Health Care Delivery

Health Care Delivery

Chapter 2

Overview of Medicare and Medicaid

Intent of Medicaid and Medicare

United States is amongst largest countries with diversified capabilities in the world. It spends over 2 trillion dollars every year on health care. United States is one of those few nations which are richly facilitated with medical coverage. Despite, spending heavily on per capita on health care and having the most superior medical technology system in the world, it is not the healthiest nation on earth.

Medicaid program is set by federal government in order to help out needy people and low-income group and it is controlled differently in every state. Medicare was introduced in order to handle higher medical costs and set in order to provide health insurance to various segments of employees who are not covered in an employer-sponsored health insurance system. Medicare varies significantly from its sister program which is Medicaid. Medicare is a social program which provides health benefits irrespective to their income level, whereas Medicaid is a welfare initiative which provides health services to those with limited income.

Coverage of Medicare and Medicaid

Medicare

Medicare coverage is divided into two parts including;

Part A - Hospital insurance which focus over assessing basic coverage for home healthcare, hospital stays and post hospital nursing.

Part B- Medical Insurance which provides some outpatient medical services and medical equipments.

Recently, it also has introduced program which provides facilities to employees to enroll over “Medicare Advantage” plan.

Medicare healthcare system in United States has the best healthcare professionals in the world. It has nurses, therapists, physicians and best doctors in their team in the clinical care of almost any discipline from the allocations of medicine, whether it is main or subsidiary. They have the latest developed clinical techniques available today. In addition, all the doctors they have are also positioned as the academic professors in various colleges and universities. There has been much advancement in the technology that has helped the healthcare professional to provide the best care to the patients.

As Medicare bill was accessible to all citizens, it is required to set some eligibility criteria through which people would receive medical insurance. This criterion for insurance is set on the basis of Medicare facilities to be provided to people with age of 65 years and a resident of the United States for a period of 5 years. Medicare also requires the person's spouse to pay medical taxes for a minimum of 10 years. Another condition for people under the age of 65 that are disabled would receive social security of retirement benefits.

In addition, individuals those do not receive benefits for 2 years would have to wait another 24 months to become eligible for gaining Medicare benefits. In such cases, if the person is suffering from diseases which are specified in policy, he or she becomes eligible for Medicaid. There are some individuals that qualify for both Medicare and Medicaid due to some strict restrictions. It is true in few states where individuals earn less than a specific ...