Medicare is a health insurance for people who are 65 years of age or older. Medicare is based on a three-part system; part A is hospital insurance which helps cover inpatient care at hospitals, skilled nursing facilities, hospice care, and home health care, part B is medical insurance which helps cover services from doctors and other health care providers, outpatient care, home health care, durable medical equipment, and preventative services, and part D which is drug coverage. - Essay Prowess

Medicare is a health insurance for people who are 65 years of age or older. Medicare is based on a three-part system; part A is hospital insurance which helps cover inpatient care at hospitals, skilled nursing facilities, hospice care, and home health care, part B is medical insurance which helps cover services from doctors and other health care providers, outpatient care, home health care, durable medical equipment, and preventative services, and part D which is drug coverage.

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Module 3

Medicare is a health insurance for people who are 65 years of age or older. Medicare is based on a three-part system; part A is hospital insurance which helps cover inpatient care at hospitals, skilled nursing facilities, hospice care, and home health care, part B is medical insurance which helps cover services from doctors and other health care providers, outpatient care, home health care, durable medical equipment, and preventative services, and part D which is drug coverage. This coverage helps cover the costs of prescription drugs and vaccinations (“Parts of Medicare”, n.d.).

Private health insurance refers to health insurance plans that are marketed by private health insurance owners rather than government-run insurance programs such as Medicare and Medicaid (“What is private health insurance?” n.d.).

Self-pay patients are ones who must pay all or part of the cost of their care. Typically, uninsured or full payment self-pay patients will receive a discount on charged based on the individual or family income to assure access to health care services (“Self-pay patients – discount policy”, n.d.).

In 1965, President Lyndon B. Johnson enacted the Medicare and Medicaid programs to provide healthcare to Americans 65 and older, and, eventually, to people with disabilities. About one-half of America’s seniors did not have hospital insurance prior to Medicare. Medicare, along with other programs such as Social Security, have improved the ability of the elderly and disabled to live without medical worries (De Lew, 2000).

Private health insurance also includes employer-sponsored plans which cover half of the American Population. Another six percent of Americans purchase private coverage outside of the workplace in the individual/family health insurance market.

Question: What should the professional nurse do should she encounter a patient needing care who is uninsured and unable to self-pay?

De Lew, N. (2000). Medicare: 35 years of Service. Health care financing review. Retrieved November 5, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4194690/.

Parts of Medicare. Medicare. (n.d.). Retrieved November 5, 2021, from https://www.medicare.gov/basics/get-started-with-medicare/medicare-basics/parts-of-medicare.

Self pay patients – discount policy. Family Health Centers | Orangeburg. (n.d.). Retrieved November 5, 2021, from https://www.myfhc.org/payment/self-pay-patients-discount-policy/.

What is private health insurance? healthinsurance.org. (2021, March 13). Retrieved November 5, 2021, from https://www.healthinsurance.org/glossary/private-health-insurance/#:~:text=Private%20health%20insurance%20refers%20to,to%20government%2Drun%20insurance%20programs.&text=Private%20health%20insurance%20includes%20employer,half%20of%20the%20American%20population.

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