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Medicare vs Medicaid

Medicare and Medicaid are two very important programs in the United States, providing health care coverage to millions of Americans. While similar in name and purpose, there are distinct differences between the two programs. Medicare is a federal program that provides health insurance for individuals over 65 and younger people with certain disabilities or diseases. Medicaid is a government-funded health insurance program to provide medical services to those with low income and limited resources.

Reading a dossier

What Is Medicare?

In the United States, Medicare is a national health insurance program started in 1965. Previously administered by the Social Security Administration, it is overseen by the federal agency Centers for Medicare and Medicaid Services. When it comes to assisting those with disabilities, Medicare is essential. For 60 million elderly Americans living in the United States, Medicare also offers financial and health security. It covers various fundamental medical services, including hospital admission, doctor visits, and prescription medications.

Who can receive Medicare?

The Medicare umbrella gives rise to two subbranches.

Many senior citizens in America use Original Medicare, a government-funded health insurance program.
For those who want Original Medicare with more coverage options, there is a product called Medicare Advantage. 
Most of the population will be over 65, and trust funds are used to pay for their medical expenses regardless of their income. It also provides care for people under 65 who are disabled, receiving Social Security Disability Insurance (SSDI) for a specific period, or who have End-Stage Renal Disease (ESRD) and have undergone or are undergoing dialysis.

What Is Medicaid?

Medicaid is a joint federal and state-run public health insurance and assistance program in the United States. It offers low-income people of all age's effective health coverage. Only families who meet the low-income requirements, which vary from state to state, are eligible for Medicaid.

Who can receive Medicaid?

Legal immigrants, permanent residents, and U.S. citizens are all eligible for Medicaid. Almost 70.6 million people had Medicaid coverage as of September 2020.

Medicaid offers medical insurance to Children, pregnant women, seniors, people with disabilities, and those with low incomes and resources.

What Is Covered?
Covered by Medicare

The Medicare program is divided into several components that provide coverage for various facets of healthcare. Details can be found in this link.

Covered by Medicaid

The benefits of Medicaid programs vary from state to state, but a few are common to all programs, as listed below:

  • Services for lab and X-rays.

  • Hospital services for inpatients and outpatients.

  • Birth control, nurse, and midwife services are examples of family planning services.

  • Health examinations and appropriate pediatricmedical care.

  • Adult nursing facility services.

  • Adult surgical and dental services.

It is always advisable to speak with a caseworker in each state to learn about the applicable coverage since Medicaid varies from state to state.

How Can I Enroll ?
How Can I Get Medicare?

Obtaining a Medicare plan could be a significant accomplishment. To get you started on that journey, here is a warning.

Some people who are 65 or nearly 65 and not receiving Social Security will need to sign up for Medicare; others who receive Medicare automatically.
One can sign up or alter how they receive coverage at specific times of the year.
It will be simpler to avoid penalties in the future if you enroll in Medicare Part B when you are first eligible.
It is not necessary to enroll in Medicare every year; rather, there will be an opportunity to review coverage and possibly change plans each year.

How Can I Get Medicaid?

There are two methods for requesting Medicaid:

  1. Call the Medicaid Agency for your State. It demands that the applicant be a citizen of that state.

  2. Submitting a form via the Health Insurance Marketplace.

Benefits & Drawbacks
Benefits of Medicare

Medicare offers protection to those who otherwise wouldn’t have it because they couldn’t afford it.

  • There are very few monthly out-of-pocket expenses.

  • The Medicare Advantage plans provide older Americans who would otherwise be without coverage with extra benefits.

  • Medicare has sparked advancements in the pharmaceutical industry by giving businesses more opportunities to create prescription drugs.

  • Medical standards have significantly increased thanks to Medicare

The Drawbacks of Medicaid

Since Medicaid varies from state to state, not all low-income people will qualify for benefits.

  • In the worst-case scenarios, when people need an emergency procedure, they might be forced to receive subpar treatment simply because they have Medicaid coverage.

  • People covered by Medicaid plans are vulnerable to discrimination.

  • Few procedures are excluded from Medicare coverage, which makes it difficult for those who require such procedures but couldn’t afford to have them done in the first place.

The drawbacks of Medicare

Medicare administration costs for the healthcare system are extremely high.

  • Out-of-pocket expenses were twice as high for those with poor or worse health than those with better health.

  • People with treatable conditions incur gradually higher hospital costs, which puts more strain on hospitals.

  • Fraud among doctors and an increase in opioid-related crimes. The New York Times reported that these doctors submitted Medicare claims for medicines they had never purchased.

  • The cost of Medicare is enormous for the taxpayer.

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