Question

Identify the similarities and differences between Medicare and Medicaid with regard to: a. Patient eligibility. b. Benefits provided. c. State and/or federal revenue sources. d. Historical origins in the U.S.

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Answer #1

Feature

Medicaid

Medicare

Patient Eligibility

Low income people without regard to age

Usually for old age. Can begin around 62 though 65 is common.

People younger than 65 may also be eligible for Medicare if they:

  • Have received at least 24 months of Social Security disability benefits or a disability pension from the Railroad Retirement Board (RRB).

·         Have permanent kidney failure and need routine dialysis or a kidney transplant.

·         Have amyotrophic lateral sclerosis (Lou Gehrig’s disease).

Benefits provided

Medicaid covers basic health care costs such as visits to the doctor and hospital stays, but can also cover things like the cost of eyeglasses.

Medicaid also pays for nursing home care for those in need.

Medicare Part A (Hospital Insurance) - Part A helps cover inpatient care in hospitals, including critical access hospitals, and skilled nursing facilities (not custodial or long-term care). It also helps cover hospice care and some home health care. Beneficiaries must meet certain conditions to get these benefits. Most people don't pay a premium for Part A because they or a spouse already paid for it through their payroll taxes while working.

Medicare Part B (Medical Insurance) - Part B 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. Most people pay a monthly premium for Part B.

Medicare Part D (Prescription Drug Coverage) - Medicare prescription drug coverage is available to everyone with Medicare. To get Medicare prescription drug coverage, people must join a plan approved by Medicare that offers Medicare drug coverage. Most people pay a monthly premium for Part D.

State and federal revenue sources

It is jointly funded by the Federal and State governments out of general tax revenues, with Federal government matching Medicaid spending at least dollar for dollar to State spending. The Medicaid program is administered by the States, subject to Federal minimum requirements for benefits.

It is funded by Federal payroll taxes, general tax revenues, and beneficiary premiums. Medicare is administered by the Centers for Medicare & Medicaid Services (CMS).

hisory of origin

On July 30, 1965, President Lyndon B. Johnson signed into law the bill that led to the Medicare and Medicaid. The original Medicare program included Part A (Hospital Insurance) and Part B (Medical Insurance). Today these 2 parts are called “Original Medicare.” Over the years, Congress has made changes to Medicare:

  •      More people have become eligible.

For example, in 1972, Medicare was expanded to cover the disabled, people with end-stage renal disease (ESRD) requiring dialysis or kidney transplant, and people 65 or older that select Medicare coverage.

  •      More benefits, like prescription drug coverage, have been offered.
Medicaid (Title XIX of the Social Security Act) was created in 1965 in tandem with the Medicare program (Title XVIII)
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