Between Medicare and Medicaid

by - Thursday, February 23, 2017

Medicare

In the United States, Medicare is a single-payer, national social insurance program administered by the US federal government since 1966, currently using about 30-50 private insurance companies across the Unites States under contract for administration. Medicare provides health insurance for Americans aged 65 and older who have worked and paid through payroll tax. It also provides health insurance for younger people with some disabilities status as determined by the Social Security Administration, as well as younger people with end stage renal disease and amyotrophic lateral sclerosis (permanent kidney failure requiring dialysis or a kidney transplant).(source: Wikipedia)

Medicare has 3 type :

1. Part A Hospital Insurance

Most people don't pay a premium for Part A because they or their spouse already paid for the premium through their working payroll taxes. Part A Hospital Insurance helps cover inpatient care in hospitals, including critical access hospitals, and skilled nursing facilities (custodial and/or long-term care are not included). This Part A also helps cover hospice care and some health care.

2. Part B Medical Insurance

People pay a monthly premium for Part B. This medical insurance helps cover doctors' services, outpatient care, some of the physical services and occupational therapists and also some home health care which are not covered by Part A Hospital Insurance.

3. Prescription Drug Coverage

Starting on January 1, 2006 new Medicare prescription drug coverage will be available to everyone with Medicare. Most people choose the drug plan and pay a monthly premium. This coverage help lower prescription drug expenses and protect against higher costs in the future. Like any other insurance, if you decides not to take a drug plan when they are first eligible, you might pay penalty if you choose to join later.


Medicaid

Medicaid is USA government insurance program for persons of all ages with low income to pay for health care, pregnant woman, elderly adults and people with disabilities. Each state currently having leniency to determine who is eligible for the program's implementation. Medicaid beneficiaries must be U.S citizens or legal permanent residents, low-income include adults and their children, and people with certain disabilities. Medicaid is administered by states, according to federal requirements. This program is funded jointly by states and the federal government.

There is mandatory Medicaid benefits, states are required to provide under federal law, and also optional benefits that states may cover. The mandatory benefits are:
  1. Impatient hospital services
  2. Outpatient hospital services 
  3. Nursing facility services
  4. Physician services
  5. Rural health services
  6. EPSDT (Early and Periodic Screening, Diagnostic, and Treatment Services
  7. Home health services
  8. Federally qualified health center services
  9. Nurser midwife services
  10. Laboratory and X-ray services
  11. Family planning services
  12. Certified Pediatric and Family Nurse Practitioner services
  13. Tobacco cessation counseling for pregnant women
  14. Freestanding Birth Center services (licensed or recognized by the state)
  15. Transportation to medical care

You can read further information about medicare and medicaid on these website below:

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