Catastrophic Health Insurance: Hearing Before the Committee on Labor and Human Resources, United States Senate, One Hundredth Congress, First Session on S. 210 ... April 8, 1987, Volume 4

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Page 117 - Medicare pays a large -2portion of the elderly 's expenses for acute illness and private insurance policies known as "medigap" pick up the deductibles and coinsurance — those gaps in coverage that Medicare assigns to the elderly to pay themselves. Today, seven out of ten older people have some form of private insurance or medigap to supplement their Medicare benefits thereby avoiding catastrophic hospital and medical bills. A medigap policy allows older Americans to spend up to 150 days — that's...
Page 273 - None of the funds appropriated under this title shall be used in programs where abortion is a method of family planning.") The Conference Report accompanying the FY 1972 HEW Appropriations Act (PL 92-80, 92nd Cong.
Page 232 - The AAFP believes that a variety of strategies for addressing long term care should be considered. This organization supports the following Bowen report recommendations : *the federal government work with the private sector to educate the public about the risks, costs, and financing options available for long term care, as well as the limitation of coverage for such services under Medicare and Medigap supplemental insurance. *that the federal government encourage personal savings for long term care...
Page 149 - Proposal Ideally, the addition of catastrophic coverage to current Medicare benefits should be accomplished as part of a broad reform of the Medicare program. With this in mind, we have developed a new program, one that is fiscally sound and will assure health care services for the elderly into the 21 century and beyond.
Page 82 - ... Massachusetts were impoverished after only 13 weeks in a nursing home. As such statistics indicate, the impoverishment of a spouse in the community in order to finance the care of an institutionalized mate is one of the most serious problems facing older couples today. To be eligible for Medicaid, couples must often spend-down their combined income and assets, leaving one spouse - usually the wife - destitute. Many of the same women who are caught in the spend-down problem have spent years taking...
Page 142 - Research on Mental and Addictive Disorders," 15% of the population suffers from serious mental disorders at any one time. During their lifetime an estimated 3 million people will develop schizophrenia.
Page 129 - H1AA companies are selling policies in each of the 50 states. What is covered by the typical private long-term care policy? In our survey, we defined this type of policy as one which covers nursing home stays and/or home health care for not less than 12 consecutive months. The maximum benefit period for a typical policy, however, is 3 years, although a substantial number offer 5 years of coverage. This coverage appears to be adequate since...
Page 37 - Medicare, in many cases they cannot receive additional coverage from Medicaid or any other payment source (private insurance, self-pay, Title XX, etc.)- For example, if patient A is receiving 3 hours of nursing care and 2 hours of aide care for 3 days a week paid for by Medicare, and he or his family wants an additional 2 hours of nursing care on the other 2 days which will be paid by concerned relatives, Medicare intermediaries will deny the Medicare coverage.
Page 38 - A less sweeping benefit which could be provided without the development of a case management system for Medicare, could be provided with Medicare covering a limited amount of personal care per week, to assist family and community caregivers in maintaining functionally disabled individuals in their homes.
Page 38 - ... fiscal intermediaries. This is especially so in cases where beneficiaries are leaving their homes to go out for periodic adult day care, outpatient kidney dialysis, chemotherapy and other similar treatment. Even though the current guideline allows beneficiaries to go out for medical reasons, some FIs severely limit frequency and others do not honor the medical reason exception at all. In situations where individuals leave their homes for either medical or non-medical reasons, individual FIs have...

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