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Medicare is the primary payer for most services, but Medicaid covers benefits not offered by Medicare. Medicare coverage for dual-eligibles includes hospitalizations, physician services, prescription drugs, skilled nursing facility care, home health visits, and hospice care.
The Medicare Trustees have reduced their forecast for Medicare costs as %GDP, mainly due to a lower rate of healthcare cost increases. Medicare was established in 1965 and expanded thereafter. In 2009, the program covered an estimated 45 million persons (38 million aged and 7 million disabled).
Medicare Advantage was created under the Balanced Budget Act of 1997, with the intent to better control the rapid growth in Medicare spending, as well as to provide Medicare beneficiaries more choices. But on average, Medicare Advantage plans cost 12% more than traditional Medicare. [59]
Fee-for-service (FFS) is a payment model where services are unbundled and paid for separately. [1]In health care, it gives an incentive for physicians to provide more treatments because payment is dependent on the quantity of care, rather than quality of care.
The revenue base is capped so it does not keep pace with the increase in national income. Premiums are regulated by politicians, [28] and infrequently raised. [14] There is a low doctor-to-population ratio resulting in too many patients depending on too few doctors. There is also a shortage of nurses. [9]
The loan arrangement may last from one year to the life of the policy. The premium finance company then pays the insurance premium and bills the individual or company, usually in monthly installments, for the cost of the loan. Typically, clients that engage in this transaction are age 29 to 75; with net worth of $5MM or greater.