Medicare and Medicaid are both government-sponsored programs designed to help cover healthcare costs. Because the programs have similar names, people are often confused about how the programs work and what coverage they offer. While both were established by the U.S. government in 1965 and are taxpayer funded, they are actually very different programs with differing eligibility requirements and coverage. In the most basic sense, Medicare is designed to help with long-term care for the elderly, while Medicaid covers healthcare costs for the poor, but there is much more to it than this.
What is Medicare? What is Medicaid?
Medicare Part A, or Hospital Insurance (HI), helps pay for hospital stays, which includes meals, supplies, testing, and a semi-private room. This part also pays for home health care such as physical, occupational, and speech therapy that is provided on a part-time basis and deemed medically necessary. Care in a skilled nursing facility as well as certain medical equipment for the aged and disabled such as walkers and wheelchairs are also covered by Part A. Part A is generally available without having to pay a monthly premium since payroll taxes are used to cover these costs.
Medicare for green card holder, Medical and Medicaid insurance for GreenCard and US immigrants
1) Part A Hospital Insurance helps cover inpatient care in hospitals, including overnight hospitalization in hospitals, and skilled nursing facilities. It also helps cover hospice care and some home health care. Beneficiaries must meet certain conditions to get these benefits 2) Medicare Part B (Medical Insurance) helps cover doctors’ services and outpatient care. It also covers some other medical services that Part A doesn’t cover, such as some of the services of physical and occupational therapists, and some home health care. Part B helps pay for these covered services and supplies when they are medically necessary. 3) Medicare Part C is managed care 4) Medicare Part D is Prescription drug coverage to help lower the price of prescription drugs
What is the Difference between Medicare and Medicaid?
Unlike Medicare, which is federally-run, Medicaid is run at the state level with federal guidelines. There are also very different qualifying guidelines for Medicaid. Because Medicaid is a needs-based program, there are specific income and asset limits. The limits vary by state and by the number of dependents in a particular household. Having low-income, however, is not always enough to qualify for Medicaid in some states. Priority is usually given to pregnant women, families, children, the disabled and elderly. For example, a single male may make the same amount of money as a single, pregnant female, but the male may not qualify whereas the female will qualify due to the fact that she is with child and the child will also qualify once he or she is born.
Medicare vs. Medicaid Incentives
To participate under Medicaid, however, a provider must have a practice that is 30% Medicaid (20% for pediatricians), based on number of patient encounters. Some providers are eligible only under Medicaid—nurse practitioners, certified nurse-midwives, dentists, and physician assistants who practice in a Federally Qualified Health Center or rural health clinic that is led by a physician assistant.