What are the eligibility requirements and coverage of Medicaid for the categories of low-income adults, pregnant women, and the aging/blind/disabled
NUR 508 GRAND CANYON WEEK 5 ASSIGNMENT NUR 508 GRAND CANYON WEEK 5 ASSIGNMENT ? NUR 508 Grand Canyon Week 5 Discussion 1 What are the eligibility requirements and coverage of Medicaid for the categories of low-income adults, pregnant women, and the aging/blind/disabled in the state where you live? Do you consider the eligibility requirements reasonable or restrictive? Do you consider the coverage reasonable or liberal? What are the benefits and drawbacks to keeping these populations insured through Medicaid? Consider both direct and indirect factors. ? NUR 508 Grand Canyon Week 5 Discussion 2 Review the CMS.gov 30-Day Mortality and Readmission Data website. Review at least two local hospitals and see how they compare to state and national benchmarks. How and why may a consumer or a health care professional use this data to make decision about their next hospitalization? Will reporting this data have an impact on hospitals bottom line in addition to financial penalties from CMS? Give at least two examples of how this data may be used and what type of impact if may have if at all on the hospitals. CLICK HERE TO ORDER YOUR NUR 508 GRAND CANYON WEEK 5 ASSIGNMENT NUR 508 Week 5 Assignment 1-Health Issue Analysis Part 3 Details: This is a CLC assignment. In your Collaborative Learning Community, write a paper of 500-1,000 words that includes the following in addressing the health issue: Discuss past and present funding for initiatives that address the health issue. Include both public and private sources. Analyze past and present quality initiatives that address the health issue. Include both public and private sources. Differentiate how being insured versus uninsured impacts health outcomes relative to this issue. Compare health outcomes for the issue between the United States and a country with universal health coverage. Refer to ?CLC Health Issue Analysis Overview.? Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required. This assignment uses a grading rubric. Instructors will be using the rubric to grade the assignment; therefore, students should review the rubric prior to beginning the assignment to become familiar with the assignment criteria and expectations for successful completion of the assignment. You are required to submit this assignment to Turnitin. Refer to the directions in the Student Success Center. ? NUR 508 Grand Canyon Week 5 Assignment 2 Cost and Quality Analysis Details: In a paper of 500-1,000 words, describe the relationship between health care cost and quality. Address the following: Select one public agency and one private agency and differentiate their roles and major activities in addressing cost and quality in health care. See Topic 4 Readings for sources regarding health care agencies. Analyze current and projected initiatives to improve quality while simultaneously controlling costs. Describe any unintended consequences. Synthesize implications for staff nurses and advanced practice nurses, including evidence-based practice, relative to cost and quality. Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required. This assignment uses a grading rubric. Instructors will be using the rubric to grade the assignment; therefore, students should review the rubric prior to beginning the assignment to become familiar with the assignment criteria and expectations for successful completion of the assignment. You are required to submit this assignment to Turnitin. Refer to the directions in the Student Success Center.
ADDITIONAL INFORMATION;
Introduction
Medicaid is a health insurance program for low-income individuals and families. It provides access to health care services, including primary and preventive care, prescription drugs, mental health services and hospitalization. The Medicaid program was established in 1965 as part of the Social Security Act. To qualify for Medicaid benefits on a state level, you must meet specific requirements in addition to having a low income (see below).
Eligibility requirements and coverage for low-income adults
The eligibility requirements for Medicaid are based on your income and assets. The income limits are lower for children, pregnant women, and people with disabilities (see below).
The asset limits are higher for people with disabilities than for other low-income adults. Eligibility for disability-related services is determined by the type of disability you have or could develop due to various factors including age; gender; or state law (such as having HIV/AIDS).
The eligibility requirements for low income adults
You must be a US citizen or qualified alien.
You must be a resident of the state in which you are applying for benefits.
You must be a low-income individual, meaning that your income does not exceed 133 percent of the federal poverty level (FPL). This means that if you make $1,000 per month, your income will not be considered low if it exceeds $633 per month.
