MEDICARE AND MEDICAID

Medicare and Medicaid

Medicare and Medicaid

Medicare

Medicare is the health insurance program provided by the U.S. federal government for older Americans once they reach the age of 65. Individuals with certain conditions, such as those who are permanently disabled or have end-stage renal disease, may also be eligible for Medicare, regardless of their age. The Medicare program is administered by the Centers for Medicare and Medicaid Services (CMS), a federal agency headquartered in Baltimore, Maryland (Kotlikoff, 2007). Medicare is a complex program with multiple options for receiving insurance coverage and varying features and rules that accompany each option. The program is continually evolving as new legislation is introduced and plan types, features, or payment policies are changed. While older adults often require more healthcare services due to chronic medical conditions or declining health, they may also have limitations in available income and health insurance options due to retirement from work, resulting in a greater need to understand the insurance benefits provided to them through Medicare (Matthews & Berman, 2011). This entry provides a brief history of the Medicare program, including the introduction of prescription drug coverage, a description of the types of decisions Medicare beneficiaries must make, and an overview of special considerations when conducting research on Medicare decision making.

Medicaid

Medicaid on the other hand, is meant for the individuals who fall under the category of a low income group or simply poor people. Thus, Medicaid serves the people of low socio economic status irrespective of their age. Medicaid is specially meant to aid pregnant women, blind, disabled, old age and children below the age of 19 years. Patients who are suffering from chronic and severe disorders or require any long term treatment can avail the benefits of Medicaid (Matthews & Berman, 2011). It offers a wide coverage to the patients to meet their medical and hospitalization expenses.

Differences

Both national insurance programs that are Medicaid and Medicare are designed to help help people pay for stays in skilled nursing facilities. Medicare can pay for short term stays in skilled nursing facilities for individuals who qualify under Medicare Part A. This means that rehabilitation stays are covered under Medicare Part A. Medicare does not pay for long term stays in skilled nursing facilities (Kotlikoff, 2007). Only Medicaid pays for long term care costs, but Medicaid is only available to individuals who have a limited amount of resources.

Medicare insurance coverage currently ...