workforce and thus had income. Married couples had double income which made it possible to leave healthy lifestyles and have savings for old age. The government and private employers also paid better retirement benefits.
Moreover, many people had access to better healthcare and even information on how to eat and leave healthy.
Ageism is the discrimination of people based on age. Ageist biases and attitudes among healthcare workers and the society at large have made older adults inferior, forcing some to depression. Young people working in health institutions discriminate against the older generation when they come for services. The industrialization has also given wealth and power to the younger generations. The advancements in technology forced the older generations out of work while those still working are perceived to be old class and thus alienated. At home, the younger generation has to provide for the family, which renders the older people as a burden.
Mistreatment and Abuse
Mistreatment and abuse of older people have become a significant problem in society today. When older people become frail and unable to depend on themselves, they find themselves at the mercies of the younger generation who, in most cases, mistreat them. The most common form of elderly abuse occurs in the form of intentionally being deprived of care and basic needs. Some older people also reported cases were those supposed to take care of them fail to give them medication on time or take them for medical appointments and checkups.
Other problems that older adults encounter include idleness and lack of emotional support, lack of privacy, physical weaknesses, lack of proper accommodation, increased level of losses in terms of friends, relatives, and property.
It was evident that most of the sufferings of the old could be solved by boosting their financial muscles and reducing their expenses. The team identified some factors that could help improve the conditions of older people in society. The solutions included companionship, providing adequate comfortable space for oneself, showing affection to old family members, allowing older people who are willing to engage in part-time jobs, and the government to raise the level of pension to meet the basic needs of the retired individuals.
The most crucial was the need for care and accessibility to better and affordable healthcare. The study also indicated that most older people and the persons, especially family members, were ignorant of the benefits of Medicaid and Medicare. The programs, if well utilized, could solve a reasonable percentage of the suffering of older people in society. Medicaid is a public assistance program and has several benefits to the old, including they can apply and obtain financial assistance to sort medical bills whenever necessary. Medicaid also offers special considerations to beneficiaries’ custodial care (Alderman, 1998). People under custodial care get help with various activities such as bathing, dressing, eating, and using the bathroom. Medicaid also offers nursing home care where the patients may only pay for a fraction while the program caters for the remaining amount.
Conversely, Medicare was also established to take care of the needs of older people. It is a USA federal government program that subsidizes healthcare services for older people above age 65 and younger people who are eligible (Goldman & Hagopian, 2018). It covers costs billed and even subsidies for the cost of prescribed drugs. We realized the ignorance of people concerning the two programs and thus formulated a plan that could inform them of the benefits and how to apply to receive the aid. The programs would create awareness to society and encourage individuals to enroll their old relatives to the programs. It would also enlighten young people to join in the programs earlier.
Individuals who will enroll in the programs would obtain subsidized costs and purchase prescribed drugs at subsidized prices, thus helping with the cost of medication. Moreover, those who will meet the eligibility criteria may obtain custodial care and home nursing care which would improve their safety. Obtain care in the facilities ensures improved safety to the individuals and enhanced quality of services provided, including feeding.
My Professional Product: Medicaid/Medicare Patient Coverage Guide
The eligibility criteria for one to qualify for the help vary from state to state. In most cases, the states have expanded the program to allow more people to qualify. Some of the factors considered when an individual applies for the program include the level of income, family size, and disability. Moreover, one as to be either a United States citizen, a permanent resident of the country, or a United States National. More information can be found on the website Medicaid.gov, including requirements for specific states.
Individuals can apply for Medicaid programs directly with the respective state Medicaid agency or through the health insurance marketplace. Applications through the marketplace are possible by visiting the application website. Once in the site, create a marketplace account, and fill in the application document.
To confirm your eligibility, individuals can contact their respective state Medicaid offices. Alternatively, you can visit their websites through Centers for Medicare and Medicaid Services and collect the phone numbers of the customer care offices of various states.
Medicare is a federal health insurance program that was established in 1965 to take care of the older people of age 65 and over. It also covers for people within specific disabilities, or individuals in the advanced stage of the Renal Disease. It is divided according to the areas it covers to obtain the following parts:
Medicare Part A (Hospital Insurance)
Part A is meant for inpatient services, conditions that need skilled nursing (not custodial nor long-term care), and home health visits. Beneficiaries have to meet certain criteria. Most people enrolled in part A do not pay premiums because either they had paid or their spouses had paid through payroll taxes (Moyo et al., 2019).
Medicare Part B (Medical Insurance)
Part B covers services rendered by doctors and outpatient care. It also covers most of the services that are not included in Part A, including costs for physical and occupational therapies, and a few other home health care. Most people a monthly premium for this part since it only covers the services when they are medically necessary.
Medicare Part D (Prescription Drug Coverage)
To become eligible, you must be of age 65 and above or have a disability. Individuals at the End-Stage Renal Disease ( people with fatal kidney problems and who require kidney transplants) are also admitted into the program regardless of their ages.
Program Application Process
Individuals who wish to apply can visit the Medicare website online, socialsecurity.gov/medicare/apply.html.
Individuals who would wish to communicate with Medicare for clarifications can visit their website Medicare.gov or call their 1-800-633-4227.
Benefits at Medicare.gov website include:
Detailed information about the program and the cost of services rendered and premiums paid.
Users also get to interact with healthcare providers and suppliers in the field
Users can obtain Medicare appeals forms
You also get to learn about the quality of care provided by nursing homes, home health agencies, dialysis facilities, and hospitals.
Users can also obtain useful contacts to call and make inquiries.
Alderman, J. (1998). Medicaid & Medicare: HCFA must monitor HMOs to ensure appeal rights for medicare beneficiaries. Journal of Law, Medicine & Ethics, 26(3), 253.
Goldman, D. P., & Hagopian, K. (2018). It Is Time for Universal Coverage without Breaking the Bank. Journal of Policy Analysis & Management, 37(1), 182–188
Mao, J. J., Davis, R. T., Coeytaux, R., Hullender-Rubin, L., Kong, J.-T., MacPherson, H., … Harris, R. (2019). Acupuncture for Chronic Low Back Pain: Recommendations to Medicare/Medicaid from the Society for Acupuncture Research. Journal of Alternative & Complementary Medicine, 25(4), 367–369.
Moyo, P., Simoni, W. L., Griffin, B. A., Harrington, D., Alexander, G. C., Palumbo, F., … Simoni-Wastila, L. (2019). Prescription drug monitoring programs: Assessing the association between “best practices” and opioid use in Medicare. Health Services Research, 54(5), 1045–1054.
Tinetti, M., Dindo, L., Smith, C. D., Blaum, C., Costello, D., Ouellet, G., … Naik, A. (2019). Challenges and strategies in patients’ health priorities-aligned decision-making for older adults with multiple chronic conditions. PLoS ONE, 14(6), 1–13.
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