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Alex Dulin Alex Beecham Nadim Wahab.  Medicare is an insurance program that pays for hospital and medical care for elderly and certain disabled Americans.

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Presentation on theme: "Alex Dulin Alex Beecham Nadim Wahab.  Medicare is an insurance program that pays for hospital and medical care for elderly and certain disabled Americans."— Presentation transcript:

1 Alex Dulin Alex Beecham Nadim Wahab

2  Medicare is an insurance program that pays for hospital and medical care for elderly and certain disabled Americans.  Federal based  The program costs about $432 billion, or 3.2% of GDP, in 2007.

3  Must be at least 65 years old  Or, under 65 and disabled, or any age with End-Stage Renal Disease (permanent kidney failure that requires dialysis or a transplant.)  Must be a U.S. citizen  Or permanent legal resident for 5 continuous years and is eligible for Social Security benefits with at least ten years of payments contributed into the system.

4  Payroll taxes collected through FICA (Federal Insurance Contributions Act) and the Self-Employment Contributions Act mainly fund Medicare.  The tax is 2.9% of wages  Half paid by the employee//Half paid by the employer.  Money is placed in a trust fund.

5 Part A  Hospital Insurance, Home health care  No monthly premium Part B  Supplementary Medical Insurance  a monthly premium ($96.40 per month in 2009) Part C  More client specific plans  Private insurance companies provide some of the coverage Part D  A prescription drug plan  Requires payment of a premium and a deductible

6  It is a means-tested health and medical services program  State based  Costs about $330 billion, or 2.4% of GDP, in  States:  Establish their own eligibility standards  Determine the type, amount, duration, and scope of services  Sets the rate of payment for services, and  Administer their own Medicaid program.

7  Each state sets its own Medicaid eligibility guidelines  States must provide Medicaid services for individuals who fall under certain categories of need in order for the state to receive federal matching funds

8  Each State is then reimbursed for a share of their Medicaid expenditures from the Federal Government.  This Federal Medical Assistance Percentage (FMAP) is determined each year and depends on the State's average per capita income level.  Richer states receive a smaller share than poorer states  By law the FMAP must be between 50% and 83%.

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10 Source:

11  Medicaid is a social welfare (or social protection) program that serves about 40 million people (as of 2007)  Costs about $330 billion, or 2.4% of GDP, in  Medicare is a social insurance program that serves more than 44 million enrollees (as of 2008).  The program costs about $432 billion, or 3.2% of GDP, in  Together, Medicare and Medicaid represent 21% of the FY 2007 U.S. federal government.

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14  Medical Malpractice  Approval Takes Years  Private Companies Want Profit

15  What is it?  Who Offers It?  How does it work?  How Much Does It Cost?

16  Better Access  Works If You Can Pay  Will Cover More Expenses  Protection From Bankruptcy  Better Chance of Living

17  Expensive  Companies Want Profit  Eligibility  Dropped Coverage

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19  Obama has changed the current Healthcare plan in America.  This plan has prospects of being better for everyone and working out for the better in the long run.  He expanded and strengthened some aspects.  He also put an end to other current policies.

20  Children with pre-existing conditions can no longer be denied health insurance coverage.  Health care plans will allow young people to remain on their parents' insurance policy up until their 26th birthday.  This year, adults who are uninsured because of pre-existing conditions will have access to affordable insurance through a temporary subsidized high-risk pool.  In the next fiscal year, the bill increases funding for community health centers, so they can treat nearly double the number of patients over the next five years.

21  Insurance companies will be banned from dropping people from coverage when they get sick, and they will be banned from implementing lifetime caps on coverage.  Restrictive annual limits on coverage will be banned for certain plans. Under health insurance reform, Americans will be ensured access to the care they need.  New group health plans will be prohibited from establishing any eligibility rules for health care coverage that discriminate in favor of higher-wage employees.

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23  1 in 6 on Medicare  We spend $$$ on Prescriptions  1 in 4 Retires are in “Doughnut Hole”

24  Healthcare plan created without tax dollars.  For recently unemployed Floridians or people without insurance for at least six months.  plans can be purchased for as low as $23.70 per month.  Blue Cross Blue shield of Florida and United Health care are available to all 67 Florida counties.  Wide set of benefits  Floridians have the opportunity to choose primary and preventive care instead of costly visits to emergency rooms.

25  Eliminate vaccine preventable diseases for residents and visitors.  Provide immunizations and education for infants, children, and adults.  Educate parents and guardians on importance of vaccines for adults and children.  To provide ongoing surveillance of Vaccine preventable diseases.  Provide consultative screening of immunization records.

26  The U.S. spends more than $2 trillion on healthcare annually. At least 3 percent of that spending, or 68 billion dollars is lost to fraud each year.  Miami is one of the biggest targets for healthcare Fraud.  Over 75% percent of US healthcare fraud is in South Florida.  The Obama administration is asking congress for 1.7 billion dollars to fight healthcare fraud.  Governor Rick Scott was said to be part of a Healthcare scam when he was CEO of Columbia/HCA, a healthcare company.

27  Unneeded care: Doctors may say you need treatment for something when you really don’t.  Bogus insurers: Insurance agents sell you low cost health coverage from fake insurance companies, then take your money.  Identity theft: People steal your medical ID number, then use it to bill health programs thousands of dollars for expensive treatments you never received.

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30  Great doctors  Good, Proven Treatments  No Limit to Care Recieved

31  It’s Expensive  Lower Life Expectancy  Bankruptcy  It’s Expensive

32  "Immunizations." Miami-Dade County Health Department. Web. 03 Nov  Cover Florida Health Care. Web. 03 Nov  Health Care Fraud Blog :: Published by Miami and Fort Lauderdale, Florida, Healthcare Attorney & Medicaid, Medicare, and Insurance Fraud Defense Lawyer, Robert David Malove. Web. 4 Nov  "Insurance Fraud | Medicare Fraud | False Insurance Claims | MiamiLawyer.com." Miami Criminal Lawyer | Federal Defense Attorney | White Collar Crime. Web. 11 Nov  Coalition against Insurance Fraud. "Scam Alerts." Web. 4 Nov Web. 4 Nov  Coalition against Insurance Fraud. "Fraud Data." Web. 4 Nov Web. 4 Nov. 2010

33  Cinergy Health Info. "Lack of Insurance." Cinergy Health Info. Web. 3 Nov  Medical News Today. "What is Medicare?" Medical News Today. Google, Web. 3 Nov  Gruber, Jonathan. "Worst Case Scenario: With and Without Healthcare Reform." MoveOn.org. Political Action, Web. 3 Nov  Department of Labor. "Where Does the Money Go?" Finance My Money. Web. 3 Nov  Phillips, Macon. "What is in the Health Care Bill." The White House. Web. 4 Nov

34  "Average Life Expectancy." QwickStep. QwickStep Answers Search Engine, Web. 12 Nov  Francis, Jason. "The Financial Impact of Health Care Reform." SolarShock. WordPress, 2 Sept Web. 12 Nov  Harris, Ed. "Ohio Anthem Insurance Rates." Ohio Health Insurance. WordPress, 21 Nov Web. 12 Nov  "That's Not Reality. That's A False Assumption That The Free Market Always Is More Efficient." Democratic Underground. Democratic Underground, LLC, 7 Nov Web. 12 Nov


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