Medicare and Medicaid – Helping Stay Healthy

Medicaid and Medicare are two different terms. While these two health insurance programs are sponsored by the Federal government, they differ in their target beneficiaries and policies. Medicare is intended for those who are 65 years old and above and those with long-term disabilities. It involves several components in its insurance services.

Medicaid, on the other hand, provides hospital and medical assistance for people who are below 65 years with minimal or nonexistent income. It is actually a welfare health insurance intended for the poorest sectors of society. Eligibility for this program varies from one state to another, as each State has its own rules as to who qualifies, and what medical services are covered by it.

As a joint Federal-State program, Medicaid covers doctor’s services, nursing-home care, home health services, hospital care, family planning, and other services which participating States consider necessary to be included in the program. Although the Federal government requires each State to have Medicaid for their constituents who are on public assistance, it is the prerogative of the State to design their own Medicaid program.

Unlike Medicare which has Medicare supplement plan, Medicaid has no other insurance network as its component. The Social Security Act of 1965 provides that the State has to pay for the healthcare costs of the most underprivileged sector of society, which may include families, adults, children, and those who are disabled. Today, Medicaid provides assistance to more than 36 million Americans.

Since Medicaid is a form of welfare assistance for the poor, it has no monthly premiums. Instead, it covers the full cost of medical services of the member-beneficiary. There are Medicaid members who are also members of Medicare. In most cases, Medicaid pays for Medicare premiums, deductibles, and co-payments, which are covered by the Medicare supplement plan of the member.

There are States that do not include Medicare supplement plan payments. However, some states require Medicaid beneficiaries to pay a small part of the healthcare bills unless they really can’t afford to pay. The rules applied to determine the financial status of the beneficiaries differ from state to state. Real and household properties, including bank accounts, and sources of income are carefully assessed to determine an individual’s eligibility to the program.