Medicare Managed Care Essay

A Medicare managed care plan is a type of government-subsidized health care that allows patients to get health care coverage for the bills that traditional Medicare does not cover. This is done through a private Medicare-approved insurance company. Medicare managed plans “fill the gaps” in traditional Medicare. Patients are offered reduced overall healthcare costs. However, in exchange, patients can receive care from only a specific network of hospitals, doctors, etc… Each plan includes everything that Medicare covers with lower copays and more benefits. The most common Medicare managed care types are HMOs (Health Maintenance Organizations), PPOs (Preferred Provider Organizations), and PFFS (Private-Fee-For-Service) plans. There are several benefits in having a Medicare managed care plan instead of traditional Medicare. Medicare managed care plan patients set their own deductible and copays, while traditional Medicare plan patients pay the premiums, deductibles, and coinsurances set by Medicare. Medicare managed plans can also cover extra services that traditional Medicare does not offer. Examples of such services include dental, vision, and hearing care. In addition, traditional Medicare does

While Medicare managed plans do not cover hospice costs, many modern-day patients prefer not to stay in the hospital for hospice anyway. By not covering this cost, many patients are encouraged to stay in the comfort of their own home instead. Another limitation of Medicare managed plans is the cap on healthcare spending. In traditional Medicare plans, there is no out-of-pocket limit on healthcare. However, out-of- pocket limits can protect the patient if they need expensive care. Since Medicare covers older patients with chronic illnesses, out-of-pocket limits can be a benefit to them. After the patient reaches the limit, the plan pays for the full cost of