The coverage for low income adults
Medicaid is a health program that helps low-income families and individuals pay for health care. In most states, Medicaid coverage is available to people with incomes up to 138% of the federal poverty level (FPL).
Medicaid covers many medical services, including doctor visits, prescription drugs, hospitalization and nursing home care. Some states also cover dental care under their state-funded programs like Medicaid Dental or Badgercare Plus.
Eligibility requirements and coverage for pregnant women
The eligibility requirements for pregnant women are:
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Pregnant woman must be a U.S. citizen, resident alien or visa holder
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Must be physically and mentally capable of bearing children (18 years old)
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Must be unmarried or in a valid marriage that was legally dissolved/ annulled before the pregnancy began
The requirements for pregnant women
If you are pregnant, Medicaid may be an option for you. You must meet the following requirements:
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Must be pregnant and meet income requirements.
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Pregnant women may qualify for Medicaid if they meet income requirements (see below).
Must live in an area where Medicaid is available. There are some states that do not offer Medicaid for pregnant women.
The coverage for pregnant women
Pregnant women are eligible for Medicaid coverage if they meet the following criteria:
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They must be pregnant and not able to work.
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Their child’s birth must occur within 42 days of the date of application for coverage.
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The pregnancy must have lasted for at least 90 days when it began, and there must be at least one week left until delivery (but no more than 12 weeks).
Eligibility requirements and coverage for the aging, blind, and disabled
Eligibility requirements and coverage for the aging, blind, and disabled
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You are eligible if you are 65 or older.
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You are eligible if you have a disability.
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Your income must be below 138% of the poverty level (or 185% in some states) with an elderly or disabled person as your dependent on your tax return. If you don’t have a spouse or dependents who will claim them on their taxes, then they also need to be at least one year younger than you; otherwise it won’t matter because Medicaid will only cover individuals who meet this requirement once every three years.
The eligibility requirements for the aging, blind, and disabled?
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You must be 65 or older.
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You must be blind or disabled.
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Your income should be below the federal poverty line (FPL). Medicaid eligibility is based on your monthly income, not gross salary or net worth; therefore, if you are self-employed and have a high net worth, the amount of your income that determines eligibility will be higher than it would be if you were employed by someone else and only making $50/month. The FPL varies from state to state but ranges from about $11000 per year in Mississippi to $16000 per year in California.* You must meet the citizenship or immigration requirements for Medicaid eligibility in order to apply for coverage by mail or over the phone without having been screened via an interview at a local office.* If you live outside of the United States then there may also be additional steps that need taking before applying online as opposed to going into person at their local office (which may take longer).
What does the coverage include?
Medicaid covers doctor visits and other medical services, including prescription drugs and eyeglasses. It also covers emergency care, rehabilitation services and long-term care.
The program is designed to help people with low income get access to healthcare by providing coverage for those who don’t have it otherwise.
Medicaid provides health insurance coverage to millions of Americans. Here’s how to qualify.
Medicaid provides health insurance coverage to millions of Americans. Here’s how to qualify:
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For adults who are low-income and uninsured, Medicaid can help fill the gap between what they earn and what it costs them to get their family covered by health insurance.
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In order to be eligible for Medicaid, you must be considered disabled or blind under state law (or have a disability that causes “substantial physical or mental impairment”). You also have to be receiving Temporary Assistance for Needy Families (TANF) benefits as well as Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI).
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If you’re pregnant but don’t have coverage through your job, you may still qualify if your entire household income is below 138% of federal poverty levels ($16,242 per year).
Conclusion
Medicaid has many different categories of eligibility and coverage. To be eligible for Medicaid, you must meet specific requirements. In some cases, people may qualify based on their income alone (i.e., no matter what) while in other cases they may need to have certain disabilities or come from a certain section of the country depending on where they live at the time when applying for Medicaid benefits.
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