Catastrophic health insurance: filling the long-term care gap : hearing before the Subcommittee on Health and Long-Term Care of the Select Committee on Aging, House of Representatives, One hundredth Congress, first session, July 2, 1987

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Page 11 - States may set up alternative payment programs. in the long term, a major vehicle for containing costs is through HMOs. Cost sharing of 20% for health and skilled long term care and 25% for non-skilled long term care is required, but only up to the catastrophic limits described below. Cost sharing is optional for those enrolled in qualified HMOs. The poor (under...
Page 85 - Flo matter how strong we may be, there are circumstances that can make all of us vulnerable, and in need of advocacy. If you answer yes to any of the following questions, you may be in need of patient advocacy. If so, please fill out the attached application. If you wish, a patient advocate will cal I on you. Are you now in a hospital or nursing home, wishing to return home with twenty-four hour care, but don t know where to start?
Page 25 - ... It will not take long at this rate of expenditure to deplete their entire life savings, providing their medical status remains unchanged, and that is not likely to be the case. I have already sold their home where they lived for 51 years to have funds available to cover these costs. I certainly hope something can be done to assist families such as ours who are desperately trying to cope with catastrophic illness within our own limited resources. Since my daughter is an only child and my granddaughter...
Page 8 - January 1 , 1 989.) 2) Prescription drugs are added as a benefit subject to a $300 deductible and a coinsurance of $2 per prescription and subject to the above catastrophic limit. The DHHS Secretary shall design the prescription drug benefit program so that drugs are purchased from participating pharmacies only and prescription drug prices are prospectively set by Medicare.
Page 58 - The National Council on the Aging includes as membership units, the National Institute of Senior Centers, National Institute on Adult Daycare, National Institute on Community-based Long-term Care, National Institute of Senior Housing, National Association of Older Worker Employment Services, National Voluntary Organizations for Independent Living for the Aging, and the National Center on Rural Aging. We represent a very broad coalition of organizations, agencies and individuals concerned about meeting...
Page 75 - the availability of home medical care and related services depends on the state in which a child lives and on his or her medical condition.
Page 10 - ... care provided in the home, and by increasing research and training in home care quality. THE ISSUE: With the rapid increase in the number of older persons and need for health and support services, the number of homecare providers and proprietary agencies, in particular, have mushroomed over the past two decades with virtually no provisions to ensure the quality of care delivered. Little is known about the quality of care provided in the home, who is providing services, how many people are being...
Page 11 - HMOs. Administration. The program is entitled "USHealth" and managed by the USHealth Administration (currently, Health Care Financing Administration) which is independent and off-budget. Most bill processing and review will be provided through contracts with private insurance companies. Financing. Health care cost increases will closely match increases in per capita GNP — approximating the Nation's ability to pay. The provisions to ensure financial access for all Americans are financed as follows:...
Page 9 - The respite care benefit shall, at the beneficiary's choice, cover up to 10 days of nursing home care per year (based on the national average per diem Medicare reimbursed cost for SNF services) or the equivalent dollar value of hospital-based respite care, adult day health care, or in-home care. A 50% co-insurance is required up to the catastrophic limit. (Start-up date: January I, 1990.) 6.
Page 81 - ... catastrophic health insurance if they understood that it would help to provide immediate financial protection for parents and grandparents while at the same time building up protection for themselves when they retire. A National Committee member from Cicero, Illinois, recently described the devastating impact that a long-term care illness can have on the whole family even when the family does not exhaust all its savings.

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