Introduction
A family of an elderly war veteran has been living in Colorado for the last twenty years. When the veteran’s daughter got married, and her husband was promoted, it was necessary to think about moving to another state, New York. However, there is another son in this family who currently lives in Florida and invites his parents to that state. The veteran was not able to enroll in VA health care or apply for special Civilian Health and Medical Program (CHAMPVA) or TRICARE because of personal reasons. However, he is currently enrolled in Medicare, and this coverage is enough for him to receive care at his local private health care facility during the last 15 years. He is diagnosed with post-traumatic stress disorder (PTSD) and treated for his chronic hypertension and cardiovascular problems. There is also Alzheimer’s history in this family. Now, children are interested in moving to another state and want to choose a place where the veteran’s Medicare coverage does not undergo significant changes.
New York is known for its generosity in terms of health care and home care, in particular. There are many patients whose long-term care needs are met under the federal laws applicable to the New York population. At the same time, Medicare in Florida significantly covers the costs through Alzheimer’s initiative, which is a family problem in the case under analysis. Regarding the fact that a veteran is an older adult with hypertension and cardiovascular disease and no signs of Alzheimer’s are observed, New York Medicare coverage is a more appropriate state to move to. However, any decision-making process is characterized by certain difficulties and specific circumstances, and this report will show what features could influence the state’s choice and further care quality.
Features of State to Support a Veteran
The idea of moving from one state to another is not as challenging as it could be if a person obtains enough information about important features, like quality ratings and health care access. According to Garcel et al. (2019), the extent to which patients receive treatment is one of the basic measures of healthcare quality. Therefore, such programs as Medicare work according to the 5-star quality rating system and modify rebate systems as per the plan’s quality rating. Medicare is a federal program, which means that its benefits for Parts A and B cannot be changed when a person moves from one state to another (Norris, 2020). However, Medigap premium depends on quality ratings, and even federal rules share no guarantees for veterans under age 65 to Medigap or drug prescription plans. In New York, Medigap is guaranteed-issue year-round, and in Florida, an issue-age rating is required (Norris, 2020). Therefore, New York demonstrates better care access and quality ratings compared to Florida.
It is not easy to change a state and continue living, following the already developed habits and identified needs. Garcel et al. (2019) admit that access to necessary health care services is determined by such factors as lack of education, low income, language barriers, and even cultural differences. Colorado is not as diverse as Florida or New York, but New York removes cultural barriers when it is necessary to provide patients with home care. Language barriers affect health care utilization because they promote different views on diseases and treatments. The veteran made his decision to live in New York, relying on his health literacy and readiness to cooperate with care providers and understand basic needs. He lacks language barriers, and his cultural background is not as important for him as the desire to live a healthy life. As a result, patient engagement and team-based care as a part of the Medicare program contributed to this decision-making.
The quality of health care that the veteran may need also depends on how states product and support networks of collaboration and integration. The role of managed care organizations (MCOs) and the worth of accreditation can neither be neglected. In Florida, there is the Florida Health Care Association that controls assisted living facilities for veterans. In New York, the health care network is promoted by the US Department of Veteran Affairs. Any organization has to work as per properly defined standards and norms, and each state of America is controlled by a special board. In New York and Florida, the Public Health Accreditation Board set the rules to improve the quality of care, promote effectiveness, and support the efficiency of public health services (Elbel et al., 2019). The goal is to keep Americans healthy, and caring for veterans is one of the priorities for many primary care facilities (Vest et al., 2019). As in this scenario, the veteran is enrolled with Medicare, and its accreditation and services are in equal conditions in the chosen states.
Difficulties in Choosing a State
In the scenario discussed in this paper, there were several challenges connected with decision-making. First, it was necessary to understand the right type of insurance plan for the veteran. The man has PTSD and several chronic conditions that were regulated and treated under the Medicare program (Parts I and IV). His military experience and age were the main factors in this choice. Vest et al. (2019) underline the identification of mental health needs and pharmacological requirements. If Part A of Medicare is equal for all the states, more information had to be gathered about Part D conditions. New York was defined as a more appropriate location for the veteran’s family. Another challenge was connected with research because most state networks require direct contact with the patient to evaluate his condition and other demographic characteristics. It was important to focus on military culture and his health literacy. In both aspects, the veteran had no evident problems or barriers, which facilitated decision-making.
Circumstances to Choose Another State
After a thorough investigation of the case and the differences in insurance plans per state, the identification of specific circumstances was integral. For example, Florida, Colorado, and New York have different climates, and winter in Florida is mild compared to those in Colorado and New York. Therefore, to predict the possibility of diseases connected with weather changes, Florida could be a more favorable state for living for the veteran’s family. Demographics of the states is another influential factor, and the number of personal 65 years old and over prevails in New York. As a result, it is expected that New York’s networks are better prepared for providing its citizens with care to a specific population group. However, fewer geriatric patients may mean that more care providers pay enough attention to their patients, and Florida turns out to be a good alternative for the veteran.
Importance of Care Quality
While making a final decision, a person should be confident that the level and number of services are appropriate for the veteran and his family. Medicare insurance plans are not complicated, and it is easy to use them in different states. To provide additional guarantees, it is possible to visit counseling meetings and cooperate with facilities as soon as a person arrives in a new city. Communication and the possibility to ask correct questions are the responsibility of patients, as well as caregivers. Medicare accreditation allows for profound services and options for American citizens. Routine check-ups, collaboration with nurses and doctors, and self-care are the major elements of effective care for vulnerable populations (Garcel et al., 2019). In this case, the veteran and his family are insured and informed about affordable conditions by a representative of a local facility.
Conclusion
In general, the necessity to move from one state to another is common for many Americans, and the case of the veteran shows that this step requires certain preparation and research. Instead of making fast decisions or thinking about the impossibility of using the same insurance plan, it is better to address a local insurance company and investigate the conditions under which care services are provided. Medicare is a federal program, the purpose of which is to support vulnerable populations under 65 years. The veteran and his family should change Colorado to Florida or New York, and the choice of the latter state is supported by the presence of long-term care options, mental health facilities, and solid medical experience of work with geriatric patients.
References
Elbel, B., Cassidy, E. F., Trujillo, M. D., & Orleans, C. T. (2019). Health and behavior. In J. R. Knickman & B. Eldel (Eds.), Jonas and Kovner’s health care delivery in the United States (12th ed.) (pp. 151-182). Springer.
Garcel, J. M., Ward, E. A., & Rodriguez, L. J. (2019). Vulnerable populations: Meeting the health needs of populations facing health inqeualities. In J. R. Knickman & B. Eldel (Eds.), Jonas and Kovner’s health care delivery in the United States (12th ed.) (pp. 183-230). Springer.
Norris, L. (2020). A guide to resources and state regulations for private Medicare plans. Medicare Resources. Web.
Vest, B. M., Kulak, J. A., & Homish, G. G. (2019). Caring for veterans in US civilian primary care: Qualitative interviews with primary care providers. Family Practice, 36(3), 343-350. Web.