1.22 social insurance

one must know who qualifies for what because many a time i see patients without any insurance but many a time they qualify for a governmental insurance available in the united states.

2 main systems exist

Medicaid - aids the poor

it exists in 2 forms

1. Full coverage

2. Share of cost-in this system of medicaid, there is a minimum monthly expense incurred by patient before medicaid starts covering expenses. The minimum limit is determined on the basis of the patient's income, members in family and assets.

Whenever a catastrophic expense occurs, one can think of share of cost assisting those without any insurance.

In an in-patient setting, a case manager (a hospital employee) is asked to see patients like this and follow through with the paperwork.

the second system is Medicare

it cares for the elderly and also the disabled.

It has 2 parts

part A for in-patient (hospital) care

part B for out-patient care

medicare covers 80% of cost. It has a fixed schedule for each type of service. This varies slightly from geographic location to geographic location