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slides17 - Medicare and Medicaid Take up Crowd-out...

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Medicare and Medicaid Take up Crowd-out Sustainability of Medicare Medicaid and Medicare Angela Fertig Spring 2010 Angela Fertig Medicaid and Medicare
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Medicare and Medicaid Take up Crowd-out Sustainability of Medicare Medicare I established in 1965 under Lyndon Johnson I federal program I eligible if 65+ or disabled I coverage: I Part A: hospital insurance I Part B: supplemental medical insurance, monthly premium I Part C: Medicare+Choice, managed care plan if have parts A&B I Part D: Prescription Benefit Plan, described last time Angela Fertig Medicaid and Medicare
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Medicare and Medicaid Take up Crowd-out Sustainability of Medicare Medicare I financing: I Part A: payroll tax (FICA) of 1.45% of wages paid by employee and employer, 2.90% if self-employed I Part B: monthly premium + general tax revenue I Medigap plans are optional; seniors purchase them privately to cover expenses not covered by Parts A and B I Prospective Payment System (PPS) – pay average cost of certain diagnosis, not actual cost, to lower moral hazard, we will discuss more next time Angela Fertig Medicaid and Medicare
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Medicare and Medicaid Take up Crowd-out Sustainability of Medicare Medicaid I established in 1965 I state program partly paid by federal matching dollars (match rate formula changed this year), must follow broad federal guidelines I eligible if ‘categorically needy’, specifics depend on state I family eligible for AFDC in effect in their state in 1996 (before welfare reform) I children under 6 or pregnant women with family income below 133% of FPL I children under 19 with family income below 100% of FPL I coverage – depends on state rules Angela Fertig Medicaid and Medicare
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Medicare and Medicaid Take up Crowd-out Sustainability of Medicare Medicaid Financing: I
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