Preventative Services That Traditional and Medicare Advantage Programs Cover – Health System Example

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"Preventative Services That Traditional and Medicare Advantage Programs Cover"  is an engrossing example of a paper on the health system. Traditional and Medicare Advantage Programs both offer blood pressure screening, immunization vaccines, and diabetes screening that are covered. List at least 3 items that are not covered by either Traditional or Medicare Advantage Program. Hillestad (2004) In a traditional Medicare advantage, one element that is consistent is out of pocket costs. It is clear that Supplemental insurance via a former employer  is also not covered. Medical insurance continues to be under heavy scrutiny because of the fact it may diminish over time.

This poses the question of choosing the right coverage (“ Get 2015 health coverage now” ).Identify 3 types of Medicare Advantage Plans that are available to people 65 years and older. Be sure to explain the type of plan. 3 types of plan that is available are Medicare A, B, and C. Medicare A entails that elders s part of hospital information. Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care. Secondly, Part B which is medical insurance covers Part B covers certain doctors' services, outpatient care, medical supplies, and preventive services (“ Get 2015 health coverage now” ).

Lastly, Medicare Part C takes care of the advantage plan in which special and service need plans are covered. Why is it important to know if medical providers accept "assignment. " What is the role of the Long Term Care Ombudsman? Hillestad (2004) It is important to know if medical providers accept “ assignments’ because it dictates their pay and coverage. Additionally, medical organizations may have different policies regarding these different plans. The role of Long Term Care Ombudsman is to advocates for residents of nursing homes, board and care homes, assisted living facilities, and similar adult care facilities.

They work to resolve problems of individual residents and to bring about changes at the local, state, and national levels that will improve residents’ care and quality of life. In what case is Medi-Gap Insurance Required? Medi-Gap insurance is required when the patient does not have premium insurance on class A or C drugs. COMPARE TRADITIONAL vs MAPOne of the most imperative elements to understand the Affordable Act of 2010.

The new act will ultimately change what services will be available to individuals that have mental health and addiction disorders. Traditional Medicare would not cover premiums for supplemental insurance but new coverage in MAP allows that coverage. Patients that have mental illness can now use MAP to get the correct treatment they desire (“ Get 2015 health coverage now” ). Out of Pocket costs in MAP are a bit higher than traditional healthcare, but that is to cover for extra costs outside the USA as well. Employees who use drugs or alcohol may be required to meet the same standards of performance and conduct that are set for other employees.

It is not a violation of the Affordable Care Act for an employer to give tests for the illegal use of drugs. An employer may not discriminate against a person who has a history of drugs. The Affordable Care Act has many parameters listed as Substance abuse only has 1 or more of its’ listed characteristics that need to be met in certain criteria. The Affordable Act has stringent parameters to ensure that withdrawal and tolerance are not to be taken lightly. On the contrary, there are some moral implications of understanding the issues that are revolved in providing life to someone that is in disability.

The Affordable Act It is clear that most people are not in touch with disabled individuals, which gives them a false sense of living with a disability.


(n.d.). Retrieved February 7, 2015, from

Get 2015 health coverage now. Health Insurance Marketplace. (n.d.). Retrieved February 7, 2015, from (n.d.). Retrieved February 7, 2015, from

Hillestad, S & Berkowitz E. (2004). Health Care Market Strategy: From Planning to Action (3rd Ed). Sudbury: Jones & Bartlett Publishers, Inc..

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