 Welcome back to MedSmarter where we're taking a smarter approach to preparing future physicians. Let's continue on and discuss Some of our Medicare and Medicaid policies. So what is Medicare and Medicaid? Well, these are social health care programs that originated from the Social Security Act in 1935 So Medicare Medicare ends with an E Medicare that is for the elderly patients So Medicare is for elderly Specifically anyone that is Equal to or greater than 65 years of age is eligible for Medicare There are other groups of people that are eligible for Medicare Insurance as well and those are going to be people that are less than 65 that have certain qualifying disabilities or patients with in-stage renal disease or ESRD Medicaid on the other hand Medicaid which ends in a D is for the destitute This is going to have a mixture of our federal programs and state programs that provide assistance for patients that have limited income So patients that are on food stamps patients that are on welfare people that are poor that is going to be the patient population for people on Medicaid So back to Medicare particularly Medicare has four different parts to it. All right. We have part a b c and d part A is going to be coverage for hospitals and home hospice. So if you Need coverage for a hospital visit. You have to have Medicare part a Medicare part B. This is What helps pay for your medical bills when you go see a doctor when you have tests run that kind of thing That's Medicare part B Medicare part C is a combination of parts A and B and that is usually provided by a private company A lot of times people have supplemental insurance on top of their Medicare to help cover anything that Medicare doesn't cover And that's typically going to be a part C plan And then finally part D is what covers prescription drugs So patients need to choose which of these parts that they want with their plan and may have to pay some out-of-pocket To add certain parts of this specifically prescription drugs. So if you are Needing prescription drug insurance coverage, you may have to pay some out-of-pocket on that All right, finally, we're going to talk about hospice care. What is hospice care hospice care is Patient care that is focused for end-of-life patients So we're trying to provide comfort and palliative care for patients that are at the end of their life What is considered end of their life? Well, typically based upon their diagnosis We're talking about their life expectancy is going to be less than about six months Can patients go into hospice care and then maybe make a turn for the better and come off of hospice care because we think that Their life expectancy is greater than six months. Absolutely there is Instances where patients will go in and out of hospice care because they may make a turn for the worse and they think and Based upon the medical evidence they have less than six months to live or they may Come back out of it and start doing well and go off of hospice care hospice care specifically is going to be prioritizing comfort and relieving pain so we will give opiates sedatives anti-exiety medications probably at higher doses and higher intervals Then a normal patient because we're really trying to make sure that patients comfortable at the end stage of their life We are prioritizing that over potential side effects like respiratory depression if we give more oral morphine to patients It's going to depress their respirations, but it's also going to make them more comfortable the prioritization of these positive effects of Helping patients feel more comfort and less pain. That is what is called the principle of double effect