Medicare and Medicaid
The ex-president of the United States, Lyndon B. Johnson signed a bill that paved the way for a new chapter in the history of health care (Medicaid and Medicare). The primary aim of these health programs were to give alternative health insurance coverage to the older and lower-income American population who were unable to buy private health insurance.
Medicare has since undergone many changes. People over 65 or more, disabled, those with end-stage renal disease, came under this health care provision since 1972.
Medicaid at the beginning, covered only medical insurance to those who received cash assistance, but at present, this program covers medical insurance for low-income people, people with disabilities and pregnant women. It also helps people who need long-term care.
Medicare is a national health insurance program provided by the federal government.
Eligibility for Medicare:
People who are 65 or above with severe disability (citizens who have social security for a minimum of two years), people irrespective of income are eligible for this program under Centers for Medicaid and Medicare Services of the U.S. Federal Government (Social Security Administration (1966). It also gives medical benefit for end-stage renal disease to people of all ages who are undergoing dialysis or need kidney transplant. It basically is a social insurance program that covers medical cost for people with limited income and resources.
Medicaid is a federal-state sponsored national health insurance program.
Eligibility for Medicaid:
Under this medical scheme, people having low-income are covered. Additionally, children, pregnant woman, disabled and elderly people can avail medical as well as nursing home coverage under this provision. In addition, there is a dual eligible (Medicare dual eligible or medi-medi’s). It means one can avail both Medicare and Medicaid.
Though Medicare and Medicaid are both health insurance programs, they are different in terms of coverage and cost sharing. Following are some examples of difference between the two.
Comparison between Medicaid and Medicare
|1) Medicaid is a federal program run by the states.||1)Medicare is a federal-state program.|
|2)It covers low-income population regardless of age.||2)Benefits under this scheme can be availed as early as age 62, or even earlier for people with serious disability covered by Social Security.|
|3)Under this scheme, one can avail health care expenses costs for visits to the doctor and hospital stays and other costs. Medicaid covers cost for nursing home care for the needy. Small fees are charged for some specific services. Medicaid does pay for deductibles and premiums covered under Medicare. It also covers the 20% of medical costs that Medicare does not pay for.||3)Under Medicare Part A, one gets full waiver of charges for hospital and post-hospital facility access and home health care; under Part B: Full waiver for doctor fees, lab costs, outpatient care such as physical therapy, surgical equipment; under Part C, one gets Medicare Advantage supplied through private insurers, though coverage varies from provided to provider. Under Part D: one gets free prescription drug.