Medicare refers to a program of insurance with the medical bill being paid from trust funds, which had been paid by those covered (U.S Department of Health and Human Services, 2020) . Medicare is also a national government's program and similar everywhere within the United States of America, and the Centers for Medicare & Medicaid services help in running it as a federal government agency. In this program, patients meet their costs by paying partly through deductibles for the hospital as well as other costs.
Medicaid, on the other hand, refers to a support program serving low-income people of any age (U.S Department of Health and Human Services, 2020) . Patients within this program do not pay part of the costs for the incurred medical expenditures. Additionally, it is a federal-state program varying amid states. The program is run by local governments and by the State, which follows federal guidelines. At times, a small co-payment is required within the program.
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Medicare is provided in Parts A, B, C, and D. In certain parts of the program, the patient is required to pay monthly premium analogous to health insurance in private sectors. However, the program is not founded on financial need ("Overview of Medicare Parts A-D", 2009) . In Part A, hospital care is covered, mainly costs accruing from being in hospital facilities. Enrolled individuals are accountable for deductibles as well as coinsurance. Part B of the program covers the doctors, some medical equipment and procedures, and medical tests. A monthly premium is also required in this part. This part of the program covers anything that is done to the patients. Part C works alternatively as a traditional Medicare coverage ("Overview of Medicare Parts A-D", 2009) . Part A, B, and D are often included in this part, including specific procedures not under Medicare like vision, dental, and hearing. Private insurance organizations manage Medicare Advantage plans. Medicare Part D is comprised of coverage involving drug prescription, and private insurance organizations do its administration. Individuals are required to be covered in this part of the program unless they have coverage from other sources. In most instances, a monthly premium of payment is required.
On the other hand, Medicaid that is established by federal regulations, statutes, policies, and eligibility is established by States by establishing its standards to determine the types, duration, cost, and scope of the services. The States also set the rates of payment for the services while managing its program. Eligibility, payments, and services for Medicaid policies are complicated and differ significantly, even in States with a comparable size or geographic propinquity (Klees et al., 2015). As a result, eligibility of individuals in one State might not be the same in another while services offered may change in terms of duration, amount, or the scope of the provided services. Additionally, Medicaid services, eligibility, and compensation may be changed by State legislatures at any time.
Medicare serves populations of people 65 years or older, people under 65 years and with disabilities and individuals of any age suffering from ESRD (End-Stage Renal Disease), lasting failure of the kidney necessitating transplant of the kidney or dialysis. Medicaid, on the other hand, serves the population of people having limited income and are 65 years or older. It also serves under 19 years old children, pregnant mothers, people living with disabilities, parent or adult caring for a child, and in individual States, adults lacking dependent children.
References
Klees, B. S., Wolfe, C. J., & Curtis, C. A. (2015). Brief Summaries of Medicare & Medicaid Title XVIII and Title XIX of The Social Security Act. Centers for Medicare & Medicaid Services.
Overview of Medicare Parts A-D. (2009), 5(2), 86-90. https://doi.org/10.1200/jop.0922502
What is the difference between Medicare and Medicaid?. HHS.gov. (2020). Retrieved 18 May 2020, from https://www.hhs.gov/answers/medicare-and-medicaid/what-is-the-difference-between-medicare-medicaid/index.html.
