Wednesday, November 5, 2014
Medicare vs Medicaid
8:26 AM | 
Posted by
Kaplan Center for Health and Wellness
While many readers of this blog will be
familiar with Medicare vs Medicaid, some might still have confusion on the
similarities and differences of the two.
Both are government funded health assistance programs, but that is
generally where the similarities end.
Medicare is a federally sponsored
program that provides healthcare coverage for adults 65 years of age and older,
as well as some adults younger than 65 years with certain disabilities or
end-stage renal failure. Medicare is
divided into several parts:
Part
A – helps cover the cost of inpatient care in hospitals, skilled nursing
facilities, hospice, and home health care.
This coverage generally comes at no cost to the patient because the
patient and/or the patient’s spouse has already contributed income tax dollars
toward the Medicare program.
Part
B – covers other doctor expenses, including some preventative care, medical
equipment, and rehabilitation services.
There is usually a monthly premium associated with Part B.
Parts
C and D – optional, additional coverage, including prescription drugs.
Medicaid provides assistance to
low-income individuals and families to pay for health care. The funding for Medicaid comes from your
federal tax dollars, but the state governments choose who qualifies and how to
distribute the coverage. The Affordable
Care Act has encouraged some states to expand their Medicaid programs to
include more individuals who do not have insurance coverage through their
employer and cannot afford individual coverage.
It is important to note that a physician
is not required to accept Medicare or Medicaid payments. If a physician does not accept payments from
government-funded programs, then a patient must either pay out of pocket for
the service or seek another healthcare provider. Providers may choose not to accept these
payments because they feel the reimbursement rate is too low. Some medical providers may be prevented from
accepting Medicare or Medicaid payment because they have been penalized for
fraudulent activity or do not meet certain safety regulations monitored by such
agencies as the Joint Commission.
For more information, please see this
helpful video from Khan Academy:
Valerie J Connor, MA CCC-SLP
Reference:
Stanford, C. C., & Connor, V.
J. (2014). Ethics for Health Professionals. Burlington, MA: Jones and Bartlett Learning.
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medicare medicaid
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