Medicare and Medicaid are both administered by the Centers for Medicare and Medicaid Services (CMS) along with other Federal healthcare programs and services. We’ll try and share a little information about both and list the key differences between the two.
Medicare
Medicare is a national program administered by the federal government and broadly includes hospital insurance, medical insurance, Medicare Advantage, and prescription drug benefits. It primarily offers health care coverage for people who are 65 or older, people with certain disabilities, and people diagnosed with end-stage renal disease. It is an insurance program and the nation’s largest payer of inpatient hospital services for the elderly and people with ESRD. Medical bills are paid from trust funds which have been built by payments from the people covered by Medicare. Patients do pay part of the costs through deductibles for hospital costs and other expenses. Non-hospital coverage requires small monthly premiums as well. Beneficiaries are allowed to choose their coverage, and some can also get a supplement plan called Medigap for expanded coverage. Since it is a federal program, it is the same all over the country.
Medicaid
This is a federal-state program and is administered by state governments that follow broad national guidelines set up by federal statutes, regulations, and policies. It offers healthcare coverage for low-income adults, pregnant women, and children. Eligibility varies depending on the state. It is also the nation’s largest payer of mental health services, long-term care services, and births. It actually pays for 40 percent of all births. But unlike Medicare, it is not an insurance program. It is an assistance program that sometimes requires a small co-payment. Some Medicaid programs pay for care directly, whereas other programs use private insurance companies to provide Medicaid coverage. Medicaid also covers doctor visits, needed medications, prenatal and maternity care, and preventive care like immunizations, mammograms, and colonoscopies. You will need to visit healthcare.gov to see if you qualify for your state’s Medicaid or Children’s Health Insurance program.
To understand and get more information about Medicare and Medicaid, visit the official sites set up for each of these programs.
