Medicare is a federal health insurance program that covers older
adults 65 and over and younger people with disabilities regardless of
their income, medical history or health status. Another benefit of
medicare is that it provides many medical care services which
includes hospitalizations, doctor visits, prescriptions, home health
care and hospice care (Kaiser Family Foundation, 2019). Although
Medicare provides coverage and protection for many health services
there are still challenges that occur. Traditional medicare has high
deductibles, high cost sharing requirements and some places have no
limit on beneficiaries out of pocket spending for some services
(Kaiser Family Foundation, 2019). Medicare also doesn’t pay for
needed services such as long-term services for older people, dental
services, hearing aids and eyeglasses (Kaiser Family Foundation,
2019).
Medicaid is a public federal health insurance program that covers low
income families and individuals (Center on Budget and Policy
Priorities, 2020). This coverage includes children, parents, pregnant
women, seniors and people with disabilities. Medicaid benefits cover
children long term resulting in those children doing better and missing
fewer days of school. These children are also more likely to finish high
school, attend college, and graduate from college, all while
experiencing fewer emergency room visits and hospitalizations
(Center on Budget and Policy Priorities, 2020). Some challenges of
medicare is that it doesn’t cover adults over the age of 21 no matter
their status or their disability. Another challenge is that parents are
also ineligible if their income exceeds just 42 percent of the poverty
line (Center on Budget and Policy Priorities, 2020).
HIPAA was passed in 1996 and allows patients information to be
transfered, covers their privacy and extends benefits to their families.
A benefit of HIPAA is that it increases personal privacy in healthcare
information and decision-making (Ayres, 2018). This allows personal
privacy for patients because their personal case can only be discussed
with other health professionals on that case; thus limits sharing
personal information. Another benefit is that it prevents any form of
discrimination. According to Ayres (2018), when receiving health
insurance coverage, HIPPA was the first step taken to limit the impact
of pre-existing conditions for people. A challenge with HIPAA is that
it doesn’t require consent for billing. Medical providers do not need
to obtain consent to submit claims to your insurance; so, if you went
to an office for a service, they can automatically submit claims to your
insurance (Ayres, 2018).
Ayres, C. (2018). 22 Pros and Cons of HIPAA. Vittana Personal Finance
Blog. https://vittana.org/22-pros-and-cons-of-hipaa
Center on Budget and Policy Priorities. (2020, April 14). Policy Basics:
Introduction to Medicaid. Center on Budget and Policy Priorities.
https://www.cbpp.org/research/health/introduction-to-
medicaid#:~:text=Created%20in%201965%2C%20Medicaid%20is
Kaiser Family Foundation. (2019, February 13). An Overview of
Medicare. The Henry J. Kaiser Family Foundation.
https://www.kff.org/medicare/issue-brief/an-overview-of-
medicare/
