Medicaid vs. Medicare


Many people living in the United States usually rely on programs made by the government to get essential medical care. These programs, such as Medicare and Medicaid, play a significant role in helping people cover their medical care costs. Comparing these two government programs shows how different they are from each other. Taking a closer look at the fundamental differences between the two programs gives a better clearance on which of the two you would qualify for (Centers for Medicare & Medicaid Services 2016).

Medicare is a federal health insurance for people who have a working history. These individuals can be 65 years or over, have renal diseases at end stages or younger citizens who have disabilities. Financial assets and the income of an individual are a requirement to qualify for the program (Smith 2017). As long as a person has worked for over ten years and paid the Medicare taxes, one qualifies for the program. Alternatively, if a person is married to a spouse who has the ten years-work requirements fulfilled, one usually receives the Medicare benefits.

Medicaid, on the other hand, is a program designed to help those people that have limited or no financial resources and income cover their medical bills. Some of the people who benefit from this program include those who are 65 years or older, people living with disabilities, parents, kids under the age of 19, and adults with dependent kids as well as those without them (Smith 2017). However, those people who have qualified for Medicare usually fail to be eligible for Medicaid and vice versa.

Both programs cover different types of medical costs such hospital stays, prescribed drugs and medication, and doctor visits. Medicare is divided into parts A, B, C, and D. Part A which includes hospital services, Part B covers for medical services such as doctor’s visits, and a Part D which covers for the prescribed drug costs. In Medicaid, these three parts are all covered in one section. The last chapter in Medicare, Part C, is for Medicare Advantage plan (Disability Benefits Help 2017).

Medicaid covers a couple of areas way beyond the Medicare program. It provides long-term coverage of the medical care which is contrary to Medicare. Some of the services that are covered by this plan include; nursing homes cost, essential living facilities, and other long-term care that might come up as long as they are necessary for medical use (Disability Benefits Help 2017).

The two programs differ in their administration. The states govern most of the things covered by the Medicaid program. On the other hand, Medicare is run by the federal government. Thus, people who qualify for Medicaid in one particular state might not be eligible for the same in a different state (Centers for Medicare & Medicaid Services 2016). The types of medical services they would receive under the program also differ from one state to another.

The costs covered by the Medicare program depending on the coverage chosen by the applicant. These costs may include deductibles, coinsurance, copays, and premiums. On the other hand, the costs covered by the Medicaid program depend on the income of an individual and the rules present the state they come from. However, the costs included are similar to those offered by Medicare, although some exemptions are put into some groups from most out of cost pockets (Smith 2017).

Understanding these two programs helps to point an individual in the right direction so they can get the kind of medical benefits that they want. Despite the plans being different from each other, they both have a common goal which is providing those who qualify with health care.

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  1. Centers for Medicare & Medicaid Services 2016, ‘Medicare and Medicaid Programs; Reform of Requirements for Long-Term Care Facilities,’ Federal Register, vol. 81, no.192, pp. 68688.
  2. Disability Benefits Help 2017, What is the difference between Medicare and Medicaid, Disability Benefits Help.
  3. Smith, D. G 2017, Entitlement politics: Medicare and Medicaid, 1995-2001, Routledge, London.
